Smoking, Vaping, and COVID-19














With the concerns of COVID-19 and its potential for increased harm to smokers, MDQuit is compiling resources and information concerning smoking, vaping and COVID-19.

No peer-reviewed population-level studies have been conducted to determine the risk of infection associated with smoking.1  However, tobacco users may be vulnerable to being seriously infected by COVID-19 due to reduced lung capacity, and possible lung disease, which would greatly increase their risk of serious illness from the disease.1 Additionally, “the act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips, which increases the possibility of transmission of virus from hand to mouth.”2

The damage caused to the cardiovascular and respiratory systems by tobacco use can lead to a higher risk for severe illness from COVID-19. A systematic review of five studies found that compared to non-smokers, smokers were 1.4 times more likely to have severe symptoms of COVID-19 and 2.4 times more likely to be admitted to an ICU, require mechanical ventilation, or die.Smoking has resulted in more severe COVID-19 infections, partially by blocking the activity of immune system messenger proteins called interferons in the airways that help attack viruses and alert uninfected cells to prepare to fight the virus.4 

Studies have shown that exposure to nicotine and other chemicals in e-cigarettes can damage lungs comparable to combustible cigarettes.5,6 Also, as with cigarettes, the hand-to-mouth action of e-cigarette use may increase risk of transmission of the virus. A population-based study led by researchers at Stanford University found that adolescent and young adult (aged 13–24 years) users of e-cigarettes and dual-users of e-cigarettes and cigarettes are at greater risk of COVID-19.7 

Individuals who used both e-cigarettes and cigarettes in the past 30 days were 4.7 times more likely to experience COVID-19-related symptoms.7 Those who had ever used e-cigarettes were 5 times more likely to be diagnosed with COVID-19.7 Ever-dual-users were 7 times more likely and past 30-day dual-users were 6.8 times more likely to be diagnosed with COVID-19.7 

Leading health authorities thus continue to recommend that tobacco users (cigarettes, e-cigarettes, cigars, hookah, and smokeless) try to quit.


If you are currently using tobacco and are interested in quitting,

please visit our page for consumers by clicking here.


If you are a provider and would like resources to help your clients quit tobacco use, please visit our page for providers by clicking here.


For more information about COVID-19, visit the following websites

COVID-19 / Coronavirus and Smoking or Vaping

Tips to Quit Smoking or Vaping During COVID-19 / Coronavirus

World Health Organization

Centers for Disease Control and Prevention

National Institutes of Health

National Institute on Drug Abuse

CDC: Manage Anxiety & Stress

National Alliance on Mental Illness COVID-19 Resource and Information Guide


1. WHO. (2020). Smoking and COVID-19 Scientific Brief.

2. WHO. (2020). Q&A: Tobacco and COVID-19.

3. Vardavas, C. I., & Nikitara, K. (2020). COVID-19 and smoking: A systematic review of the evidence. Tobacco Induced Diseases, 18.

4. Purkayastha, A., Sen, C., Garcia Jr, G., Langerman, J., Shia, D.W., Menses, L.K.,… Gomperts, B.N.  (2020) Direct exposure to SARS-CoV-2 and cigarette smoke increases infection severity and alters the stem cell-derived airway repair response  Cell Stem Cell, 27 (6) P869-875.

5. Hamberger, E. S., & Halpern-Felsher, B. (2020). Vaping in adolescents: Epidemiology and respiratory harm. Current Opinion in Pediatrics32(3), 378–383.

6. Reinikovaite, V., Rodriguez, I. E., Karoor, V., Rau, A., Trinh, B. B., Deleyiannis, F. W., & Taraseviciene-Stewart, L. (2018). The effects of electronic cigarette vapour on the lung: direct comparison to tobacco smoke. The European Respiratory Journal51(4), 1701661.

7. Gaiha, S. M., Cheng, J., & Halpern-Felsher, B. (2020). Association Between Youth Smoking, Electronic Cigarette Use, and Coronavirus Disease 2019. Journal of Adolescent Health.


Additional references