Taking action on smoking and health
This page is not updated anymore (as of 03/2021)
Note of caution
After careful deliberation we have added preprint articles, i.e. not yet peer reviewed scientific articles. This is not something we would ordinarily do. However, the peer review process can take some time in what is currently a fast-moving situation. Some preprints have already proven a valuable source in the research community. Hence, given the urgency of the situation we feel that it is important these papers are considered. However, there is an increased risk of errors and incorrect claims made in preprints/unpublished articles. We invite readers to interpret these with due consideration. These papers can be found at the bottom of the page.
Tobacco Industry funding
The Tobacco Industry (TI) has a history of influencing research, and indeed many scientific journals do not accept papers with TI funding for this reason. Due to the connection between Covid-19 and smoking and nicotine, it is a prime opportunity for TI to seek to influence research and this is not always easy to identify. There is evidence this may indeed be occurring. For more information on this please follow the below links:
Stopping Tobacco Organisations and Products (STOP.)
(If you identify any errors or would like new or missing papers to be included please email us on email@example.com. Some papers are preprints for which newer versions are likely to become available or some papers may be rejected for publication)
** Research based on UK data is highlighted with ' ** '
Search papers by date:
Where available publication dates have been standardised to the day/month/year format, this is done so papers can be searched by date using the search function (ctl+f on Windows or CMD+f on Mac). E.g. when searching whether any papers are published on the 1st of June, search for '01/06'.
Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, et al. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. 11/05/2020 PloS One. 2020;15(5):e0233147. https://doi.org/10.1371/journal.pone.0233147
Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta- Analysis. Arch Acad Emerg Med. 24/03/2020 24;8(1):e35.
Farsalinos c, Barbouni A, Niaura R. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? Internal and Emergency Medicinie. 09/05/2020 https://doi.org/10.1007/s11739-020-02355-7
Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 10/04/2020 2020;80(6):656‐665. doi:10.1016/j.jinf.2020.03.041
Gülsen A, Yigitbas BA, Uslu B, Drömann D, Kilinc O. The Effect of Smoking on COVID-19 Symptom Severity: Systematic Review and Meta-Analysis. Pulm Med. 08/09/2020 2020:7590207. https://doi.org/ 10.1155/2020/7590207
Guo FR. Smoking Links to the Severity of Covid-19: An Update of a Meta-Analysis. J Med Vir. 05/05/2020 https://doi.org/10.1002/jmv.25967 [update of Zhao et al, The impact of COPD and smoking history on the severity of Covid-19. 15/05/2020
Karanasos A, Aznaouridis K, Latsios G, et al. Impact of smoking status on disease severity and mortality of hospitalized patients with COVID-19 infection: a systematic review and meta-analysis. Nicotine and Tobacco Research. 20/06/2020 https://doi.org/10.1093/ntr/ntaa107
Li J, He X, Yuanyuan, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control. First published 12/06/2020 S0196-6553(20)30369-2. https://doi.org/10.1016/j.ajic.2020.06.008
Lippi G and Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. 16/03/2020 16:S0953-6205(20)30110-2. doi: 10.1016/j.ejim.2020.03.014.
Suggested correction to Lippi and Henry (above) - Guo FR. A flaw on a meta-analysis of smoking and the severity of COVID-19: the association should have been endorsed. J Public Health (Oxf). 16/06/2020 2020;fdaa083. https://doi.org/10.1093/pubmed/fdaa083
Patanavanich R, Glantz SA. Smoking is Associated with COVID-19 Progression: A Meta-Analysis. Nicotine & Tobacco Research. 11/05/2020 ntaa082, https://doi.org/10.1093/ntr/ntaa082
Reddy RK, Charles WN, Sklavounos A et al. The effect of smoking on COVID-19 severity: a systematic review and meta-analysis. Journal of Medical Virology. 04/08/2020. https://doi.org/10.1002/jmv.26389
Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review with Bayesian meta-analyses (version 7). Addiction. 02/10/2020. https://doi.org/10.1111/add.15276.
Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. 20/03/2020 20;18:20. doi: 10.18332/tid/119324. http://www.tobaccoinduceddiseases.org/COVID-19-and-smoking-A-systematic-review-of-the-evidence,119324,0,2.html
World Health Organisation (WHO). Smoking and Covid-19 - Scientific Brief. 26/05/2020. https://www.who.int/news-room/commentaries/detail/smoking-and-covid-19
Zhao Q, Meng M, Kumar R, et al. The impact of COPD and smoking history on the severity of Covid-19: A systemic review and meta-analysis. 15/04/2020 J Med Virol. 2020. https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25889
Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 23/04/2020 2020;S0163-4453(20)30234-6. doi:10.1016/j.jinf.2020.04.021
Archie SR, Cucullo L. Cerebrovascular and Neurological Dysfunction under the Threat of COVID-19: Is There a Comorbid Role for Smoking and Vaping? Int J Mol Sci. 30/05/2020 2020;21(11):E3916. doi:10.3390/ijms21113916
Edwards R, Munafò M. COVID-19 and tobacco – more questions than answers. Nicotine & Tobacco Research. 15/07/2020. ntaa132, https://doi.org/10.1093/ntr/ntaa132
I Berlin, D Thomas, A Le Faou, J Cornuz. Smoking and Covid-19. Nicotine and Tobacco Control. 03/04/2020. https://academic.oup.com/ntr/article/doi/10.1093/ntr/ntaa059/5815378
Khot WY, Nadkar MY. The 2019 Novel Coronavirus Outbreak - A Global Threat. J Assoc Physicians India. 2020 Mar;68(3):67-71. PMID: 32138488.
van Zyl-Smit RN, Richards G, Leone FT. Tobacco smoking and COVID-19 infection 22/05/2020. Lancet Respir Med. 2020;S2213-2600(20)30239-3. https://doi.org/10.1016/S2213-2600(20)30239-3
Azar KMJ, Shen Z, Romanelli RJ et al. Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California. Health Aff (Millwood) 21/05/2020. https://doi.org/10.1377/hlthaff.2020.00598
Bhargava A, Fukushima EA, Levine M et al. Predictors for Severe COVID-19 Infection. Clin Infect Dis. 30/05/2020. https://doi.org//10.1093/cid/ciaa674
Bi X, Su Z, Yan H et al. Prediction of severe illness due to COVID-19 based on an analysis of initial Fibrinogen to Albumin Ratio and Platelet count. Platelets. 05/05/2020. https://doi.org/10.1080/09537104.2020.1760230
Brenner EJ, Ungaro RC, Gearry RB et al. Corticosteroids, but Not TNF Antagonists, Are Associated With Adverse COVID-19 Outcomes in Patients With Inflammatory Bowel Diseases: Results From an International Registry. Gastroenterology. 18/05/2020 https://doi.org/10.1053/j.gastro.2020.05.032
Buckner FS, McCulloch DJ, Atluri V et al. Clinical Features and Outcomes of105 Hospitalized Patients With COVID-19 in Seattle, Washington. Clin Infect Dis. 22/05/2020 https://doi.org/10.1093/cid/ciaa632
Chen Q, Zheng Z, Zhang C et al. Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China. Infection. 28/04/2020 https://doi.org/10.1007/s15010-020-01432-5
Gaiha, S. M. et al. Association Between Youth Smoking , Electronic Cigarette Use , and Coronavirus Disease 2019. J. Adolesc. Heal. 11/08/2020. doi:10.1016/j.jadohealth.2020.07.002.
Hu L, Chen S, Fu Y et al. Risk Factors Associated With Clinical Outcomes in 323 COVID-19 Hospitalized Patients in Wuhan, China. Clin Infect Dis. 23/05/2020. https://doi.org/10.1093/cid/ciaa539
Huang J, Cheng A, Lin S, Zhu Y, Chen G. Individualized Prediction Nomograms for Disease Progression in Mild COVID-19. J Med Virol. 05/05/2020 https://doi.org/10.1002/jmv.25969
**Jackson, S. E., Brown, J., Shahab, L., Steptoe, A. & Fancourt, D. COVID-19, smoking and inequalities: a study of 53 002 adults in the UK. Tobacco Control. 21/08/2020 https://doi.org/10.1136/tobaccocontrol-2020-055933.
Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patientswith COVID-19 in Wuhan, China. Clin Infect Dis. 12/03/2020 https://doi.org/10.1093/cid/ciaa248
Rastrelli G, Di Stasi V, Inglese F, et al. Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients. Andrology 2020. 20/05/2020. https://doi.org/10.1111/andr.12821
Stanton R, To QG, Khalesi S, et al. Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults. Int J Environ Res Public Health. 07/06/2020. 2020;17(11):E4065. https://doi.org/10.3390/ijerph17114065
Sun DW, Zhang D, Tian RH, et al. The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: A sentinel? Clin Chim Acta. 14/05/2020 https://doi.org/10.1016/j.cca.2020.05.027
Toussie D, Voutsinas N, Finkelstein M, et al. Clinical and Chest Radiography Features Determine Patient Outcomes In Young and Middle Age Adults with COVID-19. Radiology. 14/05/2020 https://doi.org./10.1148/radiol.2020201754
Wang K, Zhang Z, Yu M, Tao Y, Xie M. 15-day mortality and associated risk factors for hospitalized patients with COVID-19 in Wuhan, China: an ambispective observational cohort study. Intensive Care Med. 23/04/2020 https://doi.org/10.1007/s00134-020-06047-w
Yu X, Sun X, Cui P, et al. Epidemiological and clinical characteristics of 333 confirmed cases with coronavirus disease 2019 in Shanghai, China. Transbound Emerg Dis. 29/04/2020 https://doi.org/10.1111/tbed.13604
Zhang R, Ouyang H, Fu L, et al. CT features of SARS-CoV-2 pneumonia according to clinical presentation: a retrospective analysis of 120 consecutive patients from Wuhan city. Eur Radiol. 11/04/2020 https://doi.org/10.1007/s00330-020-06854-1
Brake SJ, Barnsley K, Lu W, McAlinden KD, Eapen MS, Sohal SS. Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J Clin Med. 20/03/2020 ;9(3):E841. doi: 10.3390/jcm9030841.
Cai G, Bossé Y, Xiao F, Kheradmand F, Amos CI. Tobacco Smoking Increases the Lung Gene Expression of ACE2, the Receptor of SARS-CoV-2. American Journal of Respiratory and Critical Care Medicine. Published 24/04/2020. doi:10.1164/rccm.202003-0693LE
Garufi G, Carbognin L, Orlandi A, Tortora G, Bria E. Smoking habit and hospitalization for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related pneumonia: The unsolved paradox behind the evidence. Eur J Intern Med. 23/04/2020 2020;S0953-6205(20)30163-1. doi:10.1016/j.ejim.2020.04.042
Gonzalez-Rubio J, Navarro-Lopez C, Lopez-Najera E et al. Cytokine Release Syndrome (CRS) and Nicotine in COVID-19 Patients: Trying to Calm the Storm. Front Immunol. 11/06/2020. 11:1359. https://doi.org/10.3389/fimmu.2020.01359
Kloc M, Ghobrial RM, Kubiak JZ. How nicotine can inhibit cytokine storm in the lungs and prevent or lessen the severity of COVID-19 infection? 06/06/2020. Immunol Lett. 2020;224:28‐29. https://doi.org/10.1016/j.imlet.2020.06.002
Leung JM, Yang CX, Tam A, Shaipanich T, Hackett TL et al. ACE-2 Expression in the Small Airway Epithelia of Smokers and COPD Patients: Implications for COVID-19. Eur Respir J. 08/04/2020 2000688. doi:10.1183/13993003.00688-2020.
Leung JM, Yang CX, Sin DD. COVID-19 and Nicotine as a Mediator of ACE-2. European Respiratory Journal. 29/04/2020. DOI: 10.1183/13993003.01261-202
Leung JM, Sin DD. Smoking, ACE-2, and COVID-19: Ongoing Controversies. 19/05/2020 .Eur Respir J. 2020;2001759. doi:10.1183/13993003.01759-2020
Lutchman D. Could the smoking gun in the fight against Covid-19 be the (rh) ACE2? 19/05/2020. Eur Respir J. 2001560. doi:10.1183/13993003.01560-2020
Oakes JM, Fuchs RM, Gardner JD, Lazartigues E, Yue X. Nicotine and the renin-angiotensin system. Am J Physiol Regul Integr Comp Physiol. 2018;315(5):R895-R906. doi: 10.1152/ajpregu.00099.2018.
Rajput DV. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?: Comment. Intern Emerg Med. 08/06/2020. 2020;1‐2. https://dx.doi.org/10.1007%2Fs11739-020-02396-y
Sanches Jj , Acevedo N, Guzman E. Active smoking and severity of coronavirus disease 2019 (COVID-19): Differences in measurement of variables could cause errors in the results. Eur J Intern Med. First published 28/05/2020 2020;77:127-128. https://doi.org/10.1016/j.ejim.2020.05.033
Smith JC, Sausville EL, Girish V, et al. Cigarette smoke exposure and inflammatory signaling increase the expression of the SARS-CoV-2 receptor ACE2 in the respiratory tract 16/05/2020. Dev Cell. doi:10.1016/j.devcel.2020.05.012
Tindle HA, Newhouse PA, Freiberg MS. Beyond Smoking Cessation: Investigating Medicinal Nicotine to Prevent and Treat COVID-19. Nicotine & Tobacco Research. [Letter] 08/05/2020 ntaa077, https://doi.org/10.1093/ntr/ntaa077
Voinsky I, Gurwitz D. Smoking and COVID-19: Similar bronchial ACE2 and TMPRSS2 expression and higher TMPRSS4 expression in current versus never smokers.Drug Dev Res. 05/08/2020. doi:10.1002/ddr.21729
Yue X, Basting TM, Flanagan TW, Xu J, Lobell TD, et al. Nicotine Downregulates the Compensatory Angiotensin-Converting Enzyme 2/Angiotensin Type 2 Receptor of the Renin–Angiotensin System. Ann Am Thorac Soc. 2018 Apr; 15(Suppl 2): S126–S127. doi: 10.1513/AnnalsATS.201706-464MG.
Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020 Apr;8(4):e20. doi: 10.1016/S2213-2600(20)30117-X. Epub 11/03/2020. Erratum in: Lancet Respir Med. 2020 Apr;8(4):e26.
Eisenberg S, Eisenberg MJ. Smoking Cessation During the COVID-19 Epidemic. Nicotine & Tobacco Research. ntaa075, 04/05/2020 https://doi.org/10.1093/ntr/ntaa075
Jackson S E, Garnett C, Shahab L, Oldham M, Brown J. Association of the Covid‐19 lockdown with smoking, drinking, and attempts to quit in England: an analysis of 2019‐2020 data. Addiction. 21/10/2020. https://doi.org/10.1111/add.15295
Kamiński M, Muth A, Bogdański P. Smoking, Vaping, and Tobacco Industry During COVID-19 Pandemic: Twitter Data Analysis. Cyberpsychol Behav Soc Netw. 30/07/2020. https://doi.org/10.1089/cyber.2020.0384
Kaur G, Lungarella G, Rahman I. SARS-CoV-2 COVID-19 susceptibility and lung inflammatory storm by smoking and vaping. J Inflamm (Lond). 10/06/2020 2020;17:21. https://doi.org/10.1186/s12950-020-00250-8
Klemperer EM, West JC, Peasley-Miklus C, Villanti AC. Change in tobacco and electronic cigarette use and motivation to quit in response to COVID-19. Nicotine & Tobacco Research. 28/04/2020 ntaa072, https://doi.org/10.1093/ntr/ntaa072
Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med. 10/03/2020. M20-0504. doi: 10.7326/M20-0504.
Lee, J. J., Wang, M. P. & Yang, S. C. Will the tobacco industry ultimately triumph in the midst of COVID-19 pandemic?: a call for nurses’ action in tobacco control. Int. J. Nurs. Stud. 25/07/2020. 103726 doi:10.1016/j.ijnurstu.2020.103726.
Majmundar A, Allem J, Boley Cruz T, Unger JB. Public Health Concerns and Unsubstantiated Claims at the Intersection of Vaping and COVID-19 Nicotine & Tobacco Research. 14/04/2020. ntaa064. https://doi.org/10.1093/ntr/ntaa064
McAlinden KD, Eapen MS, Lu W, Chia C, et al. COVID-19 and vaping: risk for increased susceptibility to SARS-CoV-2 infection? 19/05/2020. Eur Respir J. 2001645. doi:10.1183/13993003.01645-2020
Misra DP, Agarwal V, Gasparyan AY, Zimba O. Rheumatologists' perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets. Clin Rheumatol. 10/04/2020. https://doi.org/10.1007/s10067-020-05073-9 Epub ahead of print.
Patwardhan P. COVID-19: Risk of increase in smoking rates among England's 6 million smokers and relapse among England's 11 million ex-smokers. BJGP Open. 07/04/2020. https://doi.org/10.3399/bjgpopen20X101067
Siddiqi K, Siddiqui F, Khan A, Ansaari S, Kanaan M, Khokhar M, Islam Z, Mishu MP, Bauld L. The impact of COVID-19 on smoking patterns in Pakistan: findings from a longitudinal survey of smokers. Nicotine Tobacco Research. 08/10/2020 ntaa207. https://doi: 10.1093/ntr/ntaa207
Vanderbruggen N, Matthys F, Van Laere S, Zeeuws D, Santermans L, Van den Ameele S, Crunelle CL. Self-Reported Alcohol, Tobacco, and Cannabis Use during COVID-19 Lockdown Measures: Results from a Web-Based Survey. Eur Addict Res. 22/08/2020. 2:1-7. https://doi.org/10.1159/000510822
Gonzalez-Rubio, J. Navarro-Lopez, C. Lopez-Najera, E et al., What is Happening with Smokers and COVID-19? A Systematic Review and a Meta-Analysis. 30/04/2020 Preprints2020, 2020040540 https://doi.org/10.20944/preprints202004.0540.v1. Preprint (NOT PEER REVIEWED)
Patanavanich R, Glantz SA. Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: A systematic review and meta-analysis. 23/09/2020 medRxiv [Preprint]. https://doi.org/10.1101/2020.09.22.20199802 (NOT PEER REVIEWED)
Qi D, Yan X, Tang X, Peng J , Yu Q et al., Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study. MedRxiv – Preprint. 03/03/2020. https://www.medrxiv.org/content/10.1101/2020.03.01.20029397v1 (NOT PEER REVIEWED)
CHANGEUX J, Amoura Z, Rey F, Miyara M. A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications. Qeois. Version2. 22/04/2020 https://www.qeios.com/read/article/581 preprint (NOT PEER REVIEWED)
Wang J, Luo Q, Chen R, Chen T, Li J. Susceptibility analysis of COVID-19 in smokers based on ACE2. Prereprints 05/03/2020 doi: 10.20944/preprints202003.0078.v (NOT PEER REVIEW)
(This page was last updated on 08/10/2020)
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