Low incidence of daily active tobacco smoking in patients with symptomatic C19

Hypothesis: if you have any pre-existing lung conditions, you are more likely to quit smoking. In other words, if you're the sort with pre-existing conditions that make you more likely to be hospitalized if you get Covid-19, then you would be more likely to have quit smoking (or died before now if you didn't).

Still an interesting result, but not, needless to say, a reason to start smoking.

This paper is terrible. There are errors in the abstract. It uses percentage of percentages to make results look important. It relies on self reporting when people are strongly encouraged to misreport. It excludes groups arbitrarily (no ICU patients, no one treated by certain departments). Its all about 1 hospital for a few weeks in one part of France.

Its like a test paper to teach people to spot errors and weaknesses in papers.

Interesting, they hypothesize that nicotine is responsible:

> There are however, sufficient scientific data to suggest that smoking protection is likely to be mediated by nicotine. SARS-CoV2 is known to use the angiotensin converting enzyme 2 (ACE2) receptor for cell entry[14-16], and there is evidence that nicotine modulates ACE2 expression[17]which could in turn modulate the nicotinic acetyl choline receptor (manuscript submitted).

It would make sense if smoking (the oxidants from smoke) kills the virus. However, once the infection actually progresses it is clear that smokers are worse off.

https://chrismasterjohnphd.com/covid-19/covid-19-and-the-smo...

I was joking the other day that it would be funny if the reason that Covid19 was less sever in Asian countries was not the high rate of mask usage but the high rate of smoking!

It's an interesting data discrepancy - fewer smokers in covid-19 infected individuals - but it doesn't tell us much. The survival bias is a problem. They took the smoking status of alive patients, not in the ICU. The results could indicate the opposite effect. Smokers tend to be in the ICU or die at an accelerated rate so are under-represented. That said, one would expect counter-acting effects in such a situation that would make the counter-intuitive result of fewer smokers meaning it's worse for smokers less likely, e.g. greater diagnosis rate in smokers due to increased severity, higher rates of infection in smokers, etc.

I don't think any conclusions can be drawn from this study. It does suggest that there is value in investigating the impacts of smoking on Covid-19.

There is a story from the Golden Age of Science Fiction called Pandemic by JF Bone. It postulates a global virus the cure for which in the end turns out to be smoking tobacco.

And the improbably beautiful nurse marries the curmudgeon who is her boss.

And they put babies in smoke ventilators.

I find it fascinating how willing people are to accept the vital importance of chemicals not directly related to covid 19 or coronaviruses. People were very willing to swallow Chloroquine as a "cure" or treatment, but that is (was?) used for treating malaria (not a virus). Now tobacco smoke is preventative? And that must be because of nicotine. Not one of 1000s of other chemicals in the same smoke? And forget that other research found smoking increased the density of the proteins covid 19 binds to to enter cells (another small study with unverified results I think).

Jesus people, the solution to this problem will not be as simple as antimalarials or taking up Cuban cigars. Stop grasping at straws like they are lifeboats!

Smoking may well have some hormetic effects, being a non-smoker is a risk factor in a handful diseases.

That's maybe because someone who has a "strong enough health" to tolerate smoking, builds some resistance in the short term. That's in the long term that smoking is really deadly though

That kind of study would also find out that people doing daily physical exercise would be much less affected by Covid, etc..

Well stick that in your pipe!

So, smoke em if you got em?

It doesn't seem to take the social aspects of smoking into account. In a sense, smokers were already doing social isolation.

I'd bet that people who scream on street corners are less likely to contract it than people who spend time quietly on street corners.