May 2021

There's growing evidence that vaping and COVID-19 are very much connected, Elisa Tong, M.D., explained in an interview with Mic earlier this month. Dr. Tong is an associate professor of Internal Medicine, the medical director for the Comprehensive Cancer Center’s Stop Tobacco Program (SToP), and a core faculty member with the Center for Healthcare Policy and Research (CHPR) at UC Davis.

Some of that evidence comes from a study published last August which found that 13- to 24-year-olds who had ever both vaped and smoked combustible cigarettes were seven times more likely, and those who had only ever vaped were five times more likely, to report being diagnosed with COVID-19 than “never users.” Additional evidence along with insights into how and why vaping and smoking are connected to COVID-19 were recently summarized in a report from the UC Merced Nicotine & Cannabis Policy Center (NCPC): “cigarette use and smoke exposure [can increase] risk of COVID-19 through…suppressing the immune system [and] increasing susceptibility [since “tobacco increases enzyme receptors that are doorways for COVID-19 to enter”]. The NCPC also reported that, based on current knowledge, smoke exposure increases the “likelihood that the illness will progress to the most extreme stages.”

Dr. Tong also told Mic how COVID-19 symptoms overlap those of EVALI. EVALI (which stands for E-cigarette or Vaping product use-Associated Lung Injury) is the condition that caused 2,800 hospitalizations and killed 68 people in the U.S. between June 2019 and February 2020, after which the CDC “stopped collecting state data on EVALI cases because of a significant decrease in cases and deaths since September 2019….” (Heating elements that use nickel-chromium alloy have since been implicated in causing EVALI.) EVALI can mimic many of the symptoms of COVID-19 including shortness of breath, chest pain, cough, vomiting, diarrhea, and fever.

“It’s not that EVALI went away [in March 2020],” Dr. Tong said, citing confirmed cases since in California and Utah, but rather that the overlap between EVALI and COVID-19 symptoms can complicate diagnoses.

The bottom line? EVALI stills exists and remains a problem, one that may not be putting as many people in hospital as it did pre-pandemic but one that “may be a lot bigger phenomenon than we realize, especially when people are maybe turning to substances to help relieve their anxiety or boredom” during the pandemic, according to Tong.

And in addition to vaping (and smoking) causing problems on their own, according to the NCPC there is mounting evidence that “smokers, former smokers, and people exposed to chronic secondhand smoke are also [additionally] vulnerable to COVID-19.”

There may never be a better time to call the California Smokers’ Hotline: 1-800-NO-BUTTS.