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

https://www.qeios.com/read/article/574

by xbmcuser • 6 years ago

53 52 6 years ago

rossdavidh2• 6 years ago

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.

snikeris2• 6 years ago

I find it interesting that smoking itself isn't a pre-existing condition that makes you more likely to be hospitalized if you get Covid-19.

rossdavidh2• 6 years ago

Same here, although I already suspected it based on the fact that Japan's death total is very low; smoking is more prevalent in Japan than most advanced economies, I believe.

justizin• 6 years ago

engaging in a risk factor is not a condition.

ajross2• 6 years ago

It's important to be careful here: the finding above is with symptomatic covid, not hospitalization. We don't know whether or not it makes you more likely to be hospitalized.

evancox100• 6 years ago

I believe they raised and tried to address this confounding factor by determining whether or not one is a smoker based on a date prior to COVID-19 hitting. But I only skimmed it, so can’t be sure what they did.

snikeris2• 6 years ago

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).

cat1992• 6 years ago

Not in medical field, but nicotine is generally biotoxic and used as a pesticide so i'm not at all surprised. Detriments to any symbiotic microorganisms aside, regularly spraying the lungs and other airways with a light coating of biotoxic film seems a good way to generally inhibit replication or damage any negative bioparticles, so long as the damage doesn't overwhelmingly interfere with the smoker's own biological functions and weaken the overall system ...

bobchops• 6 years ago

Being toxic to an insect or human doesn't mean it will have any effect on a virus.

IIRC the reason nicotine is poisonous to humans is because it binds to receptors involved in nerve function, which in turn are required to control muscles.

vernie• 6 years ago

So start taking nicotine lozenges as a prophylactic?

catalogia3• 6 years ago

Would orally ingested nicotine protect lungs the same way that inhaled nicotine does?

downerending2• 6 years ago

This might be a joke, but I'm "addicted" to nicotine gum (and don't otherwise smoke). I probably caught the virus early on, and it wasn't particularly bad for me (even compared to typical flu).

That's not even really a single data point, but I'm curious to see how this pans out.

cskinner• 6 years ago

Nicotine (smoking) has been known to act as an immunomodulator and can act as a preventative for gastrointestinal inflammatory disease such as ulcerative colitis. This could be attenuating the inflammatory response and reducing symptoms for COVID-19 patients.

https://www.medscape.com/viewarticle/516104_4

rapjr9• 6 years ago

The additives in cigarettes have been shown to dilate lung airways, suppress coughing, and disguise symptoms of illness:

https://www.verywellmind.com/cigarette-additives-2824737

Perhaps the additives are keeping COVID-19 patients alive by supporting breathing in difficult circumstances? There are hundreds of additives so figuring out if any of them help would be difficult:

https://ec.europa.eu/health/scientific_committees/emerging/d...

drewcoo• 6 years ago

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.

cat1992• 6 years ago

digs aside, this is highly culturally dependent - before smoking was quasi-taboo in the west, smokers were often more social and smoking was a 'good' way to meet people - just join the local smoking circle outside. Same is likely still true in less smoking hostile countries.

boomboomsubban• 6 years ago

While non-smokers may try to avoid smokers, smokers frequently end up quite close to other smokers in any designated smoking area.

whoisjuan• 6 years ago

The study is done with a Covid positive population.

They didn’t study if people who smoked where less likely to get Covid. The study goal, as I understand it, was to theorize the idea that smoking serves as some sort of protection leading to less severe symptoms.

Otherwise the study wouldn’t make sense. The study must have clearly accounted for ratios in the smoking general population against the sample population. That’s the only way it makes sense.

I’m curious what makes you think that smokers isolated earlier than anyone else. I don’t think being a smoker makes you more self-aware of your own health. If anything is quite the contrary.

gridlockd2• 6 years ago

The OP does have a point. You cannot control for the social isolation factor because there is no data on it.

The people who isolate with 100% success never get COVID and thus are missing from the sample population.

It is also easier to isolate than to give up smoking.

12xo• 6 years ago

Very few habits are hand to mouth in the way smoking does. Smokers will touch their hands to their mouths hundreds of times a day...without a thought as to where that hand has been.

catalogia3• 6 years ago

The smokers in my apartment building go outside everyday and make social contact with other smokers hanging out outside the door.

baron_harkonnen• 6 years ago

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!

phillnom• 6 years ago

So, smoke em if you got em?

gridlockd2• 6 years ago

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

gregwebs2• 6 years ago

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...

raverbashing• 6 years ago

Actually in the article there's a different proposed explanation related to nicotine and its withdraw when in an hospital setting.

gregwebs2• 6 years ago

The nicotine explanation in the article discussion isn't actually studied, it is just pure speculation (which is fine, mine is as well). But there's no explanation why there's fewer smokers even though smokers have more ACE2 receptors. That's table stakes for having a hypothesis on this.

LatteLazy6• 6 years ago

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!

ebg134• 6 years ago

This has nothing to do with "accept the vital importance of chemicals" and everything to do with the fact that we record smoker status when patients enter hospitals and HOLY COW, LOOK, A TREND IN THE DATA.

Now tobacco smoke is preventative?

Maybe! If you just casually ignore data, you will miss opportunities for important discovery.

And that must be because of nicotine. Not one of 1000s of other chemicals in the same smoke?

That's called a _hypothesis_. Hypotheses are somewhat important for research.

LatteLazy6• 6 years ago

Now you're in trouble. You named a hypothesis but the experiment doesn't test that hypothesis does it? No one checked whether any or all of these people actually smoked. Weirdly they let them report different levels of smoking but don't include that data And no one thought to ask about vaping (where there are far fewer chemicals and you would have a stronger case to pin point nicotine). Plus they included Chinese data which is mostly made up. And they excluded random arbitrarily groups (no ICU patients, maybe all the smokers went straight there?).

A good experiment is one where you learn something. You prove or disprove your hypothesis.

This paper doesn't mean anything. Like you say, the answer to the question si "maybe". Maybe nicotine helps, maybe it doesn't. Maybe literally any chemical helps, maybe it doesn't. Great, thanks for wasting everyone time...

billman• 6 years ago

Well stick that in your pipe!

LatteLazy6• 6 years ago

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.

ebg134• 6 years ago

Its all about 1 hospital for a few weeks in one part of France.

We already have similar results from hospitals all over China. This is gravy.

Read the "smoking history" section of Table 1. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 and compare it to smoking rates in China over the past several decades.

LatteLazy6• 6 years ago

We don't have any data for China. None of their numbers are reliable, they make them up. This is one of the biggest issues in this pandemic: we don't know shit partly because China insist on lying...

scandox• 6 years ago

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.

11235813213455• 6 years ago

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..

jholdn• 6 years ago

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.

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

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