Young smokers at higher risk for severe COVID-19

Two women smoke cannabis vape pens at a party in Los Angeles in 2019. (Richard Vogel, Associated Press files)

Young adults who smoke have double the risk of getting seriously sick with COVID-19 than do nonsmokers, according to new research from the University of California San Francisco.

Smoking and vaping are risky for any age group when it comes to respiratory illnesses, including COVID-19. But they stand out as a vulnerability for people between 18 and 25 years old partly because that age group has so few other high-risk conditions for severe COVID-19, according to the study, which was recently published in the Journal of Adolescent Health (JAH).

“The most prevalent factor conferring medical vulnerability to severe COVID-19 illness among young adults is smoking. Notably, the risk of being medically vulnerable to severe disease is halved when smokers are removed from the sample,” wrote senior author Dr. Charles Irwin Jr. of the UCSF Division of Adolescent and Young Adult Medicine. “Efforts to reduce smoking and e-cigarette use among young adults would likely lower their vulnerability to severe disease.”

A May study by University of California San Francisco (UCSF) researchers also found that smokers and vapers — and people who used to smoke or vape —were almost twice as likely to experience negative COVID-19 outcomes as people who had never smoked.

The UCSF studies do not address marijuana. But cannabis smoke also comes with issues for the lungs, according to Dr. Mitchell Glass, a pulmonologist and spokesperson for the American Lung Association.

“Marijuana burns at a much, much lower temperature than a commercially made cigarette. Because of that, the person is inhaling a certain amount of unburnt plant material,” which irritates the lungs in a similar way as ragweed, birch and oak pollen or other foreign particles, Dr. Glass told CNN.

The authors of the May article say cigarettes, cigars and e-cigarettes increase damage to upper airways and decrease pulmonary immune function. They also note that smokers are known to have a higher risk of infection and mortality from MERS-COV, a respiratory illness caused by a different coronavirus.

The study in the JAH also said young adults are now picking up cigarettes at higher rates than adolescents, a reversal of previous initiation patterns.

In Washington state, eighth-grade, 10th-grade and 12th-grade use of vapor products all jumped by about 50% between 2016 and 2018, the DOH wrote in a bulletin.

Whether it’s vapor or smoke, regularly inhaling something besides air into the lungs is proving to be even riskier during a pandemic involving a respiratory illness. And while a young adult’s chances of severe COVID-19 symptoms or death are generally low, the UCSF studies show the equation can change when the person is a smoker.

People younger than 40 now make up the majority of Washington state’s COVID-19 cases, with 39% in people age 20-39 (the largest share of cases for any age group) and 12% in people 19 or younger. The DOH doesn’t include in its COVID-19 data what proportion of those patients smoke.

— Christine Clarridge, The Seattle Times, via McClatchy