Smoking adds to the inequity of the coronavirus

In just six months, Covid-19 has become notorious for its ability to wreak havoc on people’s health, and especially the lungs. With that in mind, it’s no surprise that smokers and vapers appear to be in danger of its most severe effects. Smoking cigarettes already contributes to the chronic conditions — namely, heart and lung disease — associated with severe Covid-19 cases, and those conditions disproportionately plagued Black, Hispanic, and lower-income communities long before the pandemic took hold.

“We already knew pre-Covid that communities of color live sicker and died younger,” said Dr. Patrice Harris, immediate past president of the American Medical Association, at the recent “Tobacco Use and Covid-19: Health Inequity” webinar. “We absolutely need to come into Covid with an understanding about these health inequities.”

Harris joined a panel of health experts — including Matthew L. Myers, president of the Campaign for Tobacco-Free Kids; Dr. Kelly Henning, public health program lead at Bloomberg Philanthropies; and Dr. Nora Volkow, director at the National Institute on Drug Abuse at the National Institutes of Health — for the webinar, hosted by Vox Media Publisher Melissa Bell. Together, the group discussed wide-reaching inequities regarding health in the US, and how vital it is to reduce tobacco use in the age of coronavirus. Below are three ways the health experts say we can accomplish just that.

Although teens are a comparatively low-risk group for the novel coronavirus, their tobacco-use rates are the highest they’ve been in nearly 20 years because of the rise of e-cigarettes, some of which can deliver very high doses of nicotine. When lowering cigarette-smoking rates, public health officials found one particularly effective strategy to change youth behavior: showing teens how advertisers targeted them. Public health advocates are also working to prohibit the sale of flavored e-cigarettes, as high numbers of youths have reported using flavored products.

“One of the greatest successes we’ve seen has been the [anti-]tobacco campaign that was targeted toward teenagers [that] led them to realize the manipulation of media in order to make them actually consume cigarettes,” said Volkow.

This time, Henning thinks the best way to spread the message is to put anti-vaping campaigns in teens’ hands. “The question is: how do we make vaping uncool?” she said. “How do we get teens to really propel that message among their peer groups?”

Although there needs to be more research on the connection between smoking, vaping, and Covid-19, there’s growing evidence that smoking increases the risk of serious complications from the disease. The World Health Organization recently found that “smokers are more likely to develop severe disease with Covid-19, compared to non-smokers.” Evidence is also emerging that vaping can harm lung health, raising concerns that it, too, could worsen Covid-19. Additional research is needed to give the public an evidence-based understanding of the true risks of smoking and vaping, and to allow doctors to intervene more effectively when a patient has a history of either.

Also, the science and health communities need more complete data on Covid-19 patients. “We have a lot of data coming out of hospitalized patients, so it would be great to have more community-based research done, more broad-based demographic information,” said Henning. “There’s a real lack of smoking status [figures about Covid patients]. And 77 percent of race and ethnicity areas in the data are absent, unknown.”

Reducing smoking rates comes down to simple math: Lower the number of people starting, and increase the number quitting. With political will — something hard to find at the federal level but that’s gaining traction at state and local levels — it’s possible to do both. For example, banning the sale of menthol cigarettes could have a huge impact on smoking rates in Black communities, where research has shown that advertising has disproportionately pushed the usage of menthol varieties.

Expanding insurance coverage for smoking-cessation programs also could be a game-changer. “We know that if we encourage people to quit smoking and provide the proven mechanisms for quitting, we can double, triple, and quadruple the percentage of low-income individuals who quit,” said Myers. “If we do those things, we can do more to reduce health disparities than almost anything else we could do quickly and with the knowledge we have now.”

To learn more about these inequities and how we can lower smoking rates in the U.S., watch the full webinar above.