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Coronavirus (COVID-19) and smoking - information for health professionals

Are people who smoke at higher risk of COVID-19?

The evidence to suggest that people who smoke are at higher risk of COVID-19 is inconsistent. However, there is strong evidence that people who smoke are at higher risk of acute respiratory tract infections generally, including bronchitis and influenza. Smoking increases the incidence, duration and severity of viral respiratory infections and has also been found to increase the risk of pneumonia.  Read more at Tobacco in Australia.

In addition, the hand-to-mouth action of smoking and e-cigarette use means that people who smoke may be more vulnerable to COVID-19, as they are touching their face and mouth more often.

It is also possible, but not yet proven, that the virus may be transmitted through exhaled e-cigarette vapour (either in the air or as it settles on surfaces).

Sharing any type of tobacco or smoking product (for example, cigarettes, e-cigarettes or shisha/waterpipes) can also increase the risk of spreading COVID-19.

Are people who smoke more likely to have worse outcomes, if they are diagnosed with COVID-19?

The evidence to suggest that people who smoke are at increased risk of more severe outcomes from COVID-19 continues to grow.

‘History of smoking’ has been included as a potential risk factor for more severe illness in clinical guidelines developed by the National COVID-19 Clinical Evidence Taskforce. Smoking compromises immune system functioning, both systemically and locally in the lung. Smoking impairs mucociliary clearance, increases inflammatory responses and causes cellular changes in the lining of the airway.  

There is also evidence that people with co-morbidities such as cardiovascular disease and cancer (which are caused by smoking, in many cases) are more likely to experience severe complications of COVID-19. 

Read more here.

How long do people have to stop smoking for to reduce their risk of complications from COVID-19?

This is not currently known for COVID-19 specifically, but it is well-established the stopping smoking improves lung health. For example, quitting improves mucociliary clearance in the nose after two weeks, and in the lungs after three months. Rates of bronchitis and pneumonia also decrease, compared to continued smoking.

Is it still safe to start, or continue to use, nicotine replacement therapy (NRT) and other smoking cessation pharmacotheraphies?

For people who smoke, pharmacotherapies like nicotine replacement therapy (NRT) can effectively reduce cravings and manage withdrawal symptoms.  When combined with behavioural intervention from Quitline, these pharmacotherapies give people the best chance of successfully quitting.

There is no evidence that COVID-19 has an impact on the safety and effectiveness of NRT or other pharmacotherapies. There is no reason why patients cannot commence or continue to use them to support a quit attempt, as clinically appropriate.

How can health professionals best support people who smoke?

Stopping smoking is one of the best things a person can do for their health; COVID-19 provides a great teachable moment. Health professionals are well-placed to provide people who smoke with the support they need to quit. Health professionals can help people who smoke to quit by referring to Quitline and prescribing, or facilitating access to, smoking cessation pharmacotherapy.

Quit has developed online brief advice training for health professionals. It’s all about connecting people who smoke with best practice tobacco dependence treatment; Quitline and pharmacotherapy. 


Visit education.quit.org.au to register for the online training today. 


1 in 33 conversations in which a health professional advises a patient to quit smoking will result in them successfully quitting. Health professionals can provide smoking cessation brief advice to people who smoke, which involves three steps: 

  • Ask people about their smoking status.
  • Advise all people who smoke to quit in a clear, non-confrontational and personalised way.
  • Help all people who smoke to quit, by referring to Quitline and prescribing, or helping people to access, smoking cessation pharmacotherapy (such as nicotine replacement therapy). 

There is also an Aboriginal Quitline for people who smoke identifying as Aboriginal and Torres Strait Islanders. For more information about brief advice, visit: quit.org.au/generalpractice.

Quit has also developed a Quit Tips Hub for people who want to stop smoking during coronavirus (COVID-19) and ahead of the flu season. Visit Quit Tips Hub to see what is available for consumers.

Last updated 06/07/2020


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