COVID-19 and smoking: Considerations after two years

Transparent communication is the key to delivering a trustworthy message. The unfavorable consequences of cigarette smoking are paramount and indisputable. A recent retrospective analysis has estimated that active smoking and exposure to secondhand smoke have caused nearly 21 million premature (and otherwise preventable) deaths in the US during the past 50 years . It has also been recently demonstrated that active smoking may enhance the risk of developing adverse events after COVID-19 vaccination. The evidence that quit smoking is perhaps one of the best things that one could ever do for his/her health is certainly inalienable and should foster the development of anti-smoking campaigns, especially among the youth, who may then experience the largest burden of long-term unfavorable health consequences. Nonetheless, we also emphasize here that the potential role of current smoking in influencing the clinical course of COVID-19 remains controversial and may even be confounded by synergistic effects, e.g., long-term smokers may actually develop a kaleidoscope of conditions - namely COPD and cardiovascular disease - that per se influence the prognosis of SARS-CoV-2 infection.