Effects of Tobacco on the respiratory system with reference to COVID-19: A Review


  • Mohamed Hoosen Suleman Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban 4013, South Africa
  • Jaspreet Singh Department of Social Work, Central University of Jammu, Jammu and Kashmir, India


COVID-19, Tobacco, Smoking, Lungs, Airway diseases


The novel coronavirus (COVID-19) is a lower respiratory tract disease that has negatively affected the health and well-being of millions globally. World Health Organization (WHO) has since declared COVID-19 a pandemic. The highly contagious virus spreads via respiratory droplets and aerosol particles when people cough, sneeze or talk close to others. The effects on the lungs include inflammation, fluid accumulation, reduced gaseous exchange, hypoxemia, and tissue necrosis. As the virus affects the respiratory system of humans, there are many assumptions as to whether or not smoking increases the threat of COVID-19. Tobacco use kills up to half of its all-time users, with current predictions estimating that more than 1 billion people could die from tobacco use in the 21st century. This study aims to unpack the pathological effects of tobacco smoking on the respiratory system and explore the potential impact of COVID-19 on the lungs of smokers. This is a review article that is based on secondary information collected from various sources such as published and unpublished Journal Articles, Newspapers, Books, and Reports from various Government Organizations, Non-Governmental Organizations, and Commissions.


Download data is not yet available.


Vallejo Jr, B. M., & Ong, R. A. C. (2020). Policy responses and government science advice for the COVID 19 pandemic in the Philippines: January to April 2020. Progress in Disaster Science, 7, 100115.

What does COVID-19 do to your lungs?; https://www.webmd.com/lung/what-does-covid-do-to-your-lungs#1.

Sahu, K. K., & Kumar, R. (2020). Preventive and treatment strategies of COVID-19: from community to clinical trials. Journal of Family Medicine and Primary Care, 9(5), 2149.

Vázquez, J. C., & Redolar-Ripoll, D. (2020). COVID-19 outbreak impact in Spain: A role for tobacco smoking?. Tobacco Induced Diseases, 18.

Barnsley, K., & Sohal, S. S. (2020). COVID-19, propelled by smoking, could destroy entire nations. European Respiratory Society-blog, 30.

Ekpu, V. U., & Brown, A. K. (2015). The economic impact of smoking and of reducing smoking prevalence: review of evidence. Tobacco Use Insights, 8, TUI-S15628.

Harstad, E., Levy, S., & Committee on Substance Abuse. (2014). Attention-deficit/hyperactivity disorder and substance abuse. Pediatrics, 134(1), e293-e301.

Dubray, J., Schwartz, R., Chaiton, M., O'Connor, S., & Cohen, J. E. (2015). The effect of MPOWER on smoking prevalence. Tobacco Control, 24(6), 540-542.

Schane, R. E., Ling, P. M., & Glantz, S. A. (2010). Health effects of light and intermittent smoking: a review. Circulation, 121(13), 1518-1522.

Sin, D. D., & Man, S. P. (2008). Impact of cancers and cardiovascular diseases in chronic obstructive pulmonary disease. Current Opinion in Pulmonary Medicine, 14(2), 115-121.

Industry Strategies; April 2015; https://tobaccoatlas.org/topic/industry-strategies/.

Campbell M, Ford C, Winstanley M. (2017). Chapter 4 – The health effects of secondhand smoke, in M Scollo and M Winstanley (eds), Tobacco in Australia: Facts and issues. Cancer Council Victoria.

Morris, S. B., Schwartz, N. G., Patel, P., Abbo, L., Beauchamps, L., Balan, S., ... & Godfred-Cato, S. (2020). Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection—United Kingdom and United States, March–August 2020. Morbidity and Mortality Weekly Report, 69(40), 1450.

American cancer society; harmful chemicals in Tobacco products; April 2020; https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/carcinogens-found-in-tobacco-products.

Shikina, T., Hiroi, T., Iwatani, K., Jang, M. H., Fukuyama, S., Tamura, M., ... & Kiyono, H. (2004). IgA class switch occurs in the organized nasopharynx-and gut-associated lymphoid tissue, but not in the diffuse lamina propria of airways and gut. The Journal of Immunology, 172(10), 6259-6264.

Tilley, A. E., Walters, M. S., Shaykhiev, R., & Crystal, R. G. (2015). Cilia dysfunction in lung disease. Annual Review of Physiology, 77, 379-406.

Naturopath, C. A. (2013). Asthma solved naturally: The surprising underlying causes and hundreds of natural strategies to beat Asthma. Logical Books.

Thorley, A. J., & Tetley, T. D. (2007). Pulmonary epithelium, cigarette smoke, and chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease, 2(4), 409.

Paul Boyce; What is emphysema? March 14, 2019; https://www.webmd.com/lung/copd/what-is-emphysema.

Calder, P. C., Albers, R., Antoine, J. M., Blum, S., Bourdet-Sicard, R., Ferns, G. A., ... & Zhao, J. (2009). Inflammatory disease processes and interactions with nutrition. British Journal of Nutrition, 101(S1), 1-45.

Weisburger, J. H. (1991). Nutritional approach to cancer prevention with emphasis on vitamins, antioxidants, and carotenoids. The American Journal of Clinical Nutrition, 53(1), 226S-237S.

Deborah Weatherspoon, Adam Felman; January 11, 2018; Everything you need to know about nicotine; https://www.medicalnewstoday.com/articles/240820.

Grundy, E. J., Suddek, T., Filippidis, F. T., Majeed, A., & Coronini-Cronberg, S. (2020). Smoking, SARS-CoV-2 and COVID-19: A review of reviews considering implications for public health policy and practice. Tobacco Induced Diseases, 18.

van Zyl-Smit, R. N., Richards, G., & Leone, F. T. (2020). Tobacco smoking and COVID-19 infection. The Lancet Respiratory Medicine, 8(7), 664-665.

Assessment, R. R. (2020). Coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK–seventh update.

Ubaldo Martins, L. D. B., Jabour, L. G. P. P., Vieira, C. C., Nery, L. C. C., Dias, R. F., & Simões e Silva, A. C. (2021). Renin-angiotensin System (RAS) and Immune System Profile in Specific Subgroups with COVID-19. Current Medicinal Chemistry.

Nardiello, C., & Morty, R. E. (2020). World No Tobacco Day 2020.

Hartmann-Boyce, J., & Lindson, N. (2020). The role of nicotine in COVID-19 infection. Retrieved from The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare.: https://www.cebm.net/covid-19/nicotine-replacement-therapy.

Cox, S. Risky smoking practices and the coronavirus: A deadly mix for our most vulnerable smokers [Internet]. BMJ Opin. 2020.

Sriram, K., Insel, E., & Loomba, R. (2020). What is the ACE2 receptor, how is it connected to coronavirus and why might it be key to treating COVID-19? The experts explain. The Conversation.

Fu, J., Zhou, B., Zhang, L., Balaji, K. S., Wei, C., Liu, X., ... & Fu, J. (2020). Expressions and significances of the angiotensin-converting enzyme 2 gene, the receptor of SARS-CoV-2 for COVID-19. Molecular Biology Reports, 1.

Cai, G., Bossé, Y., Xiao, F., Kheradmand, F., & Amos, C. I. (2020). Tobacco smoking increases the lung gene expression of ACE2, the receptor of SARS-CoV-2. American Journal of Respiratory and Critical Care Medicine, 201(12), 1557-1559.

Jha, P., MacLennan, M., Chaloupka, F. J., Yurekli, A., Ramasundarahettige, C., Palipudi, K., ... & Gupta, P. C. (2015). Global hazards of tobacco and the benefits of smoking cessation and tobacco taxes. Disease Control Priorities. The World Bank, 3, 175-194.

Baumeister, R. F. (2017). Addiction, cigarette smoking, and voluntary control of action: Do cigarette smokers lose their free will?. Addictive Behaviors Reports, 5, 67-84.

Office, U. S. P. H. S. (2020). Smoking Cessation: A Report of the Surgeon General.



How to Cite

Suleman, . M. H., & Singh, J. (2021). Effects of Tobacco on the respiratory system with reference to COVID-19: A Review. International Research Journal of Advanced Science, 2(2), 39-44. Retrieved from https://irjas.com/index.php/sciencejournal/article/view/47