Smokers probably aren't wearing masks, for one.

By Claire Gillespie
August 10, 2020
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Scientists believe that the main way the coronavirus is spread is through close contact with infected people via oral and nasal secretions, including saliva and respiratory droplets released from the mouth or nose when someone coughs, sneezes, speaks or sings. But what about smoking? If the person standing next to you is exhaling cigarette smoke in your direction, could their habit give you COVID-19?

In a word—possibly. While there are no studies looking directly at secondhand smoke and the spread of the coronavirus, the same droplets people spray when they’re coughing, sneezing, or talking are exhaled when they’re smoking (and vaping). 

Additionally, it’s possible that the smaller evaporated particles that are released when speaking, singing, and smoking may be transmitted via aerosolization (i.e. staying in the air for a long time), Julie Lyou, MD, MPH, a pulmonologist with St. Jude Medical Center in Fullerton, California, tells Health. 

This means you may be able to contract the coronavirus through secondhand smoke. “It’s plausible to presume that a plume of smoke, which is comprised of respiratory droplets, can result in COVID-19 transmission,” Osita Onugha, MD, thoracic surgeon and assistant professor of thoracic surgical oncology at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California, tells Health. 

There’s also one crucial difference between exhaling breath and exhaling smoke—you can breathe through a face covering, but you can’t smoke through one. 

“Since the novel coronavirus is spread via direct person-to-person contact, activities that include being in close contact (less than six feet) without a mask on should be avoided, which includes secondhand smoke,” Dr. Lyou says. “The act of smoking requires the person to take off the mask, so this is considered a high-risk environment for anyone in the vicinity.” 

Although there’s no evidence that smoke makes the virus travel farther, Dr. Onugha says there’s no safe distance that can be recommended to protect someone when standing around cigarette smokers, and advises wearing a face covering to minimize the risk of transmission. 

In relation to COVID-19, it's smokers themselves who may be at a greater risk. The Center for Tobacco Control Research and Education at University of California San Francisco carried out a meta-analysis of 19 peer reviewed papers that had data on smoking and COVID-19 disease progression (17 from China, one from Korea and one from the US). The center found that smoking was associated with more than a doubling of odds of disease progression in people who had already developed COVID-19. 

In May, the World Health Organization (WHO) stated that, "smokers are more likely to develop severe disease with COVID-19, compared to non-smokers.”

And non-smokers should steer clear of secondhand smoke, regardless of COVID-19. “Studies have shown associations of secondhand smoke with increased risk of lung cancer and cardiovascular disease, including heart attack and stroke,” Dr. Lyou says. “Even short-term exposure to cigarette smoke can worsen pre existing lung conditions, such as asthma and COPD.” 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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