Can You Get COVID-19 From Secondhand Smoke?

Since COVID-19 is spread through droplets in the breath, smokers may be putting others at risk when they blow the smoke out

If the person standing next to you is smoking a cigarette, could breathing in the secondhand smoke give you COVID-19? In a word—possibly.

We now know that the disease spreads when the tiny respiratory droplets we exhale contain SARS-CoV-2, the virus that causes COVID-19, and other people breathe them in. If an infected person coughs, sneezes, talks, sings, or simply breathes in your vicinity, you can contract the virus, according to the Centers for Disease Prevention and Control (CDC).

While few studies have looked directly at secondhand smoke and the spread of COVID-19, the same droplets people spray when they're coughing, sneezing, or talking are exhaled when they're smoking (and vaping).

"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 surgery at the John Wayne Cancer Institute in Santa Monica, California, told Health.

While experts were unsure at the beginning of the pandemic about the aerosolization of COVID-19 droplets, studies suggest that some of the smaller droplets can become suspended in air, lingering for a duration of time. For example, one 2021 study published in the journal Environmental Research suggested that "aerosols are an important transport route for SARS-CoV-2, as aerosols particles can contain the infectious SARS-CoV-2, and remain suspended in the air for hours, which may be up to several meters transported from the source."

Inhalation of "very fine respiratory droplets and aerosol particles" are one of three ways that COVID-19 can be transmitted, according to the CDC.

This means you may be able to contract COVID-19 through secondhand smoke if the person smoking is infected with the virus.

"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," Julie Lyou, MD, MPH, a pulmonologist with St. Jude Medical Center in Fullerton, California, told Health. "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, secondhand smoke can float 20 feet from its source. Dr. Onugha said there's no safe distance that can be recommended to protect someone when standing around cigarette smokers and advised wearing a face covering to minimize the risk of transmission.

Even without containing virus particles, secondhand smoke is virulent, loaded with hundreds of toxic or carcinogenic chemicals, according to the American Lung Association. "Studies have shown associations of secondhand smoke with increased risk of lung cancer and cardiovascular disease, including heart attack and stroke," said Dr. Lyou. "Even short-term exposure to cigarette smoke can worsen pre-existing lung conditions, such as asthma and COPD."

As for smokers themselves, research points to a heightened chance for serious disease should they contract COVID-19. In a 2021 observational study published in the British Medical Association journal Thorax, researchers found that smokers were at greater risk of severe COVID-19 than people who had never smoked, including higher rates of hospitalizations and death.

Former smokers, too, are susceptible to severe COVID-19. In fact, a 2021 study published in the European Journal of Integrative Medicine suggested that people who quit were more likely to develop serious illness than current smokers. Another study published in the International Journal of Epidemiology echoed these findings.

Smoking is a well-known risk factor for disease and death in general, and both the CDC and World Health Organization (WHO) caution that smoking is, indeed, a risk factor for severe COVID-19.

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 CDC, WHO, and their local public health department as resources.

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