Tobacco Use and the Risk of Suffering from COVID-19


  • Dianita Sugiyo Department of Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia; Muhammadiyah Steps, Universitas Muhammadiyah Yogyakarta, Indonesia
  • Ralalicia Limato Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
  • Saskia Dyah Handari Department of Cardiology, Medical School, Ciputra University, Surabaya, Indonesia; Department of Cardiology, Siloam Hospital, Surabaya, Indonesia



Angiotensin-converting enzyme 2 (ACE2) receptor, cigarette, COVID-19, respiratory virus epidemics, smoking


BACKGROUND: Coronavirus disease (COVID-19) has become a global pandemic and is confirmed worldwide to cause a high mortality rates; as of the April 23, 2020, over 189,000 deaths have occurred in 2,700,800 COVID-19 cases. However, it appears that little consideration has been given to smokers and the users of tobacco-related products relative to the impact of the virus on that particular cohort of patients.

AIM: The aim of the study was to commence a narrative review of research and academic articles of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence related to cigarette smoking and the consumption of tobacco-related products.

METHODS: The study involved evidence-based publication searches on ProQuest and EBSCOhost databases informed by a number of keywords. The additional data were obtained from relevant journals searched manually, as well as following up references or primary articles. The search was conducted from April 23 to 24, 2020, adopting the use of several terms, such as “tobacco use” AND “COVID”, “tobacco use” AND “SARS-CoV-2”, “smokers” AND “COVID”, “cigarette” AND “SARS-CoV-2”, and “tobacco use” AND COVID-19 AND sars-cov-2.

RESULTS: Several studies (n = 8) confirmed that conventional smoking and electronic cigarette use correlated with the decline of the human immune system and the feasibility of infection. The second group of evidence (n = 9) explored higher Angiotensin-converting enzyme 2 among smokers, as the binding sites of SARS-COV-2.

CONCLUSION: Tobacco use among smokers and former smokers is significantly correlated to the decline in the status of the human immune system and worsen the disease prognosis. In addition, smoking status is associated with a greater likelihood of smokers being infected with SARS-COV-2; a condition that can further develop into coronavirus disease.


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How to Cite

Sugiyo D, Limato R, Handari SD. Tobacco Use and the Risk of Suffering from COVID-19. Open Access Maced J Med Sci [Internet]. 2021 Mar. 4 [cited 2021 Apr. 16];9(T4):111-7. Available from:

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