Covid-19 symptoms become more pronounced with smoking, a new study published in the journal Thorax has found.

For the study, researchers from King’s College London investigated the association between smoking and the severity of Covid-19.

How smoking cigarettes worsens Covid-19 infection

Researchers analysed data from the ZOE COVID Symptom Study app. Of the participants of the app, 11 per cent were smokers. This is a lower proportion than the overall UK population of 14.7 per cent. However, it reflects the demographics of the self-selected sample of the ZOE COVID Symptom Study.

Adult male smokers in lower-middle-income countries at higher risk of Covid-19 mortality

Classic triad of symptoms

The study noted that more than a third of users reported not feeling physically well during the period of study (March 24 and April 2020). Current smokers were 14 per cent more likely to develop the classic triad of symptoms suggesting diagnosis of Covid-19: fever, persistent cough and shortness of breath, compared to non-smokers.

Current smokers were also more likely to have a higher symptom burden than non-smokers. Smokers were 29 per cent more likely to report more than five symptoms associated with Covid-19 and 50 per cent more likely to report more than ten, including loss of smell, skipping meals, diarrhoea, fatigue, confusion, or muscle pain. A greater number of symptoms suggested more severe Covid-19.

Additionally, current smokers who tested positive for SARS-CoV-2 were more than twice as likely as non-smokers to attend the hospital.

The researchers recommended that a smoking cessation strategy be included as an element to address Covid-19, as smoking increased both the likelihood of symptomatic disease and disease severity.

Stopping smoking

Dr Mario Falchi, lead researcher and Senior Lecturer at King’s College, London, said: “Some reports have suggested a protective effect of smoking on Covid-19 risk. However, studies in this area can easily be affected by biases in sampling, participation, and response. Our results clearly show that smokers are at increased risk of suffering from a wider range of Covid-19 symptoms than non-smokers”.

Claire Steves, lead researcher, consultant physician, and Reader at King’s College London, said: “As rates of Covid-19 continue to rise and the NHS edges towards capacity, it’s important to do all we can to reduce its effects and find ways to reduce hospital admissions. Our analysis shows that smoking increases a person’s likelihood to attend hospitals, so stopping smoking is one of the things we can do to reduce the health consequences of the disease.”

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