Vulnerable Risky Smoking Deadly Mix

Posted 24th March 2020 by Dave Cross
Risky smoking practices and the coronavirus pose a deadly mix for the most vulnerable, Dr Sharon Cox tells the British Medical Journal (BMJ). While fake experts cluck about the possible dangers of vaping, Dr Cox is an authority on tobacco harm reduction and its potential in deprived communities.

“Smokers are one group of adults who are at particular risk if they catch the virus. Many smokers already present with poor respiratory health caused by years or even decades of smoking,” says Dr Cox.

“A higher percentage of smokers, compared to non-smokers, have health conditions like COPD, heart disease and asthma which are made worse by smoking and exacerbated by illness. For these smokers, catching the virus increases their risk of developing complications and is potentially fatal.”

The latest advice about COVID-19 from the NHS is comprehensive, but it fails to mention smoking and the elevated risk it poses [link]. Behavioural experts have also issued advice on how to reduce personal exposure [link], but this too ignores some smoking practices that elevate danger for the most vulnerable smokers.

“However,” continues Dr Cox, “there exist a group of smokers for who the coronavirus poses a greater risk, these are the homeless, those will a serious mental illness or learning needs, and those presenting with drug or alcohol dependence.”

While vaping offers an excellent route away from tobacco use, adoption by these groups can be problematic – from access to cost. This leaves these groups at greater risk not just because they smoke, but how they smoke.


“One particular vulnerability is the common act of sharing cigarettes,” Dr Cox continues. In addition to the lung issues smoking causes, “going twos”on a cigarette runs in direct conflict with advice to avoid close contact as the virus can be spread from mouth to mouth.

Doctor Cox suggests there are a number of things that can take place:

  1. Giving service users access to accurate information about such practices and how to limit their risk
  2. Stop smoking services and the third sector need to target these groups with interventions and products
  3. Access to hand sanitiser, wipes and gels for those who do share cigarettes

One problem is highlighted by Northamptonshire’s pro-vape Quit service: The service has closed all direct services last week and is relying on phone calls in light of the outbreak, an approach that leaves the disadvantaged behind. Dr Cox points out that these groups have a population that is highly motivated to quit smoking [link].


  • “Risky smoking practices and the coronavirus: A deadly mix for our most vulnerable smokers”, Sharon Cox – [link]

Image by klimkin from Pixabay

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker