No ifs and butts

Updated: May 30, 2020, 08:58 IST | Shunashir Sen | Mumbai

With contradictory reports about the Coronavirus's relation to cigarette smoking, we got experts to clear the air

It was the sort of news report that made readers spill their morning coffee. A study conducted among patients in a Paris hospital earlier this month revealed that cigarette smoking — an act that the medical fraternity has historically treated with the same disdain that people roaming around without masks are met with these days — might actually make a person less susceptible to contracting a severe case of COVID-19. This hypothesis was based on the idea that nicotine blocks the Coronavirus molecules from attaching themselves to receptors in the human body.

Meanwhile, a simultaneous review of 28 scientific studies, conducted at the University College London, observed that, yes, it does indeed seem that smokers have an in-built protective mechanism against the disease, with a third review undertaken in China positing the same theory. But, could this really be? Multiple other studies have been taking the conventional route of advising against smoking in the wake of the pandemic. So, the layman was left confused with these contradictory reports, even as we gear up to mark World Anti-Tobacco Day this weekend.

Experts tell us that the first factor that must be taken into consideration here is that all the research surrounding the virus is still in a nascent phase, given how novel it is. Dr Kanishka Davda, head of the infectious diseases department at Jupiter Hospital in Thane, explains, "People right now are just bringing forth their experiences to the table. Let's say that there are 500 such theories. You will then have to pick and choose the most plausible ones before reaching a conclusion. But the data [around the Coronavirus] is still too raw to determine whether something is beneficial or not.

Dr Samir  Bhargava and Dr Kanishka Davda
Dr Samir Bhargava and Dr Kanishka Davda

And the other side-effects of smoking are anyway much better proven to have a detrimental effect on the immune system, which, as we all know, is crucial in combating this disease."

The point he is making here — and which internal medicine specialist Dr Amit Saraf echoes — is that it is too early yet to say with any sort of authority that the French, English and Chinese studies point in the right direction. Dr Saraf says, "The problem with many of these observational findings is that they are fraught with confounders. That is what happens whenever there is any sort of new research in the medical field — there is a lot of contradictory data initially. Even if you look at hydroxychloroquine, there were earlier studies that said it is beneficial in the fight against the Coronavirus, while others are now saying the opposite."

The path of wisdom, then, takes us back to the existing findings we have about tobacco's damaging effect on the lungs, the focal point of the virus's attack on the human system. Studies about smoking being beneficial in this war are still shots in the dark, for all practical purposes. And Dr Samir Bhargava, national president of the Association of Otolaryngologists, additionally points out, "Even if smokers are not directly more at risk, they are indirectly more susceptible because of the amount of contact a cigarette has with your mouth, which is a known entry point for the virus. And the possibilities increase even further when you are passing a hookah around, to cite an example."

Dr Amit Saraf
Dr Amit Saraf

The message, Dr Davda reiterates, is thus loud and clear — the use of tobacco as a preventive measure is not advisable at all. The balance of proven data tilts way too heavily towards the known harmful outcomes. Meanwhile, there is also an experimental vaccine being tested, which uses tobacco as one of its components. The British American Tobacco Company is, rather unsurprisingly, funding it, but the experts we spoke to see no harm in this particular research. Dr Saraf explains that this is because being vaccinated is a one-time act. So, even if these tests are successful, it's not like people will be injecting copious amounts of nicotine into their bodies. It's not like taking an actual puff of a cigarette, which opens the door for different types of carcinogens to enter your system, inviting familiar ailments like bronchitis, if not this novel virus that — in one way or the other — we are all grappling with.

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