As a respiratory disease, the severity of the novel coronavirus (COVID-19), may be greater for those in whom pulmonary function may already be compromised – such as those who smoke. However, the risk of initially contracting the disease may also be higher for those who use tobacco – chewers as well as smokers, due to the behavioral routines associated with their tobacco use.
We know that many diseases can easily be spread through inadequate hand hygiene. Any contamination on your hands can then be spread through the very act of touching other people (such as shaking hands), or touching objects or surfaces (such as doorknobs, your cell phone, a desk top, etc.) And so it is in the current pandemic that health experts ask that we try to mitigate the touching of the nose, mouth, and face (which of course, is especially second nature to those who smoke); as it introduces another link in the chain of possibly contracting the virus.
Similarly, while COVID-19 can be found in the tiny droplet secretions from the mouth or nose (such as when coughing, sneezing, or simply exhaling), the spitting behavior so characteristic of those who use chewing tobacco can prove to be part of a very viable pathway for the spread of the disease as well. After the chewer has spat, the virus can live on a surface for a few hours to several days. Others then, after touching such surfaces and then touching their face (nose, eyes or mouth), could become infected as well. In fact, in previous epidemics (such as that of influenza a century ago), in more densely populated countries such as India, the spitting associated with using chew was banned to mitigate the spread of the disease. And today, the largest state in India, Uttar Pradesh, has now banned all production, warehousing, and sale of smokeless tobacco in response to the COVID-19 pandemic.
The behavioral actions so familiar with the use of tobacco - from either smoking or chewing - combined with the current health concerns from the possible contraction of COVID-19 make tobacco use a very high risk practice both for the individual and society as a whole. And in this very uncertain moment, the stakes could not be higher.