Does Vaping Increase COVID-19 Risk?

Does Vaping Increase COVID-19 Risk?

Published on November 14, 2021 by Kristina Willis

The novel coronavirus forced countries across the globe to re-examine their approach to public safety issues and guidelines. While social distancing and mask mandates are the obvious examples that come to mind, it is also important to acknowledge how our entire lens with which we view the world has changed. For instance, vaping popularity was on a steep incline before the onset of the COVID-19 pandemic. However, COVID influences stopped the train in its tracks when it brought concerning health implications into the limelight.

Vaping is associated with increased risk for both contracting COVID-19 and experiencing severe symptoms. Like smoking, using an e-cigarette or vape system can damage the respiratory system and increase susceptibility to infections. Public health organizations and medical professionals advise against vaping in general and particularly in light of COVID, strongly encouraging current users to cease vaping altogether.

While the safety of vaping products has always been questioned, the coronavirus certainly exacerbated concerns and brought forth new ones. Read on to learn more about the impact of vaping on COVID-19 risk and prevalence.

Are Vapers at High Risk of COVID-19?

The correlation between vaping and COVID has been a trending topic since the start of the pandemic. Right off the bat, the initial state-wide vaping prevalence was a strong indicator for COVID-19 infection rates. In other words, states with a higher proportion of vapers experienced more coronavirus cases and deaths even after controlling for sociodemographic and health-related variables.

With every percent increase in the weighted proportion of vapers in a state, COVID-19 cases increased by 0.3139 and deaths by 0.3730. Moreover, states with a high proportion of vapers also had more daily COVID-19 deaths. Though the 2020 study did not determine causality, it is hard to ignore the implications.

General studies on at-risk populations also found a strong link between vaping and contracting COVID-19. For instance, e-cigarette users were five times more likely to receive a positive COVID-19 diagnosis. As an aside, smoking is a known risk factor for developing viral infections—particularly respiratory ones. A predominant hypothesis is that this is also true for vaping.

“But it is clear that smoking and vaping are bad for the lungs. Patients who smoke and vape can have damaged lungs that make them susceptible to respiratory infections, including COVID-19.”

Charles Dela Cruz, MD, Ph.D., a Yale Medicine pulmonologist and respiratory infection specialist

Reasons Why Vaping Increases COVID-19 Risk

Effects on bodily systems
ACE2 expression in airway epithelial cells is associated with COVID-19 infection, and vapers have a higher expression of ACE2 as do men, explaining why male smokers seem especially at risk for COVID-19. Therefore, having chronically elevated ACE2 in their lungs may cause someone to be predisposed to developing COVID-19.

Unsanitary practices
Following sanitation guidelines is a primary component of anti-viral safety. COVID-19 can spread through hand-to-mouth contact, which is a common practice for e-cigarette users. Thus, the hand-to-mouth vaping action likely increases your risk of infection.

Sharing devices
The coronavirus can be spread with vaping systems through droplets in the aerosols or saliva present on mouth instruments. For example, contact tracers at Purdue University found that several students were infected after sharing vaping devices. In addition, since the coronavirus remains stable on surfaces for several hours, the virus can be transmitted simply by handling someone else’s device.

Social implications
Communal behaviors might play a role in increased COVID risk as vaping tends to be a highly social activity. Even when users do not directly share devices, they are often in close proximity to one another and may not adhere to social distancing guidelines. Additionally, users must remove protective masks to use vaping equipment, putting them further at risk of COVID-19 transmission.

Does Vaping Increase the Risk of Serious Illness from COVID-19?

People who smoke or vape are more likely to develop serious COVID-19 complications compared to nonsmokers. This is primarily attributed to having a weakened immune system and compromised respiratory organs. Moreover, heart or lung disease is a substantial risk factor for a severe COVID-19 reaction, and smokers commonly have such underlying conditions.  

“In general, smokers or vapers are more at risk for COVID-19 infection and more at risk for more severe outcomes when they get infected.”

Charles Dela Cruz, MD, Ph.D., a Yale Medicine pulmonologist and respiratory infection specialist

Exposure to e-cigarette aerosol can also adversely affect lung cells involved in maintaining healthy function. Furthermore, vaping has been previously associated with respiratory distress, such as the 2019 vape pen lung injury epidemic, which was overshadowed by none other than the coronavirus itself.

Future Implications of COVID-19 On Vaping

In terms of substances, vaping was the rampant trend pre-pandemic, especially among U.S. youth. From 2011 to 2019, the proportion of high school e-cigarette users increased from 1.5% to 27.5%. And with increased marketing and availability, there was no reason to believe its popularity wouldn’t continue to rise.

Of course, no one could foresee the pandemic and its impact on both supply and demand. Prevalence in high school populations fell approximately 20%, and young adults ages 18–20 were 35% less likely to use e-cigarettes during the pandemic compared to pre-pandemic periods. Crucially, a cross-sectional survey of youth and young adults found that 25% quit because e-cigarettes may weaken their lungs—a discovery that spells optimism for educational campaigns and public service announcements.

However, it is essential to note that a significant portion of U.S. youth still currently use e-cigarettes, and the number of users might increase once the pandemic passes. Although users found it more challenging to obtain vape products in stores due to closures and restrictions, they adapted by familiarizing themselves with online retailers. Most importantly, the dangers associated with vaping will not dissipate with COVID-19 as it still poses numerous health risks.

Despite the hazards of vaping, we mustn’t let it reflect poorly on potential therapeutic uses for marijuana and hemp. For example, cannabis has been linked to reduced COVID-19 inflammation, and CBD can help manage anxiety disorders. Though vaping may not be the appropriate delivery system, many forms of cannabis may prove invaluable for medicinal applications.