smoker china covid-19
Han skal nok klare sig.
Der er ikke meget at grine om i disse dage, men nyheden om, at rygere muligvis er beskyttet mod Covid-19, er bestemt en af ​​dem. Med undersøgelse efter undersøgelse, der viser, at rygere er underrepræsenteret i coronavirus-afdelingen, arbejder den berømte franske neurovidenskabsmand, Jean-Pierre Changeux, på en randomiseret kontrolundersøgelse for at teste effekten af ​​nikotinplaster på Covid-19-patienter.

Dette er langt fra en skør teori. Changeux har forklaret sin hypotese udførligt her. Enkelt sagt siger han, at nikotinacetylcholinreceptorer spiller en nøglerolle i udviklingen af ​​sygdommen, og at nikotin kan sætte en bremse på den. Hvis han har ret - det, han har fundet frem til siger at han har det - ville det ikke kun redde tusinder af liv, men ville også være én i øjet for de "folkesundhedsgrupper", der har hævdet, at rygning og dampinhalering er risikofaktorer for Covid-19.

Disse grupper er så vant til at lyve uden hæmninger, at de ikke spilder tid på at hævde, at rygning forårsagede komplikationer med koronavirus, da pandemien begyndte. I USA er aviserne fyldt med rapporter om, at rygere og vapers 'muligvis' er i større risiko fra Covid-19, et vådord, der ikke kræver noget bevis. En gruppe læger i New York opfordrede guvernør Andrew Cuomo til at forbyde salg af al tobak og e-cigaretprodukter på den falske forudsætning, at "stigende evidens viser sammenhæng mellem tobaksforbrug og øget risiko for progressiv Covid-19". I mellemtiden har Verdenssundhedsorganisationen taget lejlighedsvise pauser fra at smigre det Kinesiske Kommunistparti for at fremsætte evidensfrie påstande om, at rygere "sandsynligvis" lider mere af coronavirus.


Three weeks ago, Public Health England fished around in the emerging literature and found a study from China involving a grand total of five smokers hospitalised with Covid-19, of whom three suffered severe symptoms. From this crumb of evidence, they made the astounding claim that 'smokers with Covid-19 are 14 times more likely to develop severe respiratory disease'.

The quango should have paid more attention to how few smokers were in hospital in the first place. In a country where 27 per cent of adults smoke, only 6.4 per cent of the Covid-19 cases were smokers. This was not a fluke finding. Awkwardly for the anti-smoking lobby, smokers have been strangely under-represented in all the studies for which smoking prevalence data is available. They made up just 1.4 per cent of the cases in Zhang et al, 6.7 per cent in Wan et al, 3.9 per cent in Mo et al, seven per cent in Huang et al, nine per cent in Dong et al, 10 per cent of cases in Yang et al, 1.9 per cent in Guan et al, six per cent in Zhou et al, and 6.4 per cent in Liu et al. In Shi et al, only 8.2 per cent of cases had any smoking history.

Dr Konstantinos Farsalinos of the University of Patras in Greece noticed this phenomenon early on and put a preliminary study online in late March. It noted the 'unusually low prevalence of current smoking was observed among hospitalised Covid-19 patients', which 'does not support the argument that current smoking is a risk factor for hospitalisation for Covid-19, and might suggest a protective role'.

A few days earlier, a group of doctors from the Royal Glamorgan Hospital had written to the British Medical Journal to point out that nicotine protects against the kind of acute inflammatory reactions seen in Covid patients and that 'the simple use of nicotine patches should be urgently considered and discussed'. Nobody paid much attention, but evidence supporting the smoking hypothesis continued to slip out.


Comment: Don't bother with patches. Smoking works so well precisely because it passes through the lungs.


On 3 April, the US Centers for Disease Control published data on thousands of American Covid-19 cases. Once again, the proportion of smokers was tiny - just 1.3 per cent. Even ex-smokers were significantly under-represented (2.3 per cent).

The most comprehensive epidemiological study appeared a week later. Based on data from 4,103 Covid patients in New York City, a team of researchers found that a history of smoking was associated with a 29 per cent reduction in risk of being hospitalised with Covid-19 and, contrary to the claims of Public Health England, smokers were no more likely to become critically ill with the disease if they were admitted. The authors would have found an even sharper reduction in risk for current smokers if they had split them up from ex-smokers in their analysis, but even the findings as published were striking.

This week, a group of French academics published their study of 343 Covid patients, of whom only 4.4 per cent were daily smokers. According to the authors, the study 'strongly suggests that daily smokers have a very much lower probability of developing symptomatic or severe SARS-CoV-2 infection as compared to the general population'. This seems to have been the study that prompted Professor Changeux to go public with his research project.

People scoffed when Emmanuel Macron exempted tobacco kiosks from France's lockdown on the basis that they provide an essential service. Who's coughing now?

Far be it from me to preempt the conclusions of the professor's research, but let us consider for a moment the policy implications of nicotine being the only tried and tested prophylactic for Covid-19. We could issue Lucky Strikes on prescription. We could #ClapForOurCigarettes every Thursday evening. The case for closing down Public Health England would be stronger than ever. We could open the pubs, but only to smokers and vapers. We might allow a few non-smokers in to enjoy the possible benefits of passive exposure, but only if they stand two metres apart. There is everything to play for.

The icing on the cake would be if British American Tobacco is first out of the blocks with a vaccine. Everyone who works for the World Health Organisation would have to go unvaccinated on principle and rely instead on herd immunity. Smokers would, of course, be pushed to the front of the queue for vaccination. They paid for it, after all.

Let's not get ahead of ourselves. But, by God, wouldn't it be fun?
About the author

Christopher Snowdon is director of lifestyle economics at the Institute of Economic Affairs. He is also the co-host of Last Orders, spiked's nanny-state podcast.