What is the link between tobacco use and COVID-19?

There is growing evidence suggesting that people who smoke, and have pre-existing damage to their lungs, are more severely impacted by the coronavirus (COVID-19). Studies have shown that people who smoke have an increased risk of severe or critical COVID-19, complications in hospital, and are more likely to need mechanical ventilation. In addition, people who smoke are more likely to have other health conditions (such as cancer), and more likely to experience severe COVID-19 complications.

There is an increased risk of COVID-19 transmission among people who smoke because of:

• the frequent hand-to-mouth action of smoking,
• the sharing of cigarettes and rollies,
• people smoking together (in close proximity) in a shared location, and
• the use of another person’s disposed bumpers/cigarette butts.

Given the need for physical distancing and wearing of masks, people may not be able to smoke as frequently, or at all. Without being able to use tobacco, people who smoke will experience symptoms of nicotine withdrawal. It is therefore important to ensure they have access to information and support to treat their withdrawal symptoms.

Why are people who access community, health and corrective services potentially at higher risk of COVID-19?

People who access these services may be unable to adhere to Government advice around COVID-19 (e.g. experiencing homelessness, living in overcrowded housing, and limited access to running water and hand sanitiser). These groups also have higher rates of smoking than the general population making them more vulnerable to infections. In times of high stress and anxiety, people who are ex-smokers may relapse back to smoking.

What information should community, health and corrective services provide to clients* who smoke?

The good news is there is a lot you can do to support the health and wellbeing of clients who smoke. Regardless of COVID-19, quitting smoking reaps large health and financial benefits. Services like yours can help reduce the chances of COVID-19 spreading by providing brief advice about quitting to clients.

Community services should consider informing their clients of the following:

Health and wellbeing for clients who smoke

• Quitting smoking is the single most important thing you can do to protect your health and it will also protect the health of others.
• I can refer you to Quitline (13 7848 or dial prefix in prisons) for free support.
• Nicotine replacement therapy is available through your local GP and pharmacy. Prisoners can purchase patches at the canteen, or access quit smoking medication through their medical services.
• Call ahead to your GP or health professional, as you may be able to receive help over the phone, reducing your risk of exposure to the virus.
• Do not smoke within at least 1.5 metres of another person.
• Do not pick up bumpers/cigarette butts from the ground.
• Do not share cigarettes with other people.
• Do not take your mask off in public to smoke.

Community, health and corrective service policy and environment

• Remind clients that according to the tobacco policy smoking is not allowed on site or only allowed in designated smoking area/s.
• Remind clients that to protect the health of others, the law for public spaces states that smoking is not allowed within five metres of the front entrance and 10 metres from air conditioning vents.
• Empty butt bins at the service regularly to decrease the opportunity for clients to smoke used cigarette butts.
• Encourage clients to try the 4 D’s and resist the urge to smoke when they have a craving:
  1)    Delaying– delay for 1-2 minutes and the urge will pass
  2)   Drinking water – sip it slowly
  3)   Deep breathing – take 3 slow deep breathes of fresh air
  4)   Doing something else – to take your mind off smoking (e.g. movies, books, puzzles)

• Ensure smoking cessation resources are easily accessible to clients and display Make Smoking History signage around your service.
• Reduce barriers to access nicotine replacement therapy by providing vouchers or subsidies from a local pharmacy or hospital and organising deliveries being made on site.

What is the advice on using carbon monoxide (CO) monitors (smokerlyzers)?

Due to the risk of infection transmission, use of CO monitors must stop. If services use personal CO monitors (that can be connected up to a person’s mobile phone), these may still be used however guidance should be provided on additional measures to reduce infection to the individual and anyone else they are living with.

What is the link between e-cigarette use and COVID-19?

There is some evidence to suggest use of e-cigarettes damages lungs and could reduce immune system response making a person more vulnerable to respiratory infections. E-cigarette use may also increase risk to COVID-19 due to ‘hand-to-mouth’ action, and exposure to aerosol exhaled by a user that is infected.

Where can community services get information and support to help clients quit?

For any questions, contact Make Smoking History or visit the Community Services web page.

To access online Smoking Cessation Brief Advice training for staff or resources for clients visit: Training and Resources.

Quitline (13 7848) can provide community, health and corrective services’ clients with personalised, non-judgmental and empathetic support and information to quit. Quitline is tailored to meet the needs of priority populations including people living with a mental illness, people in prison, and Aboriginal and Torres Strait Islander people (with dedicated Aboriginal Counsellors available to have a yarn). The service is available Monday to Friday 8:30am – 6:30pm. For more information visit:  Quitline.

What is the Government/expert advice for COVID-19?

See this website for further information and advice from the WA Government.

Please note: As the situation around the COVID-19 pandemic changes, additional recommendations will need to be made to support those that smoke.

*We recognise that some of our recommendations are not appropriate for all settings. Please also note that the term clients includes guests, patients, people in prison and more. Where possible we have provided specific information for different services.

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Last updated 24 July 2023