Smoking and Covid-19: The smoker’s paradox

Recent studies have already confirmed that cigarette smoking can aggravate Covid-19 symptoms in patients and can lead to deaths due to health complications. But still, anti-smoking efforts and the threat of coronavirus fail to change people’s behavior. In fact, some smokers even switched to vaping thinking that it is healthier and safer.

Four patients shared their Covid journey and how they recovered successfully. While all cases are related to smoking, they differed in their post-recovery behaviors. One quit smoking entirely, the other two are still smoking, but trying to quit and have switched to vaping, while the other is not even a smoker.

The firsthand and secondhand smokers

RJ Paz, 38, is a registered nurse who suffered from severe Covid pneumonia in August 2021; while Policarpio Diaz Paz, 58, a solar power installer and consultant for a subcontracting firm of Meralco, is RJ’s father who tested positive for Covid after his exposure to him.

“My near-death experience with Covid changed my father’s life. He quit smoking entirely and started living a healthy lifestyle. He is health conscious now. He reminds us to be careful not to get infected again with the virus. My father cooks for us and takes care of us at home. He made a lot of sacrifices during my illness until my hospitalization and post-care,” says RJ.

If RJ is a non-smoker, Policarpio started smoking at the age of 17. He would usually consume one cigarette pack a day. Although he tried to quit chewing gum, it didn’t help him either. Even when the prices of cigarettes increased due to the Sin Tax Reform Law or Republic Act 10351, he can still afford to buy one cigarette stick after meals.

Policarpio is hypertensive and has high cholesterol, but the good thing is after he tested positive for Covid, he only experienced mild fever, fatigue, and difficulty in breathing, so it’s manageable for home quarantine. Unlike RJ who was rushed to the emergency room and was hospitalized for days.

“My father didn’t want to go through what I’ve been through. His 14-day isolation was life-changing. He realized how precious life was. He stopped smoking for two weeks! It was a first for him so he went on and up to this day, he’s not smoking anymore. He also avoids salty foods and eats homecooked meals instead of fast food these days,” RJ shares.

Turning to vape

Diane Marcelo (not her real name), 33, was roughly around 22 years old when she started smoking. Like Gerald, she was also influenced by some of her friends.

“I usually consume around one pack of cigarettes and I do smoke more when I feel stressed and anxious,” reveals Diane.

Diane admitted that she tried to stop smoking every time she was pregnant, but a few months after giving birth, she’d started craving it again.  “I struggled to quit because most of my friends are smokers.”

When the cigarette prices increased, she tried to hoard stocks of her brand. She would smoke in their garage, which is their designated smoking area, and a lot outdoors.

At first, Diane thought it was just normal flu because it subsided after a few days. Then came one day, her temperature spiked up. She started having severe coughs and colds, difficulty in breathing, and chest pains.

“That’s when I started reducing my cigarette intake. Then I tried my best daily to resist the craving. I actually had a hard time pooping because I am very much dependent on smoking when I poop,” she shares.

Diane recovered from Covid. However, she admitted that she’s still struggled to resist her cigarette craving. When that happens, she just remembers what she’d been through. In lieu of cigarettes, Diane switched to vaping.

The smoker trying to quit

Gerald Cruz (not his real name), 32, started smoking at the age of 14 to 15. His parents separated at that time so he started spending time with his friends and smoking five to 10 sticks a day.

When the cigarette prices increased, he tried to quit, but when he failed to do so, he only decreased his consumption and replaced his brand with a cheaper one. He also looked for discreet places to smoke undetected when the university imposed the ‘No Smoking Policy’ inside the premises.

Gerald tried to quit smoking several times by motivating himself, setting goals, replacing cigarettes with vapes or candies, coffee with other beverages, enlisting a quitting buddy (with official agreement and penalties), but all those attempts were unsuccessful due to stress, alcohol, and peer pressure.

Stress added up when Gerald started working as a Security Officer in 2016 as most of his daily activities were routine. He would wake up early in the morning, go home late, render overtime during weekends, go out with workmates and others, and the same thing happens the next day. He can’t even exercise or play basketball due to his hectic schedule.

“Smoking is the only time that I can relax and temporarily escape from the stress I get from my daily routines. I would smoke 20 sticks (or equivalent to one pack) a day,” he reveals.

After arriving home from work on May 28, 2021, Gerald felt something strange – chills all over his body, fever, dry and itchy throat, and loss of smell and taste. He was then sent to the provincial isolation facility. At that time, he thought of quitting smoking for good because he assumed there was no way he can smoke while inside the facility and 14 days is a good head start.

Unfortunately, Gerald’s isolation didn’t help either even after realizing that smoking might have contributed to his health condition. He still smoked five to 10 sticks per day during quarantine.

Gerald eventually recovered and these days, he hopes to slowly reduce his consumption or replace cigarettes with vapes or nicotine gum, and tea with coffee.

“I am starting to quit smoking again and also with my low carb diet. I also exercise every morning (push-ups, sit-ups, etc.) before going to work and play basketball for 30 minutes after work (except when it rains). I also jog every Saturday for an hour or more. Hopefully, with prayers and strong motivation, this strategy will be successful [this time],” he concluded.

Vape Bill

Senate Bill No. 2239 or the proposed Vaporized Nicotine Products Regulation Act or Vape Bill seeks to regulate the importation, manufacture, sale, packaging, distribution, use, and communication of vaporized nicotine and non-nicotine products.

The bill seeks to lower the access restriction from 21 to 18 years old for vaping; allows online sales and youth-appealing flavors other than plain tobacco and menthol. The bill also transfers the regulation of vaping products from the Food and Drug Administration (FDA) to the Department of Trade and Industry (DTI).

Ratified in December 2021, SB 2239 is now with Malacañang for President Rodrigo Duterte’s signature. While consumer advocates are backing this approved bill, the DOH, around 48 medical groups, and 60 civil society organizations under the Sin Tax Coalition objected to the recently approved bill and called for the President to veto the bill.

“The approval of SB 2239 puts the Filipino youth at risk. Vape products are harmful and not risk-free and should be regulated as health products due to their toxic substances and effects. Vape liquids and their emission contain chemicals such as nicotine, propylene glycol, carbonyls, and carbon monoxide that are either addictive, toxic, or can cause cancer,” said DOH in a statement.

The DOH cited the Global Youth Tobacco Survey, which shows that the prevalence of using electronic cigarettes is increasing among Filipino youth. Data shows that there is a 110 percent increase in vape use in just four years, from 11.7 percent in 2015 to 24.6 percent in 2019. It also showed that about 14.1 percent or one in seven students in the Philippines, aged 13 to 15 said that they are currently using e-cigarettes.

As stakeholders and health advocates, ImagineLaw likewise foresees a vaping epidemic once the Vape Bill is signed into law. It suggests that the public come together and show force against the passing of the Vape Bill.

“We must call on President [Rodrigo] Duterte to veto this anti-health measure. This bill is anti-youth, anti-health, and pro-industry,” said ImagineLaw in a statement.

Relationship between COVID and smoking

Dr. Anthony Leachon, an independent health reform advocate, past president of the Philippine College of Physicians, and chair, Kilusang Kontra Covid (KILKOVID), confirmed that there is a relationship between COVID and smoking as the former attacks the lungs whether you’re a current or former smoker.

“Being a current or former cigarette smoker can make you more likely to get very sick from COVID-19. If you currently smoke, quit,” says Dr. Leachon.

But what really motivates a person to quit is “smoking-related illness that leads to death e.g. coronary artery disease, stroke, cancers, or chronic inflammatory lung disease (COPD) that causes obstructed airflow from the lungs,” says Dr. Leachon.

Even when one is not smoking, exposure to smoking or secondhand smoke is bad as well as it can cause lung cancer in adults who have never smoked. “Non-smokers who are exposed to secondhand smoke at home or at work increase their risk of developing lung cancer by 20–30 percent,” he explains.

Switching to vaping is not a good idea as well as it only encourages the youth to smoke rather than stop. It is a gateway to other diseases.

“The difference between smoking and vaping is that smoking delivers nicotine by burning tobacco, which can cause smoking-related illnesses, and vaping can deliver nicotine by heating a liquid in a much less harmful way,” he explains.

Dr. Leachon further concluded that “the most effective way to quit smoking is cold turkey. Patients just stop when they are fully educated, motivated, and developed symptoms. Education is key. Legislation can address the other problems but without knowledge of the topic, we will never achieve anything.”

According to the World Health Organization, smoking can make you more vulnerable to Covid in two aspects: One, smokers and other tobacco users bring their hands to their mouths frequently, increasing their chances of contracting the infection; and two, smoking can also give one severe symptom as it damages the lungs and can affect other organs of the body.

“Covid 19 primarily attacks the respiratory system and lungs. A lung already compromised by smoking, therefore, has little chance of surviving a Covid 19 onslaught. The chances of severe disease symptoms and death are higher for tobacco users including e-cigarettes,” said WHO.

“This story was produced under the ‘Nagbabagang Kuwento (Cycle 5) Covering a Smoke-Free Ph Media Fellowship’ by Probe Media Foundation Inc. (PMFI) and Campaign for Tobacco-Free Kids (CTFK). The views and opinions expressed in this piece are not necessarily those of PMFI and CTFK.”

Featured image courtesy of

Published by Mylene Orillo

Mylene Orillo is a contributing writer at My Pope Philippines. Prior to that, she contributed to the Health & Lifestyle magazine.  She's a former correspondent at The Manila Times; former editor-in-chief of TravelPlus magazine; and former assistant editor of Health & Lifestyle, Zen Health, and DiabetEASE magazines by FAME Publishing, Inc., a company owned by cardiologist Dr. Rafael Castillo who has given her the much-needed break and opportunity in the health industry and medical field.  Her previous job as a Media Consultant at the Philippine Charity Sweepstakes Office and Writer-Researcher at the Headquarters Philippine Army ignited her passions for charity, volunteering, selfless service, and love of country. As a young girl, she loved reading her mom's collection of Mills & Boons pocketbooks, which started her passion to write romance stories.  She has a Bachelor of Arts degree in Journalism from the University of Sto. Tomas in España, Manila. She is now working towards earning her master's degree hopefully this year. She loves traveling, long-distance running, reading romance and non-fiction books, watching Korean Drama series, feel-good rom coms, military movies, and documentaries during her spare time. Someday, she wants to meet Prince William and Pope Francis, settle down with the love of her life and have a family and kids of her own; and become a bestselling romance author.

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