The COVID-19 pandemic is still unfortunately under progression. There are limited data with regard to the clinical characteristics of the patients as well as to their prognostic factors. Smoking, to date, has been assumed to be possibly associated with adverse disease prognosis, as extensive evidence has highlighted the negative impact of tobacco use on lung health and its causal association with a plethora of respiratory diseases. Smoking is also detrimental to the immune system and its responsiveness to infections, making smokers more vulnerable to infectious diseases. Previous studies have shown that smokers are twice more likely than non-smokers to contract influenza and have more severe symptoms, while smokers were also noted to have higher mortality in the previous MERS-CoV outbreak.
National Authority on Tobacco & Alcohol (NATA) Chairman Dr. Samadhi Rajapaksa said, “As part of treaty obligations, WHO FCTC Parties are required to encourage quitting and to protect their respective tobacco control measures from the commercial and vested interests of the tobacco industry (Article 5.3 of the FCTC), and the guidelines for the implementation of Article 5.3 recommend that Parties raise awareness about tobacco industry tactics exposed in accordance with treaty guidelines because their corporate behaviour resulted in the tobacco epidemic that kills 8 million people annually.”
Hence, partnerships with the tobacco industry could erode governments’ credibility in upholding public health and in delivering anti-smoking messages in the time of COVID - 19.
In February 2020, the Head of the WHO Health Emergencies Programme posited that smoking is a risk factor for the severity of any lower respiratory tract infection and the same would be expected in COVID-19, a respiratory disease. Having had identified smokers as a potential vulnerable group for COVID-19, health experts have subsequently called for outright quitting of smoking in Indonesia (WHO), Israel (Israeli Medical Association for Smoking Cessation and Prevention), Japan (Tokyo Medical Association), Ireland (Health Service Executive), and South Africa (National Council Against Smoking (NCAS).
When the New York Mayor announced this month that smoking or vaping makes people “more vulnerable to suffer” from COVID-19 and encouraged individuals to quit, authors and publishers with links to Philip Morris International or the PMI funded Foundation for a smoke-free world actively challenged the same. They also reacted negatively to an expert who warned against the dangers of vaping during the coronavirus outbreak by asserting that inhaling the fumes produced by the cigarette substitute was equivalent to “someone spitting in your face”.
On March 16, 2020, an article published by Reason, an organisation with known links to PMI, stated that the US Centre for Disease Control and Prevention’s (CDC) ‘scare-mongering about e-cigarettes referring to COVID 19, undermined its credibility on the eve of a true public health crisis’
Scientists have opined that the “COVID-19 epidemic provides a ‘teachable moment’ in which smokers may be uniquely receptive to ‘stop smoking’ advice” and that “it is plausible that a spike in quit rates could help reduce community transmission of SARS - CoV-2. However, an analysis of the tobacco industry’s public relations and social media responses reveal that it is utilizing the global COVID-19 crisis to promote “switching” vaping and condemning those who call for outright quitting. It has even propagated the speculation that the “arrival” and “antibacterial” properties of a vape ingredient could be beneficial to curb COVID-19 transmission.
The tobacco industry has taken the opportunity to market its stocks, ensure continuous availability of its products despite the lockdowns, encourage stocking up on vaping supplies/novel tobacco products, and even provide discounts for the same.
The tobacco industry has also reportedly approached policy makers in low and middle income countries to offer so-called “donations”, while at the same time, seeking favours to ensure continuous delivery of its products during the lockdown.
The COVID-19 crisis presents an opportunity to encourage the world’s smokers to quit smoking outright, the tobacco industry is taking the opportunity to counter this by camouflaging the links between tobacco and COVID-19, and promoting vaping products or heated tobacco, even when there is no evidence that these products are safe in the context of transmitting or acquiring COVID-19.
While governments can seize the opportunity to save more lives than COVID-19 can take, the tobacco industry is poised to undermine government’s credibility and ability to do so by “partnering with” or “donating to” them in the guise of so-called “corporate social responsibility”, and shifting public attention towards the use of vaping products and heated tobacco.
Smokers are more vulnerable to influenza as well as to the coronavirus that causes the Middle East Respiratory Syndrome. Once infected with COVID-19, smokers are likely to suffer more serious conditions that could lead to premature deaths.
The disease progression of smokers with COVID-19 demonstrates what the adverse effects of smoking look like when there is no latency period. This makes the harm from smoking more real, and makes the urgency to quit more imminent. Quarantine and lockdown regulations instill an environment that fosters health and safety, leaving less room for harmful practices such as smoking. There is widespread concern over the under-capacity of healthcare systems and personnel to address COVID-19. This provides further motivation to maintain healthy practices, especially to those who are concerned that treatment of smoking-related or smoking-aggravated diseases puts undue strain on healthcare systems.
Therefore, a growing number of governments and healthcare experts see the COVID-19 crisis as an opportunity to encourage more than one billion smokers in the world to quit smoking outright, to reduce the eight million deaths annually.
COVID-19 also highlights the affliction caused by tobacco products to society, and provides a sharp contrast to tobacco companies’ claims of being “partners in development.” But the tobacco industry, despite its claims of having “transformed and committed to make smokers quit, “downplays the role of smoking in COVID-19, questions those calling for outright quitting of smoking. It paves the way to promote the use of novel tobacco and nicotine products such as vaping devices. Tobacco industry’s messages to investors reveal the industry strategy to further grow alternative addictive products to offset investment declines.
In conclusion, the tobacco industry uses “public relations” activities such as “partnerships” and “donations” to enhance its corporate image to enable itself to better market its addictive products including in a manner that attracts children.The COVID-19 pandemic magnifies the liability of the tobacco industry in inducing smokers to use its addictive products. The science linking the health harms, including respiratory damage, to tobacco products is robust. But the tobacco industry has yet to be made accountable for the global scourge. Based on either consumer/product liability laws, or equity and justice provisions in laws that exist in many countries, tobacco manufacturers can be made accountable for harm suffered and deaths caused by its products and or its behaviour.
WHO-FCTC Article 19 encourages Parties to strengthen legal and court procedures to facilitate lawsuits against the tobacco industry while establishing mechanisms for international cooperation. NATA Chairman Dr. Samadhi Rajapaksa suggested that governments must take the opportunity to exhaust means to recover healthcare costs of tobacco-related harms from large tobacco manufacturers, as cases filed in Canada, Nigeria, South Korea and United States. Governments must explore other means to make them accountable, including that of imposing taxes and surcharge to compensate victims and governments for the massive harm caused.