Smoking and coronavirus: current data 'inconclusive' says CEBM
Friday, May 1, 2020 at 14:33 H/T Rob Lyons for bringing this to my attention.
The Centre for Evidence-Based Medicine in Oxford has updated its six-week-old article 'Smoking in acute respiratory infections' in order to 'capture emerging data on smoking and Covid-19'.
In truth it doesn't add much to what we already know but that in itself is quite significant.
Back in March, when the authors first addressed the issue, it was intuitive and not unreasonable to state that 'Smoking is a known risk factor for acute respiratory infections in general' and to warn that smokers might be at greater risk from a coronavirus.
The former is still true but the implication that smokers might be at greater risk from Covid-19 is proving harder to justify.
As you know, multiple studies have now been published that suggest that smokers may actually be protected from Covid-19.
Some of them may be flawed but the comment made by health secretary Matt Hancock on March 16 in response to a question by Bob Blackman MP, chairman of the All Party Parliamentary Group on Smoking and Health, is looking unnecessarily alarmist.
According to Hancock, "It is abundantly clear that smoking makes the impact of a coronavirus worse."
Just over a fortnight later, on April 3, Public Health England went even further. Smokers, said PHE, are not only at greater risk of severe respiratory disease from Covid-19, 'Emerging evidence from China shows smokers with Covid-19 are '14 times more likely to develop severe respiratory disease.'
Incredibly, despite all the evidence that has emerged since, that over-hyped 'story' remains PHE's only public contribution to the discussion about smoking and coronavirus.
Martin Dockrell, formerly of ASH and now the tobacco control programme lead for PHE, might as well be the Invisible Man.
This latest review – which is written on behalf of the Oxford Covid-19 Evidence Service Team, the Centre for Evidence-Based Medicine and Cochrane Tobacco Addiction Group, the Nuffield Department of Primary Care Health Sciences and the University of Oxford – takes care to reaffirm that 'Smoking is considered a risk factor for all respiratory infections' (including, one presumes, a coronavirus) but however hard the authors try they cannot escape the evidence, or the lack of it.
Q: 'If you quit smoking during an acute Covid-19 is your outcome better?'
A: 'There is no data on this relating to Covid-19.'
Q: 'Will quitting smoking now help reduce risks from Covid-19?'
A: 'There is no direct evidence with which to answer this question.'
They conclude:
'Smoking is a known risk factor for acute respiratory infections more generally.'
Yes, we know that. Anything else?
'Smoking is a known risk factor for a range of comorbidities, many of which are associated with worse Covid-19 outcomes.'
Yes, yes, but where is the EVIDENCE that Covid-19 patients are at greater risk of hospitalisation or critical illness if they smoke?
'More research is urgently needed into the role of smoking in Covid-19. Current data is inconclusive.'
Compare that with the comments of Matt Hancock and Public Health England quoted above and subsequently repeated ad nauseum by ASH and other anti-smoking activists.
In short, if the underlying message of this updated article isn't a massive rebuke to the Secretary of State for Health, Public Health England and every anti-smoking campaigner who jumped on the 'Quit for Covid' bandwagon, I don't know what is.
The authors will probably deny it but decide for yourself.
Reader Comments (2)
All we ask for is honesty during this crisis - not politics from anti smoker activists, with exclusive access to Government, dripping poison in the health secretary's ear.
The Economist is now reporting this story at "Smokers seem less likely than non-smokers to fall ill with covid-19" https://www.economist.com/science-and-technology/2020/05/02/smokers-seem-less-likely-than-non-smokers-to-fall-ill-with-covid-19 Predictably many of the comments at the @TheEconomist are skeptical of the findings if not hostile toward smokers. Another consequence off tobacco control's systematic persecution of smokers.