On February 22, 2021, the United States paused to honor the tragic milestone of 500,000 COVID-19 deaths, just one year and 16 days after the first fatality was recorded in California. The peak of 5,427 new US deaths reported on Feb 12, 2021 exceeded the 4,414 Allied deaths at Normandy on D-Day. Over the 3 years and 8 months of US involvement in World War II, 407,316 US military servicemen and women were killed. The 407,000th US COVID-19 death came after just 11 months, as COVID-19 claimed American lives at a rate nearly 4 times faster than World War II.
However, there is one cause of preventable US death that surpassed the death rate of COVID-19. An estimated 480,000 Americans die annually from tobacco use, including more than 41,000 deaths from secondhand smoke exposure.
We have never shut down the economy, closed our schools, or sheltered in place to protect the public from the health hazards of Big Tobacco.
A commonly witnessed sight during the pandemic is a smoker pulling their mask aside during a cigarette break outdoors. A more extreme example of nicotine addiction is a smoker who picks up a discarded cigarette butt from the street, and places it into their mouth. This particularly high-risk activity disregards the warnings to not touch one’s face or mouth, not to share items with others who might have Covid, and to avoid contact with items on the ground where the virus falls after someone has sneezed or coughed.
Worldwide, tobacco use causes more than 7 million deaths per year, whereas the death toll from Covid-19 only crossed 3 million as of mid-April 2021.
Most studies have demonstrated that smoking is linked to transmission and developing symptoms of COVID-19, and leads to worse outcomes, including intubation and death.
It is for this reason that some states chose to vaccinate current smokers ahead of schoolteachers and others, perhaps create a perverse incentive for non-smokers to begin smoking.
An early silver lining from the pandemic is that up to 300,000 UK smokers may have quit smoking due to COVID-19 fears.
Unfortunately, the decades long decline in US cigarette sales ended in 2020, in part due to the anxiety and stress induced in smokers by the pandemic.
A major setback worldwide in the fight against Covid-19 may have resulted from the early and premature conclusions in spring 2020 based upon incomplete data suggesting nicotine and smoking protect one from acquiring COVID-19.
Researchers in China and France amplified this incorrect belief about a potential benefit from smoking, which led to a temporary shortage of nicotine patches in France as non-smokers rushed to try this ineffective strategy to prevent Covid transmission. The World Health Organization invested in educational programs to debunk this myth. The original researchers in Paris who perpetuated this misinformation have not published any prospective clinical data to support their theory, and likely should now issue a retraction, as has been done with a similarly confusing article.
Tough action was taken against the vaping industry during the pandemic in the aftermath of the E-cigarette or vaping product use-associated lung injury (EVALI) epidemic that hospitalized thousands across America in 2019.
Similar pro-active action against Big Tobacco now could help curb both the US COVID-19 mortality and the annual death toll from smoking, which are interlinked.
The Biden Administration should now follow the lead of other nations and also 1) finalize the long-awaited graphic warning levels on cigarette packs, and 2) ban menthol flavored e-cigarettes, as has been done in California.
Earlier actions undertaken in other countries years before may have helped reduce their national COVID mortality. Valuable lessons were learned from South Africa’s ban on the sale of all tobacco and vaping products between March and August 2020.
We turned the country upside down to fight COVID-19. If just half of our assets and energy were focused on simultaneously reducing smoking’s deadly toll, maybe we can also finally end Big Tobacco’s societal harm and reach the Tobacco Endgame.
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