Should Smokers Be Prioritized for COVID-19 Vaccine?

Should Smokers Be Prioritized for COVID-19 Vaccine?

It’s a controversial question that has dominated headlines recently.

 As the COVID-19 vaccines continue to have limited rollout due to supply and planning issues, controversy is being sparked by new federal guidelines that recommend smokers—even those under age 65—should be put near the front of the line, ahead of essential workers like teachers.

Health officials are likely watching to see what happens in New Jersey and Mississippi, the two states that are the first to follow those recommendations. Several other states have put under-65 smokers in the next phase of vaccination as well.

Although it might make non-smokers bristle, the data behind the federal guidelines are clear: smoking increases the risk of severe illness and death from COVID-19. The next phase, called 1C, is intended for those with high-risk medical conditions who are most likely to have severe symptoms if they contract the virus. Under that definition, smokers certainly qualify.

Smokers in High-Risk Population for COVID-19

The Centers for Disease Control (CDC) frequently updates its advisories around COVID-19, including who is at increased risk for more adverse outcomes from the virus. For example, the most recent update in late December added persons with Down syndrome, sickle cell disease, and chronic kidney disease.

One group that has been on the list since the start, however, is smokers. The CDC notes that even being a former cigarette smoker can increase your risk of severe illness from COVID-19.

Smoking negatively affects every system in the body. Smokers are more likely to develop heart disease, stroke, pregnancy complications, numerous types of cancers, rheumatoid arthritis, type 2 diabetes, and other serious conditions.

Most notably for COVID-19—which is a respiratory disease—is that smoking damages airways and the small air sacs in the lungs and compromises the immune system. Smokers who contract the virus are significantly more likely to develop life-threatening symptoms compared to nonsmokers.

COVID-19 Vaccine Recommendations for Smokers

With all these health risks at play, it’s not surprising that the federal guidelines would highlight smokers for inclusion in phase 1C of the vaccine rollout, as recommended by the CDC’s Advisory Committee on Immunization Practices.

Ultimately, though, it is up to each state whether to prioritize this population ahead of other groups. It’s possible that despite pushback, many will take the stance of New Jersey Governor Phil Murphy, who defended the decision at a recent press conference.

“I understand the optics here, and that attacking folks who took up the habit of smoking and are now addicted may be politically expedient,” he said. “But at this time, we are stuck in a position where we have to prioritize limited federally distributed vaccine doses based on medical fact and not on political want. We need to save lives. And we need to protect our hospitals, by the way, from a patient surge.”

Unnecessary Controversy

Vaccination controversy aside, one major takeaway from this debate is the understanding about how smoking and other tobacco use isn’t a bad habitit’s an addiction with deadly health risk. That’s always been true, and it always will be, even after COVID-19 is defeated.

With that in mind, this is an opportune time to evaluate new solutions that provide positive, long-term support and results to this at-risk population.

Check out our program page to learn about our evidence-based resources that can help your population quit for good—and reap the benefits of living tobacco-free now and in the future.

Jessie Saul, Ph.D.

Director, Strategic Insights

Dr. Jessie Saul brings 19 years of experience in research, program evaluation, and strategic implementation around tobacco cessation. She applies this deep understanding to improve EX Program performance and reduce tobacco use among populations. She earned her Ph.D. in Science and Technology Studies from Cornell University.

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