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New WHF Policy Brief: Navigating the crossroads of tobacco use, cardiovascular disease and the COVID-19 pandemic

29 Jan 2024

The unprecedented crisis of the COVID-19 pandemic continues to have significant and lasting impact on society. Even today, COVID-19 continues to pose a serious health threat that can lead to severe complications and deaths. In particular, people living with cardiovascular disease are more susceptible to severe COVID-19 illness and experience worse outcomes due to its inherent effect on the heart.

Tobacco, a major risk factor for cardiovascular disease, is responsible for over 8 million deaths annually. Its role as a key determinant of COVID-19 severity was largely neglected in the early stages of the pandemic, however, a myriad of studies has confirmed that tobacco use is strongly associated with increased risks of severe COVID-19 illness, complications, and mortality rates. For example, one study of COVID-19 patients in China showed that 12.4% of current smokers and 23.8% of former smokers experienced severe outcomes, including admission to intensive care units, ventilator use, or death. In general terms and with COVID-19, there is a need to better document tobacco use in clinical records to understand the extent of its impacts on population health and on prognosis in a health crisis.

Tobacco and COVID-19 each affects multiple organs beyond the respiratory system, critically impacting the outcomes of many health conditions and disproportionately burdening individuals living with comorbidities.  The triple threats of tobacco, cardiovascular disease, and COVID-19 therefore constitute a dangerous combination,” said Regina Dalmau, Lead Author of the Policy Brief. “Our paper seeks to clarify the complex interplays between tobacco, cardiovascular disease, and COVID-19, all while highlighting the critical role of effective tobacco control in the context of the pandemic.

The pandemic has also had indirect repercussions on tobacco consumption and cardiovascular health. Social distancing measures and lockdowns have led to disruption of cardiovascular disease management and tobacco cessation services, and fostered unhealthy lifestyles, while also causing psychological distress or exacerbating disorders.

Unfortunately, even in the midst of the pandemic, the tobacco industry persisted with its activities to undermine tobacco control, prioritizing profits over human lives. Indeed, the industry intensified efforts to promote its products by spreading misinformation and interfering with pandemic-related policies through government lobbying. This issue highlights the need to enact or strengthen policies that prevent tobacco industry interference in health and regulatory science. It is also crucial that healthcare professionals and researchers consistently collect data on tobacco use and cessation as timely and robust data can help counteract misinformation and save lives.

The global community needs to draw from the expensive lessons learned from the COVID-19 pandemic to better prepare for future health emergencies. It is critical that both noncommunicable disease prevention and tobacco control remain central in pandemic preparedness and response strategies. In fact, a robust tobacco control response could have helped alleviate the burden of the crisis.

The World Heart Federation urges all governments and stakeholders to accelerate the implementation of measures outlined in the WHO Framework Convention on Tobacco Control, in particular:

  • Article 5.3 to address tobacco industry interference in health and regulatory sciences;
  • Article 6 to reduce the affordability of tobacco products and generate revenue for pandemic recovery efforts;
  • Article 8 to protect the population from second-hand smoke exposure and prevent potential viral transmission; and
  • Article 14 to ensure availability, accessibility, and affordability of tobacco cessation services at all times.

Finally, we encourage all countries to maintain the tobacco control measures adopted during the pandemic in order to safeguard the progress.