CLEVELAND, Ohio -- Smoking could definitely have an impact on whether people get the coronavirus and how fast they recover, experts say.

There’s little research on this yet, but there are some preliminary theories. A study of COVID-19 cases showed that smoking status was a factor in COVID-19 progression into pneumonia. And experts at the University of California, San Francisco, state that a potential reason that more men are dying than women of the disease in China is because more men than women smoke there.

Health professionals have long said that patients with pre-existing conditions are more vulnerable to the coronavirus, but as studies are published examining the disease, the public is learning more about what underlying health issues cause problems.

In Ohio, 50 people have tested positive for coronavirus. Ohio’s smoking rate is about 21 percent, according to the Centers for Disease Control and Prevention.

Breathing anything that’s noxious to the lungs causes inflammation, said MetroHealth Dr. Yasir Tarabichi. That inflammation changes the environment in the lungs and reduces lung capacity, making it harder to breathe.

Smoking

Tarabichi said that if smokers can quit, they should. But an anxiety-provoking situation like the coronavirus pandemic can make it more difficult.

“My sense is just looking at some of the comments that I’ve seen online, that people are getting a little nervous and knowing my patients, they’ll often start reaching for more cigarettes as a result,” he said. “Increasing your smoking burden is not going to help your lungs, immune system or the immune function in your lungs fight off an illness.”

Smoking also increases chances of lung disease, including chronic obstructive pulmonary disease, which can make respiratory symptoms coming from viral illnesses more dangerous. Former smokers may have already developed these underlying conditions.

Smokers and ex-smokers often develop a cough as part of that lung damage, which can be confusing when one of the lead symptoms of the coronavirus is a dry cough.

Dr. Abhijit Duggal, a pulmonologist with the Cleveland Clinic, said it’s a difficult situation.

“What we have to be mindful of is, are there changes that are that are new for them? Like if their cough has all of a sudden changed and is much worse than it has ever been, or if they’re having fevers associated with with that cough.”

Vaping

Figuring out how vaping could affect coronavirus risk is more complicated, because it’s newer and there’s not as much research on how it affects lungs.

Tarabichi said based off what we know thus far, it’s likely that e-cigarettes are causing damage to patients’ lungs and limiting their ability to fight illnesses. Young people are more likely to vape, which is particularly concerning.

“I’m not trying to say vaping in and of itself is a terrible thing because I know that there are patients that might use vaping to help them quit smoking, wanting to wean from cigarettes to to electronic cigarettes,” Tarabichi said. “What the community does not know is overall (whether) electronic cigarettes are worse than regular cigarettes.”

Pollution

Air pollution can also play a role in developing heart and lung conditions, as well as a dampened immune system, said Loren Wold, a professor in Ohio State University’s department of Physiology and Cell Biology.

“There are certain days in Ohio when our air quality is is the same, if not worse than China or India, which is normally known as having the worst air quality,” he said.

Poor air quality can making breathing more difficult for those with lung conditions, like chronic obstructive pulmonary disease or asthma.

Duggal said people with underlying lung conditions, who smoke or who have smoked should be particularly careful by practicing good hygiene and following recommendations for social distancing, like staying away from large groups in risk areas.