TORONTO -- With COVID-19 cases soaring, health care officials are trying to get ahead of the worst by looking at who is most at risk of ending up in the ICU and on ventilators if they catch the virus.

High on that list is smokers.

There are already so many reasons not to smoke: increased risk of heart disease, stroke and cancer.

But now, scientists are warning smokers that they should quit before COVID-19 attacks their lungs.

“Given how dangerous this disease is and how fast everything's moving, all of the evidence that we're seeing is pointing in the direction that both smoking (could) increase your risk of contracting disease and, if you get it, make it worse,” said Stanton Glantz, Director of the Centre for Tobacco Research Control and Education.

Early research is showing that among people with severe pneumonia due to COVID-19 in China, 12 per cent of current smokers were admitted to an ICU, required ventilators, or died, compared to less than 5 per cent of non-smokers.

Dr. Neal Patel, a critical care specialist and pulmonologist with the Mayo Clinic says cigarette smoke damages tissues in the lungs.

“It destroys the cilia in the lungs … as well as in the nasal pharynx,” Patel said. He explained that “the cilia are tiny hairlike follicles that help to trap damaged viruses, debris, and move that debris upwards, out of your lungs so it doesn't stay there and cause issues.”

This cilia “acts as one of the main defence systems against infection,” he said.

Public Health Wales put out a press release last week urging smokers to think of their weakened lung defences and quit smoking.

The press release said that hundreds of smokers had contacted help lines seeking advice onhow to quit since the novel coronavirus outbreak began.

“We know that COVID-19 is mainly a respiratory disease and research on similar viruses shows tobacco smoke increases the risks of this type of infection, and how serious it can be,” said Ashley Gould, a public health consultant with Public Health Wales, in the press release.

The Cochrane Library, a collection of online databases that contain research and information about health care, put out a special article as part of a series on COVID-19 that compiled information about the risks of smoking and strategies aimed at helping smokers quit — a task that they acknowledge is enormous for many.

Researchers are also finding that smoking increases the number of lung cells that have receptors which draw in the novel coronavirus.

The World Health Organization has also urged smokers to quit in order to stay healthy in the fight against COVID-19. Even those who smoke sparingly are still bringing their hands to their mouths more often than others — defying one of WHO’s main recommendations against touching your face.

Already, many are taking action. Oscar-winning actress Patricia Arquette tweeted in mid-March that “as COVID-19 attacks the lungs one of the most important things you can do is to quit smoking and vaping. I’m in day 3. Care to join?”