Smoking Risks in Pregnancy and for COVID-19

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If ever there is a time to quit smoking, it’s prior to and after you become pregnant, and the same is true of the COVID-19 pandemic. The reasons for not smoking were already overwhelming prior to the pandemic and now there is one more big reason never to take up smoking and, for those who do smoke, to do everything possible to quit. We’ll go through a discussion about risks, but since you may be eager to know the answer to the question that beckons –is smoking even more likely to kill you in the COVID-19 era than it was prior to the emergence of this pandemic disease? The answer is a resounding YES. That is because if you do become infected with SARS-CoV-2 (the virus that causes COVID-19), then smoking increases the risk that you will be among the minority of SARS-CoV-2 infections that develops to acute respiratory distress syndrome, severe disturbances in blood clotting, or other complications with other organ systems that can lead to death.

It’s no joke. If you’re a woman of child-bearing age –a young to middle age adult–and if you have no major health conditions such as high blood pressure, asthma, or uncontrolled diabetes, then looking at the 80 year old man across the street, normally you can feel confident that your risk of serious illness from a SARS-CoV-2 infection would be very low compared to his. But if you smoke, this shifts you into the age group of an elderly person.

Several studies have revealed that smokers, and also vapers, of nicotine products and cannabis products have a substantially higher risk of developing severe complications of COVID-19 compared with nonsmokers who match them in terms of age and other risk factors. This includes even occasional marijuana use. One recently study by researchers in the UK found that smokers are more likely to suffer, not only the types of COVID-19 complications that require admission to an intensive care unit, often with mechanical ventilation, but also gastrointestinal problems and a range of other COVID-19 complications.

Smoking increases the risk that you will be among the minority of SARS-CoV-2 infections that develops to acute respiratory distress syndrome, severe disturbances in blood clotting, or other complications with other organ systems that can lead to death.

With this perspective in mind, let’s review the dangers of smoking during pregnancy. Starting with the maternal risks, smoking has a negative impact on your fertility, making it more difficult to get pregnant in the first place. Smoking also exposes you to carbon monoxide, which attaches to your hemoglobin within red blood cells, preventing oxygen from being able to do the same. Furthermore, in cells other than red blood cells, carbon monoxide disrupts the function of your mitochondria (the powerplant organelles that use oxygen to draw energy from molecules), in the process creating entities called reactive oxygen species that harm cells and DNA. Tobacco smoke also contains dozens of known carcinogens (cancer causing agents). Furthermore, any breathing difficulty that smoking causes you is compounded as your womb grows, making it more difficult than usual for your diaphragm to move up and down.

As for the risk to the developing baby, smoking by the mother can damage the lungs and brain and can cause birth defects, including cleft lip. Smoking also seriously increases the risk of spontaneous abortion (miscarriage) as well as preterm labor and delivery and low birth weight, all of which are associated with physical and cognitive problems during childhood. Both maternal smoking during pregnancy and exposure of a newborn to second hand smoke from a smoking parent seriously increase the risk of sudden infant death syndrome (SIDS). In fact, newborns of smoking mothers are three times more likely than newborns of non-smokers to die of SIDS. Overall, children of mothers who smoke during or after pregnancy have weaker lungs, and thus, a higher risk for a range of diseases compared with other children.

As for the take-home message of all of this, it’s very simple: DON’T SMOKE, and if you do smoke, there is no better time than now to make all efforts to quit and get medical treatments if needed. While you’re at it, keep a skeptical ear to any earthy-crunchy friends of yours who may subtly encourage pot smoking during pregnancy, or as a protective measure against COVID-19 by claiming that marijuana is natural, or by citing studies in which cancer cells died after being cultured in a medium containing cannabis extract in a laboratory setting. It’s very easy to kill cancer cells in the laboratory with a high enough concentration of anything in vitro. It’s much more difficult to destroy cancer cells in the body of someone who has cancer, while protecting the surrounding healthy tissue. Remember what we said earlier about even occasional cannabis use increasing the risk of severe complications from COVID-19. On top of that, studies have associated cannabis use with spontaneous abortion, birth defects, and other undesirable pregnancy outcomes.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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