Sir, the fatality rate of COVID-19 with no pre-existing comorbidity is on average 0.9% while tobacco kills millions of healthy individuals worldwide.1 The failure of substance abusers to quit is explained by their addictive and euphoric action. Strict lockdown measures and supply of only essential services have dampened the sale of tobacco and its products. Socialising promotes substance abuse, whereas self-isolation and family bonding time may provide support linked to smokers attempting to quit, achieve abstinence and overcome withdrawal.2 Internet-based cognitive behaviour may minimise loneliness and the inclination towards substance abuse.3An additional consideration is that smokeless tobacco users constantly spit their saliva that can harbour viral strains 29 days' post infection.4
Perhaps there is a silver lining with nature providing the possibility of substance 'disuse' during actions to stem this unprecedented crisis.
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Hubbard G, Gorely T, Ozakinci G, Polson R, Forbat L. A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking. BMC Fam Pract 2016; 17: 73.
Käll A, Jägholm S, Hesser H et al. Internet-based cognitive behavior therapy for loneliness: a pilot randomized controlled trial. Behav Ther 2020; 51: 54-68.
Barzon L, Pacenti M, Berto A et al. Isolation of infectious Zika virus from saliva and prolonged viral RNA shedding in a traveller returning from the Dominican Republic to Italy, January 2016. Eurosurveillance 2016; 21: 30159.
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Shetty, S., Jayaraj, R., Merchant, Y. et al. Substance 'disuse' during crisis. Br Dent J 228, 734–735 (2020). https://doi.org/10.1038/s41415-020-1699-z
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DOI: https://doi.org/10.1038/s41415-020-1699-z
