COVID-19, caused by a coronavirus, was first reported in Wuhan, Hubei province in China, on 31 December 2019. Since then the virus started to spread all over the world at an alarming rate. On 11 March  2020, the World Health Organization (WHO) upgraded the status of the COVID-19 outbreak from epidemic to pandemic. Reportedly, COVID-19 spread is the first pandemic to be caused by a coronavirus.[1][2][3][4]

COVID19 is not an equal-opportunity killer: Being elderly, being and having other illnesses greatly increase the risk of dying from the virus. The smokers appear to have a higher risk of experiencing serious complications including death. Any type of tobacco smoking is harmful to the whole body especially to the cardiovascular and respiratory systems, and so does the COVID-19.[5]

The coronavirus that causes COVID-19, known as SARS-CoV-2, is from the same family as MERS-CoV and SARS-CoV, both of which have been associated with either acute or chronic cardiovascular damages. According to the publicly available cell biology reports COVID-19 virus normally plug into the ACE2 receptors on the surface of the cells to inject its genetic material into the cells, in order to replicate and spread. Preliminary research suggests that lungs exposed to cigarette smoke have a higher possibility in accumulating abnormally large numbers of ACE2 receptors, which could potentially make the organ vulnerable to damage by the coronavirus. [6][7]

With information from China, where COVID-19 originated, World Health Organization(WHO) has reported that people who have cardiovascular and respiratory conditions caused by tobacco use are at higher risk of developing severe COVID-19 symptoms. Reportedly in one study, the percentage admitted to the Intensive Care Unit (ICU) was 12.3% among current smokers, and among non-smokers it was 4.7%.[8]

Quitting tobacco use is especially important at this time to potentially reduce the harm caused by COVID-19.Quitting tobacco will also reduce the chances of touching the mouth and nose with the fingers. Previous outbreaks of infections caused by viruses from the same coronavirus family such as MERS-Cov and SARS-CoV have evidenced that smoking has adverse effects on the survival of individuals. Those outbreaks also suggest that tobacco smoking could, directly or indirectly, contribute to an increased risk of infection.  [9]

Although there have not been many studies investigating the relationship between smoking and COVID-19, the available evidence suggests that smoking suppresses immune functions of the  human hosts.

Given all these findings, many requests have been made to effect a temporary ban in tobacco all around the world.[10][11][12][13][14]

Furthermore in Sri Lanka various governmental and nongovernmental groups had requested the president of Sri Lanka to take necessary actions to prevent public from smoking not only during the coronavirus pandemic but even after that.[15][16]