COVID-19 in Smokeless Tobacco Habitués: Increased Susceptibility and Transmission

Ridhima B Gaunkar,Karla M Carvalho,Praveen S Jodalli,Kennedy Mascarenhas,Aradhana Nagarsekar

doi:10.7759/cureus.8824

Abstract

As the coronavirus disease (COVID-19) pandemic continues to sweep across the globe, the world is responding by implementing public awareness campaigns, social distancing measures, and other preventive strategies to arrest the spread of this lethal disease. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exacts a heavy toll on patients with existing comorbidities. Smokeless tobacco (SLT) consumption is of particular concern in countries in South Asia with high population densities, as it facilitates exposure to SARS-CoV-2 within or between communities by the act of public spitting. Salivary droplets generated in this act are a potential threat because they can transmit this airborne infection. Moreover, large gatherings at tobacco retail outlets, frequent hand-to-mouth contact, and sharing of apparatus by SLT habitués could also aid in increasing the spread of SARS-CoV-2. SLT-induced higher expression of angiotensin-converting enzyme 2 receptors along with the presence of furin in the oral mucosa and dysfunctional immune responses among SLT habitués increase viral dissemination and an individual’s susceptibility to COVID-19. Issuing rigorous regulations to restrict the use of various forms of SLT products and the obnoxious act of spitting in public can assist in arresting the spread of COVID-19. Widespread education campaigns enlightening the community regarding the adverse effects of SLT consumption and its relationship with COVID-19, along with providing effective assistance to quit for those who are addicted, would decrease the spread of COVID-19.

Highlights

BackgroundThe coronavirus disease (COVID-19) pandemic continues to sweep across the globe, with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infecting over five million people and killing over a quarter million worldwide to date
We explore the possibility of increased susceptibility and infectivity of Smokeless tobacco (SLT) habitués to COVID-19
This review reveals that SLT addiction is likely to worsen the progression and prognosis of COVID-19

Summary

Introduction

The coronavirus disease (COVID-19) pandemic continues to sweep across the globe, with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infecting over five million people and killing over a quarter million worldwide to date. The known action of the enzyme furin and the nicotine-induced increased expression of the ACE2 receptor result in COVID-19 viral tropism to the oral mucosal tissues in smokeless tobacco habitués [11,12,13,14,15,16,17,18,19]. There should be increased public awareness through increased social media usage during this pandemic to effectively wean habitués away from their usual triggers to consume tobacco In countries such as India, it is a public health challenge to teach SLT habitués to frequently wash their hands with soap and water or alcohol-based hand sanitizer (approved by the Centers for Disease Control and Prevention) to ensure optimal hand hygiene and reduce the risk of community transmission of COVID-19 [1]. It is imperative to prioritize research aimed at exploring the potential association of SLT use with COVID-19 to develop evidence-based policy options

Conclusions

Disclosures

10. Maginnis MS

Findings

34. Desai V