France is once again the source of a new hype over a potential therapy for COVID-19: nicotine.
Paris rushed to restrict the sale of nicotine products over the past weekend, banning their sale online, to avoid shortages of products such as nicotine gum and patches.
It wasnt any sudden onset of smokers remorse that prompted the scramble, but news that French scientists were looking to start a clinical trial administering nicotine patches as a potential protective medicine to battle the coronavirus.
That announcement followed a study in a Paris hospital suggesting cigarette smokers are less likely to be hospitalized with COVID-19.
The country has already seen fanfare over another controversial would-be coronavirus cure, when Marseille based doctor Didier Raoult put forward the use of anti-malarial drug chloroquine, without adequate scientific evidence and despite serious potential side effects.
If nicotine in cigarettes indeed protects smokers, it would overturn the common-sense assumptions about an activity linked to worsening lung function.
Unlike with chloroquine, theres no indication so far that scientific interest over nicotine has generated a rush to French pharmacies — despite the governments preemptive move — nor has it prompted the sort of social media fueled hype that made Raoult a celebrity.
Yet the news risks once again blurring carefully crafted messages from health authorities.
The World Health Organization in its own informational materials has said that smokers are “likely to be more vulnerable to COVID-19.”
The health authority argues that the movement associated with smoking makes infections more likely because of increased contact between lips and fingers. Furthermore, smokers may already be suffering from lung diseases, which increase the risk of hospitalization.
A strange cure
If nicotine in cigarettes indeed protects smokers, it would overturn the common-sense assumptions about an activity linked to worsening lung function, given that the severe cases of the virus are associated with respiratory failure.
Those principles have guided the broader global response, as countries around the world have restricted the use of tobacco products since the viral outbreak.
India, for example has clamped down on chewing tobacco for fear that it could propagate the disease, while numerous states across the Middle East have stopped cafes and shops from serving water pipes to customers. South Africa went as far as banning cigarette sales altogether, though it has since relaxed the restriction.
Vinayak Prasad, the program manager leading the WHOs Tobacco Free Initiative, said the organization isnt discounting the French study. A panel of experts will look at the data alongside other evidence and put out an official communication shortly, he noted.
But for the time being, he said, the WHO stands by its message: The risk of COVID-19 and the severity of an eventual infection are likely to be higher when smoking.
“We have sufficient information from previous epidemics like SARS and others,” Prasad explained. “We have seen that these are viruses that are targeting the lungs.”
“Its a no brainer that the severity of infection would be higher among long standing smokers, especially if they have comorbidities,” he added, referring to other associated medical conditions.
The Paris study
The origin of the nicotine trial proposal lies in a study of coronavirus patients in the hospital Pitié-Salpêtrière in Paris.
Researchers observed a significantly lower-than-expected number of smokers being treated in the French hospital when compared with the smoking rate among the general French population. In a subsequent paper, they theorized that a link exists between nicotine and a protective effect from the virus.
The evidence is by no means unanimous, however. For one, the study has not yet been peer reviewed. Meanwhile, other scientific literature has taken the opposite conclusion.
The origin of the nicotine trial proposal lies in a study of coronavirus patients in the hospital Pitié-Salpêtrière in Paris | Mohammed Badra/EPA-EFE
A meta-analysis of 12 different papers, in fact, found a significant association between smoking and progression of COVID-19, with smokers more at risk of the disease getting worse than non-smokers.
Ivan Berlin, a physician and associate professor of clinical pharmacology at the Pitié-Salpêtrière hospital, the same one where the French study was conducted, was unsparing in his criticism.
“This paper has no level of evidence — its not even a low evidence,” Berlin said.
The professor noted that the French study looked only at current smokers and non-smokers. That means the sample might exclude recent quitters who had been smoking until recently.
Furthermore, the study compared COVID-19 positive patients to the general population from a 2018 survey. Thats a problem, says Berlin, because the data isnt up to date. Furthermore, the general population sample didnt accurately reflect the patient group, which was sicker and had more comorbidities than the general population.
Filippos Filippidis, a senior lecturer in public health at Imperial College London and expert member of the European Respiratory Societys Tobacco Control Committee, agreed that not knowing the smoking history Read More – Source
France is once again the source of a new hype over a potential therapy for COVID-19: nicotine.
Paris rushed to restrict the sale of nicotine products over the past weekend, banning their sale online, to avoid shortages of products such as nicotine gum and patches.
It wasnt any sudden onset of smokers remorse that prompted the scramble, but news that French scientists were looking to start a clinical trial administering nicotine patches as a potential protective medicine to battle the coronavirus.
That announcement followed a study in a Paris hospital suggesting cigarette smokers are less likely to be hospitalized with COVID-19.
The country has already seen fanfare over another controversial would-be coronavirus cure, when Marseille based doctor Didier Raoult put forward the use of anti-malarial drug chloroquine, without adequate scientific evidence and despite serious potential side effects.
If nicotine in cigarettes indeed protects smokers, it would overturn the common-sense assumptions about an activity linked to worsening lung function.
Unlike with chloroquine, theres no indication so far that scientific interest over nicotine has generated a rush to French pharmacies — despite the governments preemptive move — nor has it prompted the sort of social media fueled hype that made Raoult a celebrity.
Yet the news risks once again blurring carefully crafted messages from health authorities.
The World Health Organization in its own informational materials has said that smokers are “likely to be more vulnerable to COVID-19.”
The health authority argues that the movement associated with smoking makes infections more likely because of increased contact between lips and fingers. Furthermore, smokers may already be suffering from lung diseases, which increase the risk of hospitalization.
A strange cure
If nicotine in cigarettes indeed protects smokers, it would overturn the common-sense assumptions about an activity linked to worsening lung function, given that the severe cases of the virus are associated with respiratory failure.
Those principles have guided the broader global response, as countries around the world have restricted the use of tobacco products since the viral outbreak.
India, for example has clamped down on chewing tobacco for fear that it could propagate the disease, while numerous states across the Middle East have stopped cafes and shops from serving water pipes to customers. South Africa went as far as banning cigarette sales altogether, though it has since relaxed the restriction.
Vinayak Prasad, the program manager leading the WHOs Tobacco Free Initiative, said the organization isnt discounting the French study. A panel of experts will look at the data alongside other evidence and put out an official communication shortly, he noted.
But for the time being, he said, the WHO stands by its message: The risk of COVID-19 and the severity of an eventual infection are likely to be higher when smoking.
“We have sufficient information from previous epidemics like SARS and others,” Prasad explained. “We have seen that these are viruses that are targeting the lungs.”
“Its a no brainer that the severity of infection would be higher among long standing smokers, especially if they have comorbidities,” he added, referring to other associated medical conditions.
The Paris study
The origin of the nicotine trial proposal lies in a study of coronavirus patients in the hospital Pitié-Salpêtrière in Paris.
Researchers observed a significantly lower-than-expected number of smokers being treated in the French hospital when compared with the smoking rate among the general French population. In a subsequent paper, they theorized that a link exists between nicotine and a protective effect from the virus.
The evidence is by no means unanimous, however. For one, the study has not yet been peer reviewed. Meanwhile, other scientific literature has taken the opposite conclusion.
The origin of the nicotine trial proposal lies in a study of coronavirus patients in the hospital Pitié-Salpêtrière in Paris | Mohammed Badra/EPA-EFE
A meta-analysis of 12 different papers, in fact, found a significant association between smoking and progression of COVID-19, with smokers more at risk of the disease getting worse than non-smokers.
Ivan Berlin, a physician and associate professor of clinical pharmacology at the Pitié-Salpêtrière hospital, the same one where the French study was conducted, was unsparing in his criticism.
“This paper has no level of evidence — its not even a low evidence,” Berlin said.
The professor noted that the French study looked only at current smokers and non-smokers. That means the sample might exclude recent quitters who had been smoking until recently.
Furthermore, the study compared COVID-19 positive patients to the general population from a 2018 survey. Thats a problem, says Berlin, because the data isnt up to date. Furthermore, the general population sample didnt accurately reflect the patient group, which was sicker and had more comorbidities than the general population.
Filippos Filippidis, a senior lecturer in public health at Imperial College London and expert member of the European Respiratory Societys Tobacco Control Committee, agreed that not knowing the smoking history Read More – Source
