Correlation between adult tobacco smoking prevalence and mortality of Coronavirus Disease-19 across the world

  1. Nadya Magfira
  2. Helda

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Abstract

Background and aim

Coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide. Limited studies showed that smokers were at higher risk of having severe complications and higher mortality. This study aims to analyze the possible correlation between adult tobacco smoking prevalence and COVID-19 mortality all over the world.

Methods

This is a correlation study, we conducted a linear regression to analyse the correlation between smoking prevalence data in adults and COVID-19 Case Fatality Ratio (CFR) in countries with 1000 confirmed COVID-19 cases on May 3, 2020.

Results

Seventy-five country included with median CFR 3.66%. There are no relationships between adult male or female smoking prevalence with COVID-19 mortality in all over the countries. The multivariate analysis showed p-values of 0.823 and 0.910 for male and female smoking prevalence respectively. However, in lower-middle-income countries (LMIC), there is a positive correlation between the prevalence of adult male smoking with the lethality of COVID-19. Each percentage point increase in adult male smoking prevalence caused a CFR of COVID-19 increase by 0.08% (95% CI 0.00%-0.15%, p=0.041).

Conclusions

A correlation was found between the prevalence of adult male smoking and the CFR of COVID-19 in lower middle-income countries. Based on these findings, strengthening tobacco control policies is needed to reduce the impact of the COVID-19 pandemic especially in LMIC. Further researches are still needed.

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  1. ScreenIT

    SciScore for 10.1101/2020.12.01.20241596: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has some potential limitation to be discussed, first, we received the data of COVID-19 from situation reports by WHO, the number of deaths and cases might not always reflect the exact situation since there are differences in how different Governments across countries identifying infected cases. Second, in our report, we performed sub-analysis by categorizing countries according to their GNI per capita. However, there are still many factors that can influence the lethality of COVID-19 in which we do not control. Thus, including prevalence of other related comorbidities such as chronic kidney disease, heart disease, stroke, respiratory disease, malignancy and autoimmune conditions. We also did not include weather parameters situation of each countries which may contribute to COVID-19 CFR.15 In bivariate analysis, we found a significant negative correlation between prevalence of adult male smoking and CFR of COVID-19 in all over the world also in sub-analysis UMIC and HIC groups. However, after adjusting with other variables there are no significant correlations found. Some studies reported active smokers are under represented among COVID-19 patients and there is also a study that show protective effect of smoking in COVID-19 mortality.16,17 Those studies lead to widespread claim that smoking maybe protective against COVID-19.17 However, knowing that early in pandemic there was a race to publish, this is likely resulted in aberrant and non-standardized data collection ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.12.01.20241596v1 on medRxiv