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Smoking in indoor public venues is only permitted in designated smoking rooms in UAE. Image Credit: Gulf News Archives

Abu Dhabi: With the number of COVID-19 cases on the rise, doctors have once again advised residents to avoid smoking — both at outdoor and indoor public spaces — in order to reduce the spread of the coronavirus.

While cigarette smoke hasn’t conclusively been proven to transmit the virus, experts warn that the need to lower the face mask when smoking could allow smokers who may be unknowingly infected to spread the virus. In addition, vapers who are smoking could be up to 20 per cent more likely to transmit the virus by spreading it in clouds of smoke, according to researchers in Italy, Mexico and New Zealand. Shisha or water pipe smokers, on the other hand, also face heightened risk of contracting COVID-19, especially when smoking in shisha parlours.

“Ideally, it is advisable not to smoke at all. However, if you are habitual smoker, it is time that you try out [different] ways to quit the habit, especially since it has been found that smokers infected by COVID-19 have more severe forms of the illness. Those who still wish to smoke despite all this should only smoke in designated areas, or in private places where others are not affected,” advised Dr. Ponnusamy Tamilvedan, internal medicine specialist at Medeor Hospital, Dubai.

Public venues

Smoking in indoor public venues is only permitted in designated smoking rooms. In outdoor spaces, smoking is generally permitted. But a number of new public parks and beaches now ban the practice, even though many smokers continue to disregard this across the UAE.

One Indian resident, Z.K., said she had noticed quite a few people smoking at a public park in the capital where smoking is prohibited. “Given that there are so many children playing there, and during a pandemic, people should be more courteous towards others, especially when smoking is against the law. It is inconsiderate, and what if the smokers are unknowingly transmitting the virus?” she said.

The American Nonsmokers’ Rights Foundation specifies that exposure to second-hand smoke, or passive smoking, can trigger or cause underlying health conditions like heart disease and respiratory illnesses, or weaken the immune system. These could then prompt more severe COVID-19 symptoms in those who contract the virus.

Risk to smokers

Dr Arshia Banu Najeem

And while the jury is still out on whether smoking itself can increase the risk of COVID-19 infection, doctors say smokers are putting their own health at risk. “It is strongly advised that people refrain from smoking outdoors and indoors. Current evidence suggests that the severity of COVID-19 infection is higher among smokers. Smoking reduces the lung function, making it more difficult for the body to fight off respiratory disease due to the virus,” said Dr Arshia Banu Najeem, general physician at Aster Clinic — Aswaaq Mall.

According to the World Health Organisation (WHO), “smoking is associated with increased severity of disease and death in hospitalised COVID-19 patients”. The WHO advice was based on a number of studies using data from hospitalised patients, and while these did not provide the full picture of COVID-19 risks and spread among smokers, the authority still advised against smoking.

“Given the well-established harms associated with tobacco use and second-hand smoke exposure, WHO recommends that tobacco users stop using tobacco,” it said.

Shisha smoking

Shisha smoking presents even greater risks of COVID-19 spread, specifically because of the practice of sharing pipes and implements during a smoking session. The US National Institutes of Health also highlighted how young people, who frequent shisha parlours, may contract COVID-19 from such venues.

“Smoking shisha often involves the sharing of mouth pieces and hoses, which could facilitate the transmission of the COVID-19 virus in communal and social gatherings. [These places also make] physical distancing hard,” Dr Najeem said.

These risks prompted the initial closure of parlours in the UAE in 2020, and when these establishments resumed services, authorities banned the provision of single-use equipment, including pipes and implements, as well as the sampling of flavours by customers. Still, families are known to bring along their own shisha equipment during picnics or park visits.

Avoid smoking in public

Dr Sunil Vyas

Dr Sunil Vyas, pulmonology specialist at Aster Hospital, Al Qusais strictly discouraged the practice. “If a person is smoking despite the known hazards, the place should isolated, or a designated place for smoking. Smokers should also avoid crowded places and family gatherings,” he said.

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Need for social distancing

For those looking to avoid passive smoking, the general wisdom is the same: avoid crowded places, and maintain social distancing. And if you can smell the smoke, move away because it means you are too close to any infected particles the smoker could be exhaling, including aerosolized COVID-19 droplets.