Nicotine and Covid-19: the world needs Sweden’s help

Widespread use of snus puts Sweden in a unique position to help the world better understand the relationship between nicotine and Covid-19 argues Mark Oates of the New Nicotine Alliance (NNA) in a Snusforumet guest column. He calls for releasing more data on the nicotine use of Sweden’s coronavirus patients.

Unbeknown to most Swedes and particularly the Swedish Government, Sweden is much admired among tobacco harm reduction advocates around the world thanks to Swedish-style snus and nicotine pouches.

These low-risk products are much less harmful than cigarettes. Their widespread use in Sweden has resulted in one of the lowest tobacco-related mortality rates in Europe – despite tobacco usage rates on par with many other countries in the EU.

READ MORE: Learn about the Swedish Experience with tobacco harm reduction

And with the coronavirus pandemic raging, Sweden has yet another opportunity to inspire and enlighten the world. But I’m not talking about Sweden’s much talked about strategy for combating the virus.

A coronavirus – nicotine connection?

Rather, Sweden’s potential to add to its already impressive record on public health relates to an emerging body of research suggesting there may be a link between smoking and a reduced likelihood of dying from Covid-19.

Researchers are not yet sure about the apparent connection. Is it smoking itself or nicotine?

Greek Cardiologist and tobacco harm reduction specialist Konstantinos Farsalinos has a hypothesis that nicotine acts in an anti-inflammatory manner that lowers the severity of the Covid-19. His theory comes following an examination of 13 Chinese studies that found the prevalence of smoking among Covid-19 patients averaged only 6.5 percent, compared to a smoking prevalence of 26.6 percent for the overall population.

The illness can cause the body’s immune system to react by targeting the infection in the lungs. This causes them to become inflamed, resulting in respiratory problems and an inability to get oxygen into the bloodstream. Nicotine, Farsalinos and other researchers theorize, may be able to lessen these inflammatory effects. 

Clinical trials with nicotine in France

Preliminary data from France and the United States lend support to the hypothesis. A sample of 343 Covid-19 patients from a Paris hospital found only 5.3 percent were daily smokers, well below the country’s 25.4 percent smoking rate.

Data from the US Centers for Disease Control (CDC) show that, out of 7,162 reported Covid-19 cases, only 1.3 percent were smokers, compared to an overall smoking rate in the US of 13.8 percent. And a New York City hospital study of 4,103 Covid-19 cases found that current “tobacco users” represented about 5.2 percent of patients requiring hospitalization, while 13 percent of New Yorkers smoke.

Researchers in France have already announced plans to launch a clinical trial using nicotine patches to test nicotine’s potential for preventing infection or alter the progress of the disease. 

In Sweden, snus has long been the nicotine delivery-device of choice. Unlike other countries, Sweden has a large number of nicotine users that do not ingest it via smoking and combustion. With such a large sample size of non-smoking nicotine users, Sweden is in a unique position to add to the growing body of research regarding nicotine and its potential effects on the coronavirus.

Thus, it is vitally important that Sweden start accurately reporting and providing data on the nicotine use habits of patients who have become ill with Covid-19. Were they smokers, snus users, vapers, or had never consumed nicotine?

Wanted: Sweden’s nicotine and Covid-19 patient data

Data from Sweden will undoubtedly help researchers better understand whether or not it is the nicotine itself, the method of delivery, or some other ingredient in tobacco that has led to reduced coronavirus hospitalizations among smokers in several countries.

And with the pandemic showing no signs of letting up anytime soon, the time to act is now. Speed is vital so we can better understand what impact, if any, nicotine can have on the severity of Covid-19. Eventually, this data could help save many lives from this dreadful virus.

Sweden has already saved thousands of lives thanks to Swedish snus giving people a safer alternative to smoking cigarettes. Let’s hope Sweden can once again seize the opportunity for snus to contribute to reducing the harm associated with Covid-19.

Come on Sweden, your time is now!

Mark Oates is a trustee with the New Nicotine Alliance, founder of the UK Snus Users Association, and a consultant at Hanway Associates.

READ MORE: Discover more about snus and the Swedish Experience