Correlation Between Adult Tobacco Smoking Prevalence and Mortality of Coronavirus Disease-19 Across The World

Background and aimCoronavirus 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. MethodsThis 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. ResultsSeventy-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). ConclusionsA 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.