Tobacco use and a coronavirus infection can be a deadly combination. A health expert, however, warned that smoking alone is more lethal than the virus.

Cevdet Erdöl, the rector of Health Sciences University, said the number of people who died of COVID-19 in one year in the country was around 28,000, while the number of those who died of diseases linked to smoking is around 120,000. Erdöl said this number also includes 20,000 people who died of diseases linked to secondhand smoke.

"Smoking and the coronavirus are dangerous on their own. When they are combined, their damage is devastating. It is expected that the coronavirus will be more damaging for smokers," he told Anadolu Agency (AA) on Sunday.

Turkey last year had introduced an outdoor smoking ban amid concerns that people removing their masks to smoke may lead to new infections. Experts repeatedly call on smokers to quit the habit as it worsens coronavirus damage to lungs already battered by the impact of smoking. Erdöl said smoking itself is a "pandemic" and needs an all-out ban.

"Smoking is the primary cause of cardiovascular diseases and cancers, mainly lung cancer. It damages the lungs and veins. Similarly, COVID-19 leads to clots inside veins and causes damage to lungs," Erdöl said.

He also warned about hookah use, especially the usage of the same hookah by different smokers. "Hookah is equal to smoking five packs of cigarettes. When shared, it provides a fertile ground for COVID-19 and other infectious diseases to spread. Unfortunately, it is very popular among the youth," he said.

A study involving 1,500 coronavirus patients held between March and July 2020 by the Turkish Thoracic Society points out that active smokers face a threefold higher risk of death when compared to nonsmokers.

Former smokers who have quit still face higher risks from COVID-19 than people who have never smoked, according to another study. Researchers at the Cleveland Clinic Health System in Ohio and Florida studied 7,102 COVID-19 patients, including 6,020 who had never smoked, 910 former smokers and 172 current smokers. The risk of hospitalization and death went up with patients who had ever smoked and the increases in risk were similar for current smokers, the researchers found. Those who had smoked the most – the equivalent of a pack a day for 30 years, or two packs a day for at least 15 years – had 2.25 times higher odds of hospitalization and were 89% more likely to die following a COVID-19 diagnosis when compared with people who had never smoked, the researchers reported in the medical journal JAMA Internal Medicine.

A lifetime history of tobacco use is therefore linked with the risk of hospital admission and death from COVID-19, the research team concluded, adding that illnesses typically linked with smoking, like heart and lung diseases, probably contributed to those poorer outcomes.