Contradictory Messages on Smoking and COVID-19

We received three different submissions pertaining to the effects of smoking on COVID-19. One study suggests that those who smoke have a reduced likelihood of hospitalization. The comingling of separate data for male and female patients and analysis based on that data seems unusual to me. The second report is not restricted to hospitalizations, but only to those who tested positive for the virus. Their results also suggested a lessened number of self-identified smokers than smoking rates in the general public would suggest. The third and final story submission introduced vaping to the discussion, and comes to the opposite conclusion in suggesting that smoking or vaping may increase the risk of contracting COVID-19.

Confounding these analyses is that all reports of smoking are self-reported. I can well imagine if someone had tried to quit smoking, and had convinced their spouse they had indeed stayed stopped, they would be reluctant to reveal in their spouse's presence that they were a smoker. If anything, though, would that not run counter to the possibility of a protective effect? As with most things pertaining to the virus, it is likely too early to tell for certain, but it does add another dimension to the discussion. Assuming that smoking does have a preventative effect, what could be the cause? Increased residue in the lungs makes it harder for the virus to latch onto the lung's cells and infect? Could it be that chemicals in the smoke serve to impair the virus's ability to survive in the lungs and cause an infection?

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