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Risks of Vaping, Smoking and Other Substance Use During Coronavirus

Updated: Mar 29

Paying Attention to Your Child’s Well-Being In navigating these uncertain times, parents are in unchartered waters. A silver lining is that

with shelter-in-place, parents can keep a closer eye on their children. In particular, pay attention to any signs that your child is having a difficult time and give them coping skills for stress and anxiety. Anxiety and depression are strongly linked to substance use. Among the steps listed in the  Grown and Flown article that parents can take to help their children deal with the stresses and disruptions to their normal routine are:

  • Let your child feel what they are feeling. Validate their feelings and assure them they are normal. Talk about it, provide empathy and "name it". 

  • Be honest about how you are feeling.  Don't gloss over your feelings. This can be the perfect opportunity to begin moving into an adult to adult relationship with your teen. 

  • Look for positives once they've had time to come down from their extreme disappointment. Help them develop growth-mindset skills by searching for reasons to be optimistic. With every crisis comes creative solutions. 

  • Show your kids that times may be tough, but you and they are as well. Finding some inner peace and laughter is something to work into our day schedules.

See our blog for more tips from Dr. Lisa Damour's on managing stress and anxiety during the pandemic.


Signs of Use or Withdrawal. Pay attention to signs of use when your children come home from the outdoors.  Additionally, being unable to smoke or vape cannabis or tobacco can because behavioral and physical issues. Signs of cannabis withdrawal,

which can peak within three days, include difficulty sleeping, severe mood swings, inability to handle stress, headaches, blurred vision, nausea and even flu-like symptoms. Signs of nicotine withdrawal are similar and include difficulty sleeping, anger, irritability, restlessness, hunger or weight gain and difficulty concentrating.  And of course, withdrawal from other drugs can result in worse physical symptoms. 


If you notice such behavior, now is the time to express your concern, have those difficult conversations and perhaps seek professional help. For those who feel professional help is warranted, know that the rules around "telehealth" for doctors have been loosened by states.  This means that psychiatrists, psychologists and addiction experts, among others, can take care of people online. You also may use BTI as a resource and email us here. All information will be treated confidentially. 

Risks of Substance Use during Coronavirus Outbreak

The US National Institute of Drug Abuse (NIDA) advised the research community on March 20, 2020 that COVID-19 could hit these populations with substance use disorders particularly hard:

  • People who smoke or vape tobacco and/or marijuana. Vaping and smoking impairs lung function and the immune system. COVID-19 is a respiratory disease which attacks the lung. It can lead to respiratory failure, pneumonia and in the worst cases, death. Because of the respiratory aspects of the disease, those who vape and smoke could potentially face a serious threat if they contract COVID-19. Co-occurring conditions like chronic obstructive

pulmonary disease (COPD), cardiovascular disease and other respiratory diseases have been found to worsen the prognosis in patients with  previously identified coronaviruses such as SARS and MERS. According to a case series published in the Journal of the American Medical Association (JAMA) based on data from the Chinese Center for Disease Control and Prevention (China CDC), the case fatality rate for COVID-19 was 6.3% for those with chronic respiratory disease, compared to 2.3% overall. In China, 52.9% of men smoke versus just 2.4% of women and it may well be this is causing the higher mortality observed in men compared to women (as reported by the China CDC). Similarly, as the Italy death toll  exceeds China’s, it should be noted that in addition to Italy having an older population, more than 21% of Italians are smokers. Additionally, smoking is known to impair the immune system; evidence is emerging that vaping does so as well. A comprehensive study of the dangers of marijuana smoke by the Hazard Branch of the California Environmental Protection Agency

concluded in part that there is evidence that marijuana smoke is immunosuppressive. The study states that "studies of THC and other cannabinoids provide evidence of alterations of multiple cell signaling pathways, in endocrine function, and suppression of the innate and adaptive immune response. Prolonged exposures to marijuana smoke in animals and humans cause proliferative and inflammatory lesions in the lung."


Another study published in the January 2014 Journal of Clinical Pharmacology, entitled Respiratory and Immunologic Consequences of Marijuana Smoking, concludes "one of the most serious findings in marijuana research was the effect on various immune functions. Both cellular and pulmonary immunity are impaired as well as the ability to fight certain infections and fatal diseases. This occurs in all forms of consumption".

The authors go on to say that, "habitual smoking of marijuana has a number of effects on the respiratory and immune systems ...", including "alterations in lung function, increased prevalence of acute and chronic bronchitis and striking endoscopic findings of airway injury."

Like smoking, vaping may also harm lung health. Whether it can lead to COPD is still unknown, but emerging evidence suggests that exposure to aerosols from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection. In one NIH-supported study, for instance, influenza virus-infected mice exposed to these aerosols had enhanced tissue damage and inflammation. Source: NIDA.


  • People with disorders related to opioids use.  Due to the effect of opioids and methamphetamine on respiratory and pulmonary health, those who use these drugs may be more vulnerable to COVID-19.

Opioids act in the brainstem to slow breathing and may even inhibit the brain’s signal to take a breath, puting the user at risk of life-threatening or fatal overdose. It may also cause a harmful decrease of oxygen in the blood (hypoxemia). Lack of oxygen can be especially damaging to the brain. Chronic respiratory disease is already known to increase overdose mortality risk among people taking opioids. Diminished lung capacity from COVID-19 could similarly endanger opioid abusers. We have had several recent deaths of youth in our community due to opioids (either laced with Fentanyl or combined with alcohol and other drugs), so while the numbers of our students who use are relatively low compared to those who use alcohol and cannabis, opioid use by youth is not uncommon in our area.


  • People who use methamphetamine. Similarly, methamphetamine constricts the blood vessels, and contributes to pulmonary damage and pulmonary hypertension in people who use it. “We know very little right now about COVID-19 and even less about its intersection with substance use disorders,” the NIDA advisory states. “But we can make educated guesses based on past experience that people with compromised health due to smoking or vaping and people with opioid, methamphetamine, cannabis, and other substance use disorders could find themselves at increased risk of COVID-19 and its more serious complications”.

Source:  COVID-19: Potential Implications for Individuals with Substance Use Disorders.


The bottom line? Use this time at home to pay close attention to your child, looking for signs of how they are doing emotionally, and whether are using drugs or are exhibiting any withdrawal symptoms from non-use. In particular, be sure to discuss with your child the risks under COVID-19 of vaping and smoking tobacco or cannabis, both of which are very common with our area teens.


Now is a good time to encourage your child to quit. If you need referrals to local resources to do so, contact BTI's Founder and Executive Director, Laurie Dubin here or at administrator@betheinfluence.us. All inquiries will be treated as confidential.

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