How many cigarettes do you need to have smoked to qualify for an early vaccine? It’s an oddly specific number

smoking cigarettes covid vaccine
Photo via Revival Vape/Flickr (CC BY 2.0)

Vaccine rollouts are now approaching phase 1C in many parts of the U.S. This group includes people between the ages of 65-74, high-risk individuals between the ages of 16-64, and some essential workers. And although state and local guidelines vary, the Centers for Disease Control and Prevention lists smokers among the most high-risk individuals. Now, if you spent only a short amount of time in your life smoking cigarettes, you might get an early COVID vaccine in North Carolina. 

The recommendation came after a study published by JAMA Internal Medicine in January 2021 found that people who currently smoke or who have smoked in the past are more likely to experience severe illness from COVID-19—including hospitalization and death—than non-smokers.

However, there has been some confusion about what constitutes a smoker. North Carolina, in particular, raised eyebrows after listing criteria as those who have smoked “at least 100 cigarettes in their lifetime.” The state recently announced that residents included in the Group 4 subset of high-risk medical conditions would be eligible for the vaccine starting March 24.

The announcement has been met with no shortage of skepticism, as many people criticized the oddly specific number of cigarettes that one would need to have smoked to get bumped up in line for the COVID vaccine. After all, developing a smoking habit for a couple of months in college and never picking up a pack of cigarettes again would still qualify you to receive an early COVID vaccine, according to the North Carolina Department of Health and Human Services.

As it turns out, the answer is relatively simple and based strictly on CDC guidelines.

The National Center for Health Statistics glossary cites a current smoker as “an adult who has smoked 100 cigarettes in his or her lifetime and who currently smokes cigarettes.” This includes smokers further categorized as “every day” or “somedays” smokers.

Likewise, a former smoker constitutes an adult who has smoked at least 100 cigarettes in their lifetime but has since quit smoking, and a “never smoker” is “an adult who has never smoked or who has smoked less than 100 cigarettes in their lifetime.”

In addition to lung damage, smokers are also more likely to experience other high-risk medical conditions, such as high blood pressure, coronary artery disease, and chronic obstructive pulmonary disease. At this point, though, it doesn’t appear that smoking would interfere with the vaccine once it’s put into a person’s body.

“The finding that smoking is associated with increased risk of poor outcome from COVID-19 is not surprising,” Dr. Joe Zein, a pulmonologist at the Cleveland Clinic who co-authored the JAMA study, said in an interview with USA Today. “Smoking induces structural changes in the respiratory tract and compromises people’s ability to mount appropriate immune and inflammatory responses (against infections).”

Even, apparently, if you’ve smoked only 100 ever.

Read more on the coronavirus vaccines:

Sources: CDC, NCDHHS, USA Today

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