When exposed to smoke, it is easier tobecome infected from the novel coronavirus
⼀Michiyuki Matsuzaki, Director, Japan Society for Tobacco Control

PM2.5
1.

PM2.5 exposure increases significantly from smoking

2.

Increased PM2.5 exposure increases the expression ofACE2 receptors

3.

An increase in PM2.5 exposure by 1㎍/㎥ increases
mortality from the novel coronavirus by 8%

PM2.5 from smoking

Exposure to particulate matter (ex., PM2.5) raises therisk of infection from the novel coronavirus

Tung NT（International PhD Program in Medicine, Taipei Medical University, Taipei,Taiwan; Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, VietNam）, Cheng PC, Chi KH, et al. Particulate matter and SARS-CoV-2: A possible modelof COVID-19 transmission [published online ahead of print, 2020 Aug 5]. Sci Total
Environ. 2020;750:141532. doi:10.1016/j.scitotenv.2020.141532

Reasons why PM2.5 raises the risk of infection from the novelcoronavirus• The ACE2 receptor is the point where the novel coronavirus
can penetrate cells• Increased expression of respiratory ACE2 receptors fromexposure to PM2.5 and other particulate matter has been
confirmed in animal and human alveolar cell experiments• Epidemiological studies have confirmed that PM2.5 exposure
increases mortality risk from the novel coronavirus

average PM2.5 level

Mortality rates fromthe novel coronavirus
Wu and others, medRxiv. 2020;2020.04.05.20054502

Mortality risk from the novel coronavirus(the lowest air pollution level in area Q1 is normalized to 1)

ＰＭ2.5

Wu X and others medRxiv [Preprint]. 2020 Apr7:2020.04.05.20054502

An increase in PM2.5 exposure by 1μg/m3 increases themortality risk from the novel coronavirus by 8%
The relationship between PM2.5 exposure (2000-2016 average level) and themortality rate from the novel coronavirus in 3000 counties in the United States
was examined, and the mortality rate was shown to increase 8% for every 1㎍/m3
increase in PM2.5 exposure (95% confidence interval 2%-15%) after controlling for
20 variables including population, age distribution, population density, number ofdays since an outbreak, number of days since an announcement of a stay athome order, number of hospital beds, number of PCR tests, weather, obesity rate
and the tobacco smoking rate.
Wu X, Nethery RC, Sabath BM, Braun D, Dominici F. Exposure to air pollution and COVID-19 mortality in
the United States: A nationwide cross-sectional study. Preprint. medRxiv. 2020;2020.04.05.20054502.
Published 2020 Apr 7. doi:10.1101/2020.04.05.20054502

PM2.5 exposure increases by about 10 ㎍/m3 to 100 ㎍/m3 from indoor passive
smoking (so that a 10㎍/m3 increase in exposure increases mortality rate by 80%)
It is therefore imperative to quit smoking and to eliminate exposure passivesmoking indoors protect against infection from the novel coronavirus
Wu X and others medRxiv [Preprint]. 2020 Apr7:2020.04.05.20054502

Conclusion: let’s quit smoking tobacco

PM2.5
1.

PM2.5 exposure increases significantly from smoking

2.

Active smoking creates PM2.5 exposure of 20,000㎍/m3

3.

Increased PM2.5 increases ACE2 receptor expression

4.

As PM2.5 exposure increases by 1㎍/m3, the mortality ratefrom infection of the novel coronavirus increases by 8%

5.

The same relationship applies to passive smoking, andindoor passive smoking creates PM2.5 exposure of about 10㎍/m3 to 100 ㎍/m3