By Chris Caraveo
Twitter: @ChrisCaraveo31

People know COVID-19 can travel through respiratory droplets breathed out by an infected person.

But what about infected people who smoke? Does the smoke they breathe out pose a risk to the people around them?

It’s a possibility, according to the World Health Organization.

“The disease spreads primarily from person to person through small droplets from the nose or mouth, which are expelled when a person with COVID-19 coughs, sneezes, or speaks,” WHO stated in an email to the Daily Independent. “Therefore, exhaling cigarette smoke could potentially also spread COVID-19. WHO has advocated for years for smoke-free environments.”

Officials with the Arizona Department of Health Services are still looking into the effects smoking has on spread of the virus.

“While those who smoke are at a greater risk of developing severe illness if they contract COVID-19, ADHS does not have additional information regarding the impact that smoking has on the spread of COVID-19,” stated Holly Poynter, spokeswoman for the AZDHS. “Individuals interested in quitting tobacco should contact the Arizona Smokers’ Helpline (ASHLine) for free quit coaching services and other resources.”

Second-hand smoke without a virus is bad on its own. But the thought of possibly breathing in carcinogenic and virus-laden smoke is a double whammy for those trying to stay healthy from both issues.

“Per the Smoke-Free Arizona Act, smoking is not allowed in most enclosed areas and places of employment including restaurants and bars,” Ms. Poynter stated. “Sovereign tribal nations are exempt from this law and have authority over their own policies.”

Because COVID-19 is widespread across Arizona, AZDHS always encourages Arizonans to take everyday preventive measures in all places. This includes wearing a cloth face covering, staying home if individuals are sick, washing hands frequently with soap and water for at least 20 seconds, staying at least 6 feet away from individuals who do not live in the same household, avoiding touching your eyes, nose and mouth, and covering coughs or sneezes with a tissue and immediately throwing the tissue away.

Ever since Gov. Doug Ducey’s stay-at-home order ended in May, several businesses have resumed operations. Among them are casinos, most of which are on tribal land. However, while places like gyms, bars and movie theaters remain closed indefinitely, casinos continue to welcome visitors while adhering to social distancing guidelines.

With smoking a health concern when it comes to COVID-19, the Daily Independent asked several casinos in the Phoenix area about their smoking policies.

Over at Gila River Hotels & Casinos, officials decided to ban smoking on the gaming floor after numerous conversations with trusted health professionals, team members and the community. They have also continued to follow guidance from the Centers for Disease Control and Prevention and the Arizona Department of Health Services.

“We believe this was the responsible and prudent action to take. Again, we arrived at this conclusion and made the decision to ban smoking with feedback from guests and team members, as well as extensive input from health care professionals who we are working with on a daily basis,” officials said in a statement to the Daily Independent. “We understand that this choice has the potential to significantly reduce our revenues; however, our decisions are made in collaboration with community and experts involved. We do not take lightly our responsibility to keep guests and team members in the safest environment possible, even if that means losing much needed revenues in this instance.”

Still, patrons are allowed to smoke in designated areas to include Vee Quiva’s VQ Live outdoor patio and Lone Butte’s The Courtyard, which are outdoor areas. Chrome at Wild Horse Pass is an indoor, highly ventilated night club area, but an outdoor option also exists.

Overall, guests have been understanding of the non-smoking policy and have been utilizing the designated smoking areas, according to the statement. However, officials say they have had some customers expressing their unwillingness to visit due to the smoking ban.

“We respect their right to do so,” according to the statement. “However, we have weighed all information available, along with input from health clinicians, community leaders, and our team members which lead us to the determination that a smoking ban is currently the best approach to keep individuals healthy, even if our revenues are negatively impacted for the time being.”

Officials with the Tohono O’odham Nation — which owns and operates the Desert Diamond Casinos — and the Salt River Pima-Maricopa Indian Community — which owns and operates Casino Arizona and Talking Stick Resort — have been emailed for comment.

However, smoking is prohibited inside Casino Arizona and Talking Stick Resort until further notice, according to safety measures posted on their websites. Designated outside smoking areas are available for guest use.

A trip to Desert Diamond West Valley near Loop 101 and Northern Avenue entails having fewer gaming options, Plexiglas between slot machines, and having to wear masks except when eating, drinking and smoking. But while smoking is allowed, vaping is not, according to an FAQ.

It’s not only in Arizona where casinos are limiting smoking. Casinos in Las Vegas, Nevada and Atlantic City, New Jersey have updated policies to limit the practice, which causes people to remove the protective face masks that they’re required to wear inside.

The effects of smoking in conjunction with COVID-19 comes as a report from QuoteWizard finds that hospitalizations among young adults have seen a nearly 300% increase from April to June. Recent studies have found smoking to be a primary risk factor among younger adults for serious illness from COVID-19. Arizona was found to have a 14.4% rate of smokers, ranking it at 39 out of 50 states.

Smokers are among the highest risk groups of people for serious COVID-19 illness. Research has found that 1 in 3 young adults face severe illness from COVID-19, and the higher prevalence of smoking compared to other health conditions among young adults presents the highest risk factor for serious illness from COVID-19.

The CDC doesn’t appear to have any guidance on smoking except when it comes to psychiatric centers. According to the CDC’s FAQ on COVID-19, a higher proportion of psychiatric patients smoke cigarettes compared to the general population. Patients might congregate in outdoor smoking spaces without practicing appropriate social distancing, the FAQ states.

Potential solutions recommended, per the CDC, include limiting the number of patients allowed to access smoking spaces at the same time, and positioning staff to observe and ensure patients are practicing appropriate physical distancing.

With most state and local entities building their own guidelines around the CDC’s, it could be up to individual businesses to take charge in that regard.

Emails to the CDC have not been returned.

However, the CDC does say that being a current or former cigarette smoker may increase risk of severe illness from COVID-19.

Actions to take include quitting if you currently smoke. If you used to smoke, don’t start again. And if you’ve never smoked, don’t start. The CDC says counseling from a healthcare provider and Food and Drug Administration-approved medications can double the chances of quitting smoking.

For help quitting smoking, call 1-800-QUIT-NOW or visit www.smokefree.gov. You can also call your healthcare provider if you have concerns or feel sick. If you don’t have a healthcare provider, contact your nearest community health center or health department.

WHO also urges people to quit tobacco, especially since smoking puts people at higher risk for severe case of COVID-19. Smoking impairs lung function, making it harder for the body to fight off coronaviruses and other diseases, WHO states.

As health services are overwhelmed during COVID-19, WHO launched a digital health worker that can help the world’s 1.3 billion tobacco users quit during COVID-19. Florence dispels myths around COVID-19 and tobacco, and helps people develop a personalized plan to quit. Florence is available 24/7 via video stream or text to help people access reliable information. Visit https://who-en.digitalhero.cloud.

The WHO Framework Convention on Tobacco Control — the global tobacco control treaty — requires all indoor public places to be 100% smoke-free. Officials say this is because exposure to second-hand smoke kills and there is no safe level of exposure.