The Long-COVID Syndrome: smoking and enhanced suicide risk

The QJM has been at the forefront in highlighting the mental health problems associated with COVID-19 infection in society.^1–6 In a Commentary piece in this issue of the Journal, Leo Sher, Professor of Psychiatry from the Mount Sinai School of Medicine, highlights the role of smoking being associated with a worse prognosis in acute infections and enhancing the risk of suicide in patients suffering persistent disabling symptoms associated with the Long-COVID Syndrome.

It is well recognized that smoking is associated with suicidal ideation, suicide attempts, suicide death and a contributing factor in the pathophysiology of suicide. The author highlights the evidence that suggests that the COVID-19 pandemic has led to increased tobacco consumption as smokers use more tobacco to cope with pandemic-related stress, anxiety, depression and loneliness. Smoking will have significant psychobiological effects resulting in enhanced impulsivity and aggression which will be compounded by in particular the brain-related symptoms of Long-COVID Syndrome resulting in a significantly enhanced suicide risk for individuals. Consequently, he argues that smoking prevention and cessation strategies should be a key pillar in public health suicide prevention interventions during and after the COVID-19 pandemic.

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