Working for eight hours with a face mask on appears to be less favorable for smokers than for non-smokers.

Due to the corona pandemic, people worldwide have spent quite a few hours wearing a mask over the past few years. Does that entail additional risks for smokers? That decided cardiologist Ignatios Ikonomidis from the University of Athens and colleagues. Their conclusion: after a shift with a mask, smokers exhale considerably more carbon monoxide than without a mask. Their blood vessels also seem to work less well.

Regular and ‘smoke-free’ cigarettes

The study by Ikonomidis and his team involved 120 employees of a teaching hospital: 40 non-smokers and 80 smokers. Half of those smokers smoked regular cigarettes, half ‘smoke-free’ cigarettes (whereby the tobacco is heated, but not burned).

All participants were measured for a month at various times during the day how much carbon monoxide they exhaled: just after sleeping, after an eight-hour shift in the hospital with a mask, and after eight hours without a mask. The researchers also took measurements that gave a picture of the quality of the participants’ blood vessels.

Breathe in again

After eight hours with a mask on, ‘normal’ smokers seem to exhale twice as much carbon monoxide than after eight hours without. For smokers of smoke-free cigarettes, the difference was even a factor of four, but the amount of exhaled carbon monoxide was much smaller. For non-smokers, wearing a face mask made no difference to the (small) amount of carbon monoxide they exhaled.

A similar trend was seen in the blood vessels. The measured values ​​remained more or less the same in the non-smokers, while in the smokers they rose faster after eight hours with a mouth cap than after eight hours without. This may be because they re-breath carbon dioxide or vapors containing nicotine through the mask, Ikonomis and colleagues write.

A salient detail is also that the smokers smoked at least as many cigarettes during their shift with a face mask as during the period in which they did not wear a face mask.

More cardiovascular diseases?

Now, of course, it only concerns one study, with a not huge number of participants, who all worked in the same place. To be more sure of the result, you might want to look at larger numbers of people scattered around the world.

In addition, the Greek study only a month. That is why follow-up research would be necessary to find out whether the smoking participants actually had more problems with cardiovascular diseases.

‘Stop smoking’

According to pulmonologist Wanda de Kanter considering these limitations, it is a well-conducted study. Leon van der Toorn, lung specialist at Erasmus MC and chairman of the Dutch Association of Physicians for Pulmonary Diseases and Tuberculosisagrees.

In addition, both pulmonologists indicate that, as far as they are concerned, the advice following this examination should be: stop smoking. “And therefore not: ‘Smokers are no longer allowed to wear mouth caps’”, says De Kanter.