Fewer smokers are quitting because of COVID-19. Figures from the University of California, San Francisco’s Smoking Cessation Leadership Center showed that calls to smoking hotlines, also called “quit lines,” dropped 27% in 2020 compared to the previous year.

According to Fast Company, this marks the lowest point in hotline calls to 1-800-QUIT-NOW since 2007 and the pattern of reduction reflects the rise in COVID-19 cases across America. Linda Bailey, the president and CEO at North American Quitline Consortium, says that while sales of cigarettes have dropped 4% to 5% annually since 2015, this year they are up by 1 %.

“Stress and anxiety that resulted from the pandemic may be factors driving up the use of tobacco,” she said. “If people continue working at home, home is a place where if you want to smoke, you can smoke.”

Experts add that health officials have been concentrating on sending precautionary messages about social distancing, wearing masks, and other COVID-19 related warnings so stop smoking missives have dwindled or fell by the wayside.

People who lost their jobs during the pandemic may have also lost access to smoking cessation programs offered by their employers, according to Fast Company.

“Quitting has never been more important,” stated Anne DiGiulio, national director of Lung Health Policy at the American Lung Association. Experts add that even former smokers are now lighting up again.

“Under stress, people return to old patterns,” Daniel Seidman, Ph.D., author of Smoke-Free in 30 Says: The Pain-free, Permanent Way to Quit, told Fast Company, adding that individuals forget that smoking is an addiction and having “just one” can trigger a relapse. The expert says that the pandemic has caused such unhappiness in many Americans that their priorities have changed.

“They are in denial that you are either in or out,” he tells Fast Company. “There’s no middle ground with addiction.”

Studies have shown that smoking increases the chances of COVID-19 complications.

One recent study found that one in three young adults may be at risk for severe COVID-19 complications, and smoking is a major contributor to that risk. Researchers from the University of California, San Francisco, studied more than 8,000 participants between the ages of 18 and 25 and found that 32% of the total study population was medically vulnerable to severe illness with COVID-19. They published their findings in the Journal of Adolescent Health.

But, according to CNN, that percentage dropped dramatically to only 16% when those who smoked either cigarettes or e-cigarettes were factored out of the analysis, thus dropping medical vulnerability in that age group by half.

“Recent evidence indicates that smoking is associated with a higher likelihood of COVID-19 progression, including increased illness severity, ICU admission, or death,” Sally Adams, lead author of the study, said in a press release. “Smoking may have significant effects in young adults, who typically have low rates for most chronic diseases.”

The New York Times reported that Dr. Jonathan Winickoff, director of pediatric research at the Tobacco Research and Treatment Center at Massachusetts General Hospital warned that smoking and vaping can exacerbate the symptoms of COVID-19 and urged smokers to stop. He said that bringing cigarettes or other devices to your mouth can increase the risk of infection. He added that smokers often cough more often. “That’s a recipe for increased spread,” he told the Times.

Studies have demonstrated that smoking weakens the immune system as well as damages lung function. While research on vaping is limited, some studies suggest it causes inflammation in the lungs.