As coronavirus causes respiratory illness, smoking and vaping could worsen symptoms associated with COVID-19.

Following the initial E-cigarette or Vaping product use Associated Lung Injury (EVALI) outbreak, which caused severe and possibly fatal lung infections in otherwise healthy individuals, vaping sales and use momentarily dropped. Predominantly connected to THC vaping products purchased on the black market, EVALI caused a spike in Google searches for “quit vaping” as vapers tried to reduce their chances of contracting the illness.

A similar pattern is likely to emerge in response to the coronavirus, according to Bill de Blasio. The New York City Mayor held a press conference Sunday announcing that smoking and vaping increases potential risk for coronavirus. COVID-19 attacks the lungs and causes shortness of breath, coughing, and fever in patients.

“If you are a smoker or a vaper, that does make you more vulnerable,” de Blasio said. “If you are a smoker or a vaper this is a very good time to stop that habit and we will help you.”

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During the press conference, de Blasio added that those with compromised immune systems and diabetes are more at risk. This is especially true for anyone over the age of 50 with pre-existing conditions like heart or lung disease.

Though de Blasio didn’t make a distinction between consuming marijuana or tobacco, or between smoking or vaping, research does indicate some differences.

A study published in the American Journal of Preventive Medicine at the end of last year reported those who smoked cigarettes and vaped nicotine simultaneously were 3.3 times as likely to develop a respiratory illness when compared to nonsmokers. Those who only smoked cigarettes were 2.5 times more at risk while those exclusively vaping 1.3 times to experience lung complications.

In addition, researchers found vaporizers did not help cigarette smokers from quitting. The study, which collected data from participants over a three-year-period, showed that 91.2% of vapers still smoked traditional tobacco products like cigarettes by the end of the trial period.

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“Although switching from combustible tobacco, including cigarettes, to e-cigarettes theoretically could reduce the risk of developing respiratory disease, current evidence indicates a high prevalence of dual use, which is associated with increased risk beyond combustible tobacco use,” the study’s authors wrote.

“In addition, for most smokers, using an e-cigarette is associated with lower odds of successfully quitting smoking.”