It’s dumb that smoking can get you a COVID vaccine in NC. But don’t turn it down.

Théoden Janes
·6 min read

The text came from a friend, a fellow former smoker, just after 3 p.m. on Tuesday:

“Take a look at this,” he wrote. “If you have smoked 100 cigarettes, at any time, you’re in Group 4. Looks like you can get vaccinated on March 24.”

He also included a link to the N.C. Department of Health and Human Services’ COVID-19 Response website, which, of course at that point, was click-bait. I had to see if it was for real.

On the page, I scrolled through the list of high-risk medical conditions that will qualify North Carolinians for vaccinations as part of Group 4. Gov. Roy Cooper had just announced Tuesday afternoon that people in this group will be eligible for the COVID-19 vaccine starting March 24.

The list, which mirrors a list from the federal Centers for Disease Control and Prevention, includes major health issues like cancer, cystic fibrosis, dementia and pregnancy. Then there was this line at the very bottom: “Smoking (current or former, defined as having smoked at least 100 cigarettes in their lifetime).”

It had a bit of an air of a joke to it, almost as if someone with the keys to the website had added this at the end in a draft they’d created for a co-worker-friend’s eyes only. A goof that had gotten inadvertently published and then not been noticed.

I texted a healthcare professional who I know well, and she clearly had the same feeling about it, because she responded:

“LOL!! That makes zero sense. If you’re a current smoker or recently quit, OK. But ever? Nope.”

“A dumb rule,” she called it.

My secret life as a smoker

Speaking of dumb ... a little about me.

I used to go out of my way to try to hide the fact that I was a smoker.

I remember living in northern New Jersey and making the three-hour drive to visit my parents in eastern Connecticut, and smoking cigarettes for the first half of the drive but then driving with my windows down and knocking it off for the second half. Because I thought doing that and spraying a bunch of Febreze right before turning into their driveway would make my Volkswagen not smell like the inside of a bowling alley circa 1970.

Seriously. (Yes, even in my early 30s, I was dumb.)

A few years later I quit, became a runner, started doing marathons (also dumb, I know). While I’d talk about being my smoking past if I had to, it’s not really something I wore on my sleeve.

Former Navy SEAL? Wow. Former professional athlete? Awesome. Former “Jeopardy” contestant? Very cool. (For the record, I am none of those things.)

Former smoker, though? I mean, sure, by and large, you might get judged more harshly if you admitted you did a lot of heroin in college. But it’s still probably up there with, say, copping to a dozen speeding tickets or once being $20,000 in credit card debt.

In other words, admitting you were a smoker might feel like you’re revealing a weakness or a flaw. It’s just not something you brag about.

Then came Tuesday’s announcement that individuals who have smoked 100 cigarettes in their lifetime — not 97, not 98, not 99, but 100 — would be eligible to get vaccinated along with individuals who have had a stroke, or suffer from cardiomyopathy or hepatitis. That includes someone like me, who hasn’t lit one up since George W. Bush was president.

And while it’s still not something I necessarily feel like wearing on my sleeve, the announcement suddenly gave my history of smoking cigarettes a weird kind of cachet.

‘Rewarding’ unhealthy behavior?

After hearing the news from my former-smoker-friend, and laughing about it with my healthcare-professional-friend, I popped onto Twitter and searched “100 cigarettes” to find lots of snarky comments about picking this month to take up smoking — along with various comments from people incredulous that the state would “reward” unhealthy behaviors.

What I didn’t find on Twitter was any clarity on how those in charge of vaccine distribution in North Carolina would manage the whole “100 cigarettes” thing.

After all, short of having a doctor’s note stating you have a smoking-induced disease or a highlight-video-reel of you sucking on a long string of Marlboros, it’s an unprovable medical condition.

However, as some of you are no doubt aware, this isn’t actually a unique situation.

An NCDHHS spokesperson confirmed for me Wednesday morning that, yes, “individuals can self-attest to the criteria (e.g., age, job role, health status, living situation) that they qualify for eligible priority groups.”

In fact, according to the NCDHHS, North Carolina does not require a government-issued identification card to be vaccinated. “Some vaccine providers may ask for a way to confirm your identity (name, date of birth) to make sure they are vaccinating the right person,” its website says, “so it is important to bring an item with your name on it (utility bill, faith ID, passport, matrícula consular, credit union member card, etc.).”

But, the NCDHHS says, “vaccine providers should not withhold vaccinations or appointments for vaccinations because you cannot present identification.”

Along those same lines, a spokesperson at Novant Health told me: “We are working around-the-clock to vaccinate as many people, as quickly as we can. We are also working hard to remove any barriers to receiving the vaccine from hesitancy to equitable access. Requiring proof of medical condition would only create additional barriers, so currently we are using the honor system.

“It’s our hope, and expectation, that community members only register when they are eligible, and that when they register, they provide truthful and accurate self-identification.”

So it would be fair to say that, if you have never been a smoker, you could conceivably get away with lying your way into Group 4 and get vaccinated this month by claiming that you have. Or by saying you’ve have diabetes, or cancer, or heart disease, even if you don’t.

It would also be more than fair to say that doing so would obviously be a (very) wrong thing to do.

At the same time, I will say this: Even if you’ve legitimately managed to limit yourself to say 100 to 150 cigarettes in your lifetime (which any current or former smoker would qualify as a remarkable feat), or even if like me you haven’t smoked in more than a decade and you’re now a marathon runner, don’t be bashful about admitting it. Don’t give up your place in line.

Don’t tell yourself, “Ah, I’ll hang back so the people who I know are at higher risk can get their shots before me.”

Look, the CDC does contend that being a current or former cigarette smoker increases your risk of severe illness from COVID-19 (though it doesn’t distinguish between someone who has smoked 100 cigarettes and someone who’s smoked 300,000).

So this is the time for neither shame, nor chivalry.

This is the time to get vaccinated as soon as you possibly can in accordance with the rules — no matter how dumb those rules may seem.