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A number of independent observations show that cigarette smoke increases expression of the ACE2 gene: Mice exposed to cigarette smoke daily for 5 months had up to 80% more ACE2 expression in the lung compared with control mice Human lung epithelial cells from the bronchi of smokers had 30-55% more ACE2 expression than cells from non-smokers Lung samples from patients who smoked more than 80 pack-years had 100% more ACE2 expression than those who smoked less than 20 pack-years Quitting smoking was associated with a 40% decrease in ACE2 expression In murine and human lung, ACE2 is expressed at high levels in secretory and goblet cells and alveolar type 2 cells

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it contains the nicotine needed to satisfy the nicotine withdrawal smokers suffer when quitting smoking