Summary. Background and aim of the work: The effect of tobacco smoking on COVID-19 disease is debated, with common sense and experts suggesting a deleterious effect, and manuscripts worldwide reporting a low prevalence of active tobacco smokers among intensive care unit patients. Methods: We categorized countries worldwide into three groups with 45% of active male smokers with data expressed as median and interquartile range [IQR] and extracted data on SARS-CoV-2 infections and COVID-19 deaths per million inhabitants from public available databases. We also applied multivariate regression techniques to adjust for several epidemiological factors. Results: COVID-19 mortality was 13 (5-24) per million inhabitants in countries with male smokers >45% and 33 (4-133) in countries where male smokers were