A new survey suggests use of e-cigarettes and dual use of e-cigarettes and traditional cigarettes are significant underlying risk factors for COVID-19 among US adolescents.
Smoking has been linked with higher susceptibility to COVID-19, but currently there are no US population-based studies assessing the relationship between cigarette smoking, e-cigarette use, and COVID-19. Because of this, researchers from Stanford University and the University of California examined whether adolescent e-cigarette smokers were more likely to experience COVID-19-related symptoms, be tested for, and/or diagnosed with COVID-19.
Using an online survey posted on spaces such as social media and gaming sites, researchers recruited 4351 US participants aged 13-24 years from May 6 to May 14, 2020 who answered the 15-20-minute survey.
Multivariable logistic regression was used to assess the relationship among COVID-19-related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only, and dual use, sociodemographic factors, body mass index, and complying with shelter-in-place.
Overall, a COVID-19 diagnosis was 5-times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82-13.96), 7-times more likely among ever-dual-users (95% CI: 1.98-24.55), and 6.8-times more likely among past 30-day dual-users (95% CI: 2.40-19.55).
In addition, past 30-day dual-users were 9-times more likely to get tested for COVID-19 (95% CI: 5.43-15.47) and past 30-day e-cigarette only users were 2.6-times more likely (95% CI: 1.33-4.87). COVID-19-related symptoms were 4.7-times more likely among past 30-day dual-users (95% CI: 3.07-7.16).
It is worth noting that the survey did not explore why participants decided to get COVID-19 testing.
“Our population-based research provides timely evidence that youth using e-cigarettes and dual-users of e-cigarettes and cigarettes are at greater risk of COVID-19,” concluded authors. “Given the predominance of e-cigarette use among US youth, our investigation informs public health concerns that the ongoing youth e-cigarette epidemic contributes to the current COVID-19 pandemic.”