A new survey found adolescents who have ever used e-cigarettes are 5-times more likely to receive a COVID-19 diagnosis. More results at-a-glance in our new slideshow.
Researchers from Stanford University and the University of California recently published results of their new study in the Journal of Adolescent Healthwhich examined whether US adolescent e-cigarette smokers were more likely to experience coronavirus disease 2019 (COVID-19)-related symptoms, be tested for, and/or diagnosed with COVID-19. Scroll through the slides below for more study details and key takeaways for primary care.
Potential important COVID-19 risk factor. As of August 14, 2020 there have been >5 million confirmed cases of COVID-19 in the US and nearly 21 million cases globally. Although adolescents are at a relatively lower risk of contracting COVID-19 vs adults, given the proportion of youth using e-cigarettes, youth e-cigarette and cigarette use may pose an important risk factor for COVID-19. 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, the study examined whether adolescent e-cigarette smokers were more likely to experience COVID-19-related symptoms, be tested for, and/or diagnosed with COVID-19.
Survey attracts young smokers, vapers. Researchers conducted a national cross-sectional online survey of US adolescents and young adults from May 6-May 14, 2020. The survey was posted on spaces such as social media and gaming sites. A total of 4351 participants completed the survey with 50.2% of participants being e-cigarette ever-users and 49.8% nonusers; 33.7% of subjects were adolescents, 41.6% were young adults, and 24.7% were adults.
Definition of COVID-19. Multivariable logistic regression was conducted to assess the association of ever-use and past 30-day use of cigarettes only, e-cigarettes only, and dual use with COVID-19. COVID-19 was defined as self-reported symptoms, testing, and positive diagnosis.
Likelihood of COVID-19 symptoms. Past 30-day dual-users were 4.7-times more likely to experience COVID-19-related symptoms. Experiencing such symptoms was 2-times more likely among black, Hispanic, other/multiracial, underweight, and obese participants; 1.8-times more likely among lesbian, gay, bisexual, transgender, and questioning youth; and 1.6-times more likely among those who did not comply with shelter-in-place orders.
Likelihood of COVID-19 testing. Ever-users of e-cigarettes only were 3.3-times, ever-dual-users were 3.6-times, and ever-users of cigarettes only were 3.9-times more likely to get COVID-19 testing. Past 30-day dual users were 9-times and past 30-day e-cigarette only users were 2.6-times more likely to get COVID-19 testing. Male, black, other/multiracial, and underweight participants were 2-3-times more likely to get tested.
Likelihood of COVID-19 diagnosis. Ever-dual-users were 7-times, ever-users of e-cigarettes only were 5-times, and past 30-day dual-users were 6.8-times more likely to be diagnosed with COVID-19. Sociodemographic factors associated with a positive COVID-19 diagnosis included being male, other/nonbinary gender, Hispanic, other/multiracial, and mother's completion of college-or-graduate level education.
Conclusions:
Study provides timely evidence that e-cigarette and dual-use increases COVID-19 risk among US adolescents, young adults.
Study can help inform public health concerns that ongoing youth e-cigarette epidemic contributes to COVID-19 pandemic.
Authors noted various potential reasons for why dual use, e-cigarette use were linked with COVID-19, including heightened exposure to nicotine, other chemicals in e-cigarettes adversely affects lung function; frequent touching of one’s hands, mouth, face common among users and can increase risk of COVID-19 spread; and sharing devices being common among youth e-cigarette users.
