COVID-19 symptoms associated with smoking and vaping tobacco and cannabis: A cross-sectional analysis
Abstract
Objective Characterize symptoms observed among people using nicotine and/or cannabis compared to non-users using an institutional respiratory illness symptom checker. Methods Cross-sectional study (April 2020–August 2021) using University of California San Francisco (UCSF) COVID-19 & Flu Symptom Checker online self-triage tool measuring current tobacco and cannabis use, symptom prevalence and associations with self-reported severe dyspnea, using multivariable logistic regression. Results Excluding those with emergent symptoms requiring immediate medical evaluation, of 10,904 patients, 729 (6.7%) self-reported current nicotine or cannabis use. People smoking and/or vaporizing nicotine or cannabis reported constitutional, ear/nose and throat, respiratory, and gastrointestinal symptoms more frequently than non-users. Current vaping (aOR = 1.89, 95% CI 1.23, 2.81) and co-use of nicotine/cannabis (aOR = 2.00, 95% CI 1.26, 3.09) were associated with higher odds of dyspnea, adjusting for comorbidities and demographic factors. Conclusion People using nicotine or cannabis products had increased frequencies of self-reported COVID-19 symptoms and dyspnea. Current vaporizer use may not be associated with a difference in self-reported respiratory symptoms compared to smoking tobacco. Including tobacco and cannabis use in symptom checkers may enhance risk stratification and clinical decision-making during future respiratory virus outbreaks.
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 10,904 participants or records.
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