The Impact of Tobacco Use on COVID-19 Outcomes: A Systematic Review

Abstract

Introduction. Tobacco use increases risks for numerous diseases, including respiratory illnesses. We examined the literature to determine whether a history of tobacco use increases risks for adverse outcomes among COVID-19 patients. Methods. We conducted a systematic search of PubMed, LitCovid, Scopus, and Europe PMC (for preprints) using COVID-19 and tobacco-related terms. We included studies of human subjects with lab-confirmed COVID-19 infections that examined tobacco use history as an exposure and used multivariable analyses. The data was collected between March 31st, 2020, and February 20th, 2021. Outcomes included mortality, hospitalization, ICU admission, mechanical ventilation, and illness severity. Results. Among the 39 studies (33 peer-reviewed, 6 preprints) included, the most common outcome assessed was mortality ( n = 32 ). The majority of these studies (17/32) found that tobacco use increased risk, one found decreased risk, and 14 found no association. Tobacco use was associated with increased risk of hospitalization in 7 of 10 studies, ICU admission in 6 of 9 studies, mechanical ventilation in 2 of 6 studies, and illness severity in 3 of 9 studies. One study found that tobacco use history increased risk of pulmonary embolism in COVID-19 patients. Tobacco use was found to compound risks associated with diabetes ( n = 1 ), cancer ( n = 2 ), and chronic liver disease ( n = 1 ). Conclusion. There is strong evidence that tobacco use increases risks of mortality and disease severity/progression among COVID-19 patients. Public health efforts during the pandemic should encourage tobacco users to quit use and seek care early and promote vaccination and other preventive behaviors among those with a history of tobacco use.

Mapping One Million COVID-19 Deaths and Unhealthy Lifestyle Behaviors in the United States: Recognizing the Syndemic Pattern and Taking Action

“…A convincing association between unhealthy lifestyle behaviors and poorer outcomes associated with COVID-19 infection (e.g., hospitalization and mortality risk) has already been demonstrated and communicated by the CDC in public health messaging. 2 , 3 , 4 , 5 , 6 , 7 These behaviors and conditions included physical activity, obesity, diabetes, and smoking. Sallis et al 8 reported that individuals infected with COVID-19 were at significantly higher risk for hospitalization if they reported a sedentary lifestyle prior to diagnosis.…”

Exploring young adults’ e-cigarette use behavior during COVID-19

“…This study underscores the impact of COVID-19 on young adults’ e-cigarette use, particularly via changes in accessibility to vaping products due to retail disruptions and state-order business closures, stress, boredom, and changes in the daily environment. Quantitative findings suggested that roughly one-fifth of participants made attempts to cut down or quit vaping (respectively), and some interview participants reported decreasing their use, reflecting literature indicating a decrease in the use of current e-cigarette use among young adults 5 , 7 , 8 , 12 .…”

“…Several factors may have driven decreases in e-cigarette use, or increased attempts to cut down or quit. For example, about a quarter of participants reported living at home with parents or guardians, which is associated with less e-cigarette use 5 , 7 , 8 , 12 . Additionally, others worried about the impact of vaping on their lung function, particularly during COVID-19, and some experienced disruptions in e-cigarette supply and demand 5 , 7 , 8 , 12 , 17 .…”

“…For example, about a quarter of participants reported living at home with parents or guardians, which is associated with less e-cigarette use 5 , 7 , 8 , 12 . Additionally, others worried about the impact of vaping on their lung function, particularly during COVID-19, and some experienced disruptions in e-cigarette supply and demand 5 , 7 , 8 , 12 , 17 . Specifically, a proportion of e-cigarette users were worried that their source of vaping products would close, and some had their source go out of business.…”

Evento cerebrovascular en pacientes post COVID-19

“…Sin embargo, una limitación del estudio fue no considerar otro tipo de sustancias además de la nicotina, y tampoco los cigarros electrónicos. (Archie SR, et al, 2020;Baker J, et al, 2022) La hipertensión arterial y la diabetes mellitus, son factores de riesgo cardiovascular; y su asociación al evento cerebrovascular está ampliamente demostrado en estudios. Sin embargo, al relacionarlo con COVID-19 aún quedan dudas si el antecedente de la infección, por si solo desencadena el evento cerebrovascular o si la hipertensión y diabetes, como ya comentado, los factores de riesgo cardiovascular desencadenantes.…”