COVID-19 and tobacco products use among US adults, 2021 National Health Interview Survey

Mohammad Ebrahimi Kalan; Rime Jebai; Wei Li; Prem Gautam; Seyedeh Yasaman Alemohammad; Zeinab Mortazavizadeh; D Ward Kenneth; Aditya Chakraborty; Ghader Dargahi Abbasabad; Raed Behaleh; Zoran Bursac; Ziyad Ben Taleb

doi:10.1002/hsr2.1542

COVID-19 and tobacco products use among US adults, 2021 National Health Interview Survey

Health Sci Rep. 2023 Aug 31;6(9):e1542. doi: 10.1002/hsr2.1542. eCollection 2023 Sep.

Affiliations

¹ Eastern Virginia Medical School Norfolk Virginia USA.
² Department of Epidemiology, Robert Stempel College of Public Health Florida International University Miami Florida USA.
³ Department of Psychiatry, Yale School of Medicine Yale University New Haven Connecticut USA.
⁴ Texas State Board of Pharmacy Austin Texas USA.
⁵ Department of Psychology The University of Alabama at Birmingham Birmingham Alabama USA.
⁶ School of Public Health University of Memphis Memphis Tennessee USA.
⁷ University of New Brunswick Fredericton California USA.
⁸ School of Health Sciences Baldwin Wallace University Berea Ohio USA.
⁹ Department of Biostatistics, Robert Stempel College of Public Health Florida International University Miami Florida USA.
¹⁰ Department of Kinesiology, College of Nursing and Health Innovation University of Texas at Arlington Arlington Texas USA.

Abstract

Background: Smoking and vaping are linked to lung inflammation and lowered immune response.

Objective: Examine the prevalence of coronavirus disease 2019 (COVID-19) cases, testing, symptoms, and vaccine uptake, and associations with tobacco product use.

Methods: Data came from the 2021 National Health Interview Survey. The 2021 Sample Adult component included 29,482 participants with a response rate of 50.9%. We investigated COVID-19-related outcomes by tobacco product use status and reported national estimates. Multivariable regression models were performed accounting for demographics (e.g., age, sex, poverty level), serious psychological distress, disability, and chronic health conditions.

Results: In our regression analyses, odds of self-reported COVID-19 infection were significantly lower for combustible tobacco product users (vs. nonusers; adjusted odds ratio [AOR = 0.73; 95% confidence interval [CI] = 0.62-0.85]). Combustible tobacco users also were less likely to report ever testing for COVID-19 (AOR = 0.88; 95% CI = 0.79-0.98), ever testing positive for COVID-19 (AOR = 0.66; 95% CI = 0.56-0.77), and ever receiving COVID-19 vaccine (AOR = 0.58; 95% CI = 0.51-0.66) compared with their nonuser peers. Compared to nonusers, users of any type of tobacco who contracted COVID-19 had higher odds of losing smell (AOR = 1.36; 95%CI = 1.04-1.77), which was more pronounced among exclusive e-cigarette users. The odds of receiving vaccine were lower for all current exclusive tobacco product users compared to nonusers (AORs = 0.40 to 0.70).

Conclusions: Continued monitoring of tobacco product use and its association with respiratory diseases such as COVID-19 is crucial to inform public health policies and programs. In addition, efforts to promote vaccination, especially among tobacco product users, are warranted.

Keywords: COVID‐19; adults; smoking; tobacco use.