Concurrent use of e-cigarettes and cannabis and associated COVID-19 symptoms, testing, and diagnosis among student e-cigarette users at four U.S. Universities
Merianos et al.,
Concurrent use of e-cigarettes and cannabis and associated COVID-19 symptoms, testing, and diagnosis among..,
Addictive Behaviors, doi:10.1016/j.addbeh.2021.107170
Retrospective 800 e-cigarette users in the USA, showing higher risk of COVID-19 diagnosis and symptoms with cannabis use.
risk of symptomatic case, 211.9% higher, RR 3.12, p < 0.001, treatment 94 of 416 (22.6%), control 20 of 384 (5.2%), odds ratio converted to relative risk, COVID-19 symptoms.
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risk of symptomatic case, 70.6% higher, RR 1.71, p = 0.008, treatment 77 of 416 (18.5%), control 38 of 384 (9.9%), odds ratio converted to relative risk, COVID-19 diagnosis.
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risk of case, 3.4% higher, RR 1.03, p = 0.33, treatment 367 of 416 (88.2%), control 317 of 384 (82.6%), odds ratio converted to relative risk, COVID-19 test.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Merianos et al., 31 Mar 2022, retrospective, USA, peer-reviewed, survey, 6 authors.
Contact:
ashley.merianos@uc.edu, ar117@uark.edu, melinda.mahabee-gittens@cchmc.org, aebarry@tamu.edu, my10@iu.edu, linhsi@indiana.edu.
Abstract: Addictive Behaviors 126 (2022) 107170
Contents lists available at ScienceDirect
Addictive Behaviors
journal homepage: www.elsevier.com/locate/addictbeh
Concurrent use of e-cigarettes and cannabis and associated COVID-19
symptoms, testing, and diagnosis among student e-cigarette users at four U.
S. Universities
Ashley L. Merianos a, *, Alex M. Russell b, E. Melinda Mahabee-Gittens c, Adam E. Barry d,
Meng Yang e, Hsien-Chang Lin e
a
School of Human Services, University of Cincinnati, Cincinnati, OH, USA
Department of Health, Human Performance, & Recreation, University of Arkansas, 308 HPER Building, Fayetteville, AR 72703, USA
c
Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH 45229, USA
d
Department of Health and Kinesiology, Texas A&M University, College Station, TX 77843-4243, USA
e
Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, 47405, USA
b
A R T I C L E I N F O
A B S T R A C T
Keywords:
Electronic nicotine delivery systems
Cannabis use
College students
Introduction: This investigation assessed whether current (past 30-day) electronic cigarette (e-cigarette) and
cannabis use was associated with coronavirus disease 2019 (COVID-19) symptomatology, testing, and diagnosis
among college student e-cigarette users.
Methods: Participants were 18–26-year-old college student e-cigarette users attending four geographically
diverse, large U.S. public universities during October-December 2020 (N = 800). Multivariable logistic regres
sion models explored associations between exclusive e-cigarette use and concurrent e-cigarette and cannabis use
and COVID-19 symptoms, testing, and diagnosis. Models controlled for demographics, university site, and cur
rent use of combustible cigarettes, cigars, and smokeless tobacco.
Results: Over half of student e-cigarette users (52.0%) concurrently used cannabis. Compared to exclusive ecigarette users, concurrent e-cigarette and cannabis users were 3.53 times more likely (95%CI = 1.96–6.36) to
report COVID-19 symptoms, after adjusting for the covariates. Compared to infrequent exclusive e-cigarette
users, infrequent concurrent users (AOR = 4.72, 95%CI = 1.31–17.00), intermediate concurrent users (AOR =
5.10, 95%CI = 1.37–18.97), and frequent concurrent users (AOR = 7.44, 95%CI = 2.06–26.84) were at increased
odds of reporting COVID-19 symptoms. Compared to exclusive e-cigarette users, concurrent e-cigarette and
cannabis users were 1.85 times more likely (95%CI = 1.15–2.98) to report a COVID-19 diagnosis. Intermediate
concurrent users (AOR = 2.88, 95%CI = 1.13–7.35) and frequent concurrent users (AOR = 3.22, 95%CI =
1.32–7.87) were at increased odds of reporting a COVID-19 diagnosis, compared to infrequent exclusive ecigarette users.
Conclusions: Concurrent use of e-cigarettes and cannabis may be an underlying risk factor of COVID-19 symp
tomatology and diagnosis, with more pronounced odds found among intermediate and frequent users. Results
highlight the need to educate students about the impacts of e-cigarette and cannabis use on respiratory, immune,
and overall health.
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