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, Alex M Russell, E Melinda Mahabee-Gittens, Adam E Barry, Meng Yang, Hsien-Chang Lin
Addictive Behaviors, doi:10.1016/j.addbeh.2021.107170
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 regression 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 current 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 symptomatology 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.
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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