Association between cannabis use and result of COVID-19 testing among scholarised adolescents in Andalusia: A cross-sectional study

María-Carmen Torrejón-Guirado; Miguel Ángel Baena-Jiménez; Marta Lima-Serrano

Abstract: Citation: Torrejón-Guirado M-C, Baena-Jiménez MÁ, Lima-Serrano M (2026) Association between cannabis use and result of COVID-19 testing among scholarised adolescents in Andalusia: A cross-sectional study. PLoS One 21(5): e0347098. https://doi.org/10.1371/ journal.pone.0347098 Editor: Vincenzo De Luca, University of Toronto, CANADA Received: November 10, 2024 Accepted: March 28, 2026 Published: May 7, 2026 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal. pone.0347098 Copyright: © 2026 Torrejón-Guirado et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, RESEARCH ARTICLE Association between cannabis use and result of COVID-19 testing among scholarised adolescents in Andalusia: A cross-sectional study María-Carmen Torrejón-Guirado 1 , Miguel Ángel Baena-Jiménez 2 * , Marta Lima-Serrano 1 - 1 Department of Nursing, School of Nursing, Physiotherapy, and Podiatry, University of Seville, Institute of Biomedicine of Seville (IBiS), Seville, Spain, 2 Department of General and Specialist Surgery, Hospital Universitario Virgen Macarena, Spain * [mang.baena.sspa@juntadeandalucia.es](mailto:mang.baena.sspa@juntadeandalucia.es) Abstract Aims The COVID-19 pandemic may have impacted cannabis use among the adolescent population. Therefore, it is important to understand the potential factors linking cannabis use to COVID-19 and vice versa, as well as the consumption patterns following the onset of COVID-19. Methods This study conducted in Andalusia, Spain. Although, 1,051 adolescents aged 14-18 years were included in this cross-sectional study, of these, the 89 (8.5%) reported testing positive for COVID-19, who were the main target for our analyses. Sociodemographic, psychological, and cannabis use variables, as well as COVID-19 testing positive, isolation and some perceptions about cannabis and COVID-19 were analysed. A binary logistic regression, was conducted to examine the association between COVID-19-related factors and controlled for sociodemographic and psychological variables, assessed estimations with cannabis use. Results Adolescents testing positive for COVID-19 are almost 2.89 times more likely to have used cannabis in the last month. Additionally, number of isolations was higher among cannabis users and positive testing. Cannabis users showed a lack of perceived risk that cannabis use could exacerbate COVID-19 and that cannabis' smoke could spread COVID-19. Sharing cannabis among adolescents during the pandemic may increase the risk of COVID-19 transmission. distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement : The data underlying the results presented in the study are available from Zenodo (a public repository; accession DOI: https://doi.org/10.5281/ zenodo.15106665). Funding: This work was supported by the University of Seville research program (VPPIUS) in terms of a pre-doctoral contract of Torrejón-Guirado. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Additionally, this was a secondary objective of a..

DOI record: { "DOI": "10.1371/journal.pone.0347098", "ISSN": [ "1932-6203" ], "URL": "http://dx.doi.org/10.1371/journal.pone.0347098", "abstract": "\n Aims\n The COVID-19 pandemic may have impacted cannabis use among the adolescent population. Therefore, it is important to understand the potential factors linking cannabis use to COVID-19 and vice versa, as well as the consumption patterns following the onset of COVID-19.\n \n \n Methods\n This study conducted in Andalusia, Spain. Although, 1,051 adolescents aged 14–18 years were included in this cross-sectional study, of these, the 89 (8.5%) reported testing positive for COVID-19, who were the main target for our analyses. Sociodemographic, psychological, and cannabis use variables, as well as COVID-19 testing positive, isolation and some perceptions about cannabis and COVID-19 were analysed. A binary logistic regression, was conducted to examine the association between COVID-19-related factors and controlled for sociodemographic and psychological variables, assessed estimations with cannabis use.\n \n \n Results\n Adolescents testing positive for COVID-19 are almost 2.89 times more likely to have used cannabis in the last month. Additionally, number of isolations was higher among cannabis users and positive testing. Cannabis users showed a lack of perceived risk that cannabis use could exacerbate COVID-19 and that cannabis’ smoke could spread COVID-19. Sharing cannabis among adolescents during the pandemic may increase the risk of COVID-19 transmission.\n \n \n Conclusions\n Informing whether adolescents who use cannabis may be more likely to test positive for COVID-19 can contribute to a better understanding of substance use patterns during a public health emergency. However, given the exploratory and cross-sectional nature of this study, as well as its limited and context-specific sample, the findings should be interpreted with caution. Despite this, we believe that this research may inform future studies exploring the impact of cannabis use among adolescents during public emergency situations in larger samples and other contexts.\n ", "author": [ { "ORCID": "https://orcid.org/0000-0001-6832-0631", "affiliation": [], "authenticated-orcid": true, "family": "Torrejón-Guirado", "given": "María-Carmen", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "first" }, { "ORCID": "https://orcid.org/0009-0000-8743-4650", "affiliation": [], "authenticated-orcid": true, "family": "Baena-Jiménez", "given": "Miguel Ángel", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Lima-Serrano", "given": "Marta", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" } ], "container-title": "PLOS One", "container-title-short": "PLoS One", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosone.org" ] 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"10.3389/fpsyg.2020.582578", "article-title": "Stress, Emotional Intelligence and the Intention to Use Cannabis in Spanish Adolescents: Influence of COVID-19 Confinement", "author": "C Liébana-Presa", "doi-asserted-by": "crossref", "first-page": "582578", "journal-title": "Front Psychol", "key": "pone.0347098.ref001", "volume": "11", "year": "2020" }, { "author": "United Nations", "key": "pone.0347098.ref002", "year": "2023" }, { "author": "World Health Organization", "key": "pone.0347098.ref003", "year": "2023" }, { "DOI": "10.1080/02791072.2023.2184735", "article-title": "Solitary Cannabis Use and Related Consequences Among College Students During the COVID-19 Pandemic", "author": "AV Wedel", "doi-asserted-by": "crossref", "first-page": "168", "issue": "2", "journal-title": "J Psychoactive Drugs", "key": "pone.0347098.ref004", "volume": "56", "year": "2024" }, { "article-title": "Characteristics and clinical outcomes of adolescents infected by SARS-CoV-2: a systematic review", "author": "CG Campos", "journal-title": "Rev Paul Pediatr", "key": "pone.0347098.ref005", "volume": "42", "year": "2023" }, { "author": "United Nations Office on Drugs and Crime", "key": "pone.0347098.ref006", "year": "2020" }, { "DOI": "10.1001/jamanetworkopen.2024.17977", "article-title": "Cannabis, Tobacco Use, and COVID-19 Outcomes", "author": "NB Griffith", "doi-asserted-by": "crossref", "issue": "6", "journal-title": "JAMA Network Open", "key": "pone.0347098.ref007", "volume": "7", "year": "2024" }, { "DOI": "10.1016/S2215-0366(16)30208-5", "article-title": "Marijuana use and use disorders in adults in the USA, 2002-14: analysis of annual cross-sectional surveys", "author": "WM Compton", "doi-asserted-by": "crossref", "first-page": "954", "issue": "10", "journal-title": "Lancet Psychiatry", "key": "pone.0347098.ref008", "volume": "3", "year": "2016" }, { "key": "pone.0347098.ref009", "volume-title": "World drug report", "year": "2022" }, { "author": "National Plan on Drugs of Spain", "key": "pone.0347098.ref010", "volume-title": "Survey on drug use in secondary education in Spain (ESTUDES 2024/2025)", "year": "2025" }, { "author": "Spanish Observatory on Drugs and Addictions", "key": "pone.0347098.ref011", "volume-title": "OEDA-COVID Survey: Impact of the COVID-19 Pandemic in 2020 on the Pattern of Psychoactive Substance Use and Other Behaviors with Addictive Potential", "year": "2021" }, { "author": "National Plan on Drugs of Spain", "key": "pone.0347098.ref012", "volume-title": "Survey on drug use in secondary education in Spain (ESTUDES 2021/2022)", "year": "2022" }, { "DOI": "10.1016/j.dadr.2024.100232", "article-title": "Cannabis use among adolescents and young adults during the COVID-19 pandemic: A systematic review", "author": "Y Tang", "doi-asserted-by": "crossref", "first-page": "100232", "journal-title": "Drug Alcohol Depend Rep", "key": "pone.0347098.ref013", "volume": "11", "year": "2024" }, { "DOI": "10.1007/s00702-022-02564-8", "article-title": "Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review", "author": "U Bonnet", "doi-asserted-by": "crossref", "first-page": "7", "issue": "1", "journal-title": "J Neural Transm (Vienna)", "key": "pone.0347098.ref014", "volume": "130", "year": "2023" }, { "DOI": "10.1093/tbm/ibab025", "article-title": "Perceived impacts of the COVID-19 pandemic on cannabis-using emerging adults", "author": "EE Bonar", "doi-asserted-by": "crossref", "first-page": "1299", "issue": "7", "journal-title": "Transl Behav Med", "key": "pone.0347098.ref015", "volume": "11", "year": "2021" }, { "DOI": "10.1016/j.addbeh.2021.107170", "article-title": "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", "author": "AL Merianos", "doi-asserted-by": "crossref", "first-page": "107170", "journal-title": "Addict Behav", "key": "pone.0347098.ref016", "volume": "126", "year": "2022" }, { "author": "Institute of Statistics and Cartography of Andalusia", "key": "pone.0347098.ref017", "volume-title": "Andalusia in figures 2023", "year": "2023" }, { "DOI": "10.1097/EDE.0b013e3181577511", "article-title": "Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration", "author": "JP Vandenbroucke", "doi-asserted-by": "crossref", "first-page": "805", "issue": "6", "journal-title": "Epidemiology", "key": "pone.0347098.ref018", "volume": "18", "year": "2007" }, { "author": "National Plan on Drugs of Spain", "key": "pone.0347098.ref019", "volume-title": "Survey on Drug Use in Secondary Education in Spain (ESTUDES 2018/2019)", "year": "2018" }, { "DOI": "10.55414/bsxyn321", "article-title": "Escala de autoestima de Rosenberg: fiabilidad y validez en población clínica española", "author": "AJ Vázquez-Morejón", "doi-asserted-by": "crossref", "first-page": "247", "issue": "2", "journal-title": "Apunt Psic", "key": "pone.0347098.ref020", "volume": "22", "year": "2004" }, { "DOI": "10.20882/adicciones.909", "article-title": "Adaptation to the Spanish population of the Substance Use Risk Profile Scale (SURPS) and psychometric properties", "author": "F Fernández-Calderón", "doi-asserted-by": "crossref", "first-page": "208", "issue": "3", "journal-title": "Adicciones", "key": "pone.0347098.ref021", "volume": "30", "year": "2018" }, { "author": "Red Española de Ciudades Saludables", "key": "pone.0347098.ref022" }, { "author": "Ministry of Health", "key": "pone.0347098.ref023" }, { "author": "AP Field", "key": "pone.0347098.ref024", "volume-title": "Discovering statistics using IBM SPSS statistics", "year": "2017" }, { "author": "IBM Corp", "key": "pone.0347098.ref025", "volume-title": "IBM SPSS Statistics for Windows, Version 29.0.2.0", "year": "2023" }, { "DOI": "10.1111/jnu.12806", "article-title": "Which factors are associated with cannabis use among adolescents in Andalusia? An application of the I-Change model", "author": "M-C Torrejón-Guirado", "doi-asserted-by": "crossref", "first-page": "739", "issue": "3", "journal-title": "J Nurs Scholarsh", "key": "pone.0347098.ref026", "volume": "55", "year": "2023" }, { "DOI": "10.1080/02791072.2024.2421903", "article-title": "Fear of COVID-19 Diagnosis and Cannabis Use Patterns Among Adults with Chronic Health Conditions: Results from COVID-19 Cannabis Health Study", "author": "B-NA Diggs", "doi-asserted-by": "crossref", "first-page": "540", "issue": "5", "journal-title": "J Psychoactive Drugs", "key": "pone.0347098.ref027", "volume": "57", "year": "2025" }, { "DOI": "10.3389/fpubh.2022.829715", "article-title": "Cannabis Use Is Associated With Lower COVID-19 Susceptibility but Poorer Survival", "author": "D Huang", "doi-asserted-by": "crossref", "first-page": "829715", "journal-title": "Front Public Health", "key": "pone.0347098.ref028", "volume": "10", "year": "2022" }, { "author": "A Parrado-González", "key": "pone.0347098.ref029", "volume-title": "Psicocann Project: Technical report of preliminary results", "year": "2023" }, { "article-title": "Substance use during the COVID-19 pandemic: What is really happening?", "author": "E Mellos", "first-page": "17", "issue": "1", "journal-title": "Psychiatriki", "key": "pone.0347098.ref030", "volume": "33", "year": "2022" }, { "author": "M Arboleda", "key": "pone.0347098.ref031", "year": "2023" }, { "article-title": "COVID-19 impact on substance use and behaviors with addictive potential: Spanish Observatory on Drugs and Addictions survey", "author": "N Llorens", "journal-title": "Rev Esp Salud Publica", "key": "pone.0347098.ref032", "volume": "95", "year": "2021" }, { "DOI": "10.1111/add.15387", "article-title": "For better or for worse? A pre-post exploration of the impact of the COVID-19 lockdown on cannabis users", "author": "J Cousijn", "doi-asserted-by": "crossref", "first-page": "2104", "issue": "8", "journal-title": "Addiction", "key": "pone.0347098.ref033", "volume": "116", "year": "2021" }, { "DOI": "10.1097/ADM.0000000000000798", "article-title": "Cannabis Use During the COVID-19 Pandemic in Canada: A Repeated Cross-sectional Study", "author": "S Imtiaz", "doi-asserted-by": "crossref", "first-page": "484", "issue": "6", "journal-title": "J Addict Med", "key": "pone.0347098.ref034", "volume": "15", "year": "2021" }, { "article-title": "Academic performance under COVID-19: The role of online learning readiness and emotional competence", "author": "Y Wang", "first-page": "1", "journal-title": "Current Psychology", "key": "pone.0347098.ref035", "year": "2022" }, { "author": "D Armour", "key": "pone.0347098.ref036", "volume-title": "Rapid research information forum: Differential learning outcomes for online versus in-class education", "year": "2020" }, { "article-title": "Cambios en el consumo de cannabis en consumidores españoles durante el confinamiento por la COVID-19 según sexo, edad, situación de convivencia y nivel de adicción", "author": "V Villanueva Blasco", "journal-title": "Adicciones", "key": "pone.0347098.ref037", "year": "2023" }, { "DOI": "10.3389/fphys.2021.652198", "article-title": "Cigarette smoke exposure, pediatric lung disease, and COVID-19", "author": "M Schiliro", "doi-asserted-by": "crossref", "first-page": "652198", "journal-title": "Front Physiol", "key": "pone.0347098.ref038", "volume": "12", "year": "2021" }, { "article-title": "Espacios sin humos para la protección de la salud infantil durante la pandemia COVID-19 y para siempre", "author": "I Astigarraga", "first-page": "3", "journal-title": "Bol S Vasco-Nav Pediatr", "key": "pone.0347098.ref039", "volume": "53", "year": "2021" }, { "DOI": "10.1186/s12931-023-02399-1", "article-title": "Modulation of pulmonary immune function by inhaled cannabis products and consequences for lung disease", "author": "M Preteroti", "doi-asserted-by": "crossref", "first-page": "95", "issue": "1", "journal-title": "Respir Res", "key": "pone.0347098.ref040", "volume": "24", "year": "2023" } ], "reference-count": 40, "references-count": 40, "relation": {}, "resource": { "primary": { "URL": "https://dx.plos.org/10.1371/journal.pone.0347098" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Association between cannabis use and result of COVID-19 testing among scholarised adolescents in Andalusia: A cross-sectional study", "type": "journal-article", "update-policy": "https://doi.org/10.1371/journal.pone.corrections_policy", "volume": "21" }