Traditional forms of tobacco consumption have steadily decreased in the United States for decades, but electronic nicotine delivery systems, or e-cigarettes, have retained their popularity since rapidly entering the marketplace in the late 2000’s, especially in younger adults. While the negative health effects of these products are not as salient nor as studied as that of traditional cigarettes, emerging literature does suggest the presence of a litany of dangers related to respiratory injury and neuronal damage as a result of sustained use. Cannabis use has increased across all demographics in the United States, and its health profile has similarly been delineated as inducing more harms than are initially perceived by the public. These can also include respiratory injury, psychiatric disturbance, and impaired decision-making. The COVID-19 pandemic has provided a spotlight to general respiratory health across the globe due to the pulmonary manifestation of the illness, and many disease states have overlapping signs and symptoms with that of COVID-19. This study explores the intersection of e-cigarette and cannabis use with COVID-19 testing in a sample of college students in the United States.
The study’s sample consists of 800 students from 4 different universities in the midwestern and southwestern United States who were initiated into the study between October and December of 2020 (N=800). Eligibility criteria included being 18-26 years old, current enrollment, and current e-cigarette use. Participants completed surveys which measured the following characteristics: demographics, e-cigarette use, cannabis use, use of tobacco products, COVID-19 history, COVID-19 symptoms, and COVID-19 test results. Statistical analysis was performed using multilinear logistic regression equations.
Results of the analysis found 52% of all e-cigarette users also endorsed current cannabis use. Students who reported use of both cannabis and e-cigarettes were over three times more likely to experience COVID-19 symptoms. This trend was constant across concurrent use frequencies and was also found to be associated with a near doubled chance of having a history of a COVID-19 diagnosis.
Takeaway: most likely due to a variety of factors related to general pulmonary and immunological health, concurrent users of both e-cigarettes and cannabis may be placed at higher risk for contracting symptomatic COVID-19.