Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19

Purpose: This study aimed to assess whether youth cigarette and electronic cigarette (e-cigarette) use are associated with coronavirus disease 2019 (COVID-19) symptoms, testing, and diagnosis. Methods: An online national survey of adolescents and young adults (n 1/4 4,351) aged 13-24 years was conducted in May 2020. Multivariable logistic regression assessed relationships among COVID-19-related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only and dual use, sociodemographic factors, obesity, and complying with shelter-in-place. Results: COVID-19 diagnosis was five times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82-13.96), seven times more likely among ever-dual-users (95% CI: 1.98-24.55), and 6.8 times more likely among past 30-day dual-users (95% CI: 2.40-19.55). Testing was nine times more likely among past 30-day dual-users (95% CI: 5.43-15.47) and 2.6 times more likely among past 30-day e-cigarette only users (95% CI: 1.33-4.87). Symptoms were 4.7 times more likely among past 30-day dual-users (95% CI: 3.07-7.16). Conclusions: COVID-19 is associated with youth use of e-cigarettes only and dual use of e -cigarettes and cigarettes, suggesting the need for screening and education. (C) 2020 Society for Adolescent Health and Medicine. All rights reserved.