Estimating the association between cigarette and e-cigarette use patterns and SARS-CoV-2 negative conversion time: retrospective online survey in China

Abstract Background Cigarette smoking has been reported to be associated with SARS-CoV-2 negative conversion, while little is known about the effect of its dual use with e-cigarettes. This study aimed to investigate whether tobacco product use patterns including e-cigarette use were linked with dela...

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Main Authors: Ying Xie, Yinghua Li, Zheng Su, Xueyan Han, Zhao Liu, Zhenxiao Huang, Anqi Cheng, Xinmei Zhou, Jinxuan Li, Rui Qin, Xiaowen Wei, Yi Liu, Xin Xia, Qingqing Song, Liang Zhao, Kian Fan Chung, Dan Xiao, Chen Wang
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10545-x
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Summary:Abstract Background Cigarette smoking has been reported to be associated with SARS-CoV-2 negative conversion, while little is known about the effect of its dual use with e-cigarettes. This study aimed to investigate whether tobacco product use patterns including e-cigarette use were linked with delayed negative conversion of SARS-CoV-2. Methods An online national survey was conducted from January 28 through February 21, 2023, targeting a community-based population in mainland of China after peak waves of the coronavirus disease 2019 (COVID-19). Participants were followed from the onset of COVID-19 symptoms until the negative conversion day or the day of answering the questionnaire as the endpoint of the study. Multi-variable adjusted Cox proportional hazard models were used to compare the negative conversion time of SARS-CoV-2 across different cigarette and e-cigarette use patterns. Results A total of 66,537 participants infected with COVID-19 were enrolled and 13,294 were included in the analyses. During the median duration of 7 days (interquartile range 5 to 10 days), a total of 11,587 (87.2%) had a negative conversion. Compared with never users, current exclusive smokers (multi-variable adjusted HR 0.59, 95% CI 0.48–0.71), current dual users (HR 0.31, 95% CI 0.22–0.44), and previous smokers (HR 0.56, 95% CI 0.37–0.83) took longer to turn negative after 10 days of follow-up. Conclusions Both current exclusive cigarette use and dual use of cigarettes and e-cigarettes were associated with the delayed negative conversion of SARS-CoV-2, which strengthens the importance of smoking and vaping cessation messaging and community-based tobacco control strategies during pandemics like COVID-19 next time.
ISSN:1471-2334