Work

Cigarette smoking status and COVID-19 hospitalization in the context of cannabis use: An electronic health record cohort study in northern California

Year: 2024

Type: article

Abstract: • Former and current cigarette smoking were risk factors for COVID-19 hospitalization. • No detected link between the co-use of cigarettes and cannabis and COVID-19 hospitalization. • Current cigarette smoking was a risk factor for COVID-19 hospitalization when the cannabis use status was unknown. • The association between cigarette smoking and COVID-19 hospitalization varied by cannabis use. • It is important to consider both cigarette smoking and cannabis use when investigating COVID-19 risk factors. Research investigating the association between cigarette smoking and COVID-19 outcomes has yielded mixed results, often overlooking cannabis use. This study examined the association between cigarette smoking and COVID-19 hospitalization with consideration of cannabis use. We used electronic health record data from adult patients with COVID-19 (2/1/2020 to 2/3/2022) at a northern California academic medical center. The outcome was COVID-19 hospitalization. We conducted three multivariable logistic models to examine the relationship between cigarette smoking and hospitalization. Model 1 included cigarette smoking status and other covariates; Model 2 added cannabis use status to Model 1; Model 3 added interaction term of cigarette and cannabis use to Model 2, followed by a post-hoc analysis. Of the 14,440 patients, 8.5 % had COVID-19 hospitalization, 4.9 % and 24.1 % currently and formerly smoked cigarettes, respectively; 7.2 % currently used cannabis, 62.8 % had unknown cannabis use status. Both current and former cigarettes smoking were associated with hospitalization (Models 1–2). In Model 3, the cigarette-cannabis interaction was significant. Former cigarette smoking had higher odds for hospitalization (adjusted odds ratio [AOR] = 1.36; 95 % confidence interval [CI] 1.09–1.70) only among people who did not currently use cannabis. Current cigarette smoking yielded higher odds of hospitalization (AOR = 1.47; 95 % CI 1.02–2.12) among people whose cannabis use was unknown. Cigarette smoking status was not associated with hospitalization among people who currently used cannabis. Cigarette smoking’s associations with COVID-19 hospitalization varied by cannabis use. Future research should include both cigarette and cannabis use in understanding risk factors for COVID-19 outcomes.

Source: Addictive Behaviors Reports

DOI: 10.1016/j.abrep.2024.100565

Authors: Dian Gu, Patrick Ha, Jesse T. Kaye, Michael C. Fiore, Janice Y. Tsoh

Institutions: San Francisco General Hospital, University of California, San Francisco, UCSF Helen Diller Family Comprehensive Cancer Center, University of Wisconsin–Madison, University of Wisconsin Carbone Cancer Center

Language: English

Topic: COVID-19 Clinical Research Studies

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,140