International Journal of Public Health (Nov 2023)

The Association Between Tobacco Use and Risk of COVID-19 Infection and Clinical Outcomes in Sweden: A Population-Based Study

  • A. N. Shaaban,
  • F. Andersson,
  • F. Andersson,
  • S. Peña,
  • I. H. Caspersen,
  • C. Magnusson,
  • C. Magnusson,
  • N. Orsini,
  • N. Orsini,
  • S. Karvonen,
  • P. Magnus,
  • M. P. Hergens,
  • M. P. Hergens,
  • M. R. Galanti,
  • M. R. Galanti

DOI
https://doi.org/10.3389/ijph.2023.1606175
Journal volume & issue
Vol. 68

Abstract

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Background: The association between tobacco use and COVID-19 is controversial. During the early course of the pandemic, limited testing prevented studying a wide spectrum of clinical manifestations.Objective: To examine the potential causal association between tobacco use and COVID-19 during the second wave (1 October 2020–30 June 2021) of the pandemic in Stockholm, Sweden.Methods: A population-based cohort study was conducted in the Stockholm region of Sweden, with information on tobacco use collected prior to the pandemic. Adjusted relative risks (RR) of COVID-19 and 95% confidence intervals (CI) were calculated, contrasting current smokers and snus users to non-users of tobacco.Results: Compared with non-users of tobacco, current smokers had a lower risk of COVID-19 (RR 0.78, 95% CI = 0.75–0.81) and of hospitalisation for the disease. Current snus users had a higher risk of COVID-19. Heavy smokers and snus users had longer hospital stays than non-users of tobacco.Conclusion: Tobacco use may have a different impact on the risk of being infected with SARS-CoV-2 and the risk of developing severe clinical manifestations. Further research is needed to determine the underlying mechanisms.

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