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Updated: Oct 3, 2025
10:44
Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
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Association between smoking, e-cigarette use and severe COVID-19: a cohort study
Min Gao1,2,3, Paul Aveyard1,2, Nicola Lindson1
1Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.
International Journal of Epidemiology
|February 18, 2022
Summary
Current smoking may reduce the risk of severe COVID-19, but increases overall mortality. E-cigarette use showed no clear association with COVID-19 severity. Further research into smoking
Area of Science:
- Epidemiology
- Public Health
- Respiratory Medicine
Background:
- Smoking is a known risk factor for respiratory infections.
- The potential protective effect of smoking against SARS-CoV-2 infection requires investigation.
Purpose of the Study:
- To determine if smoking and e-cigarette use are associated with severe COVID-19 outcomes.
- To analyze the association between smoking status and COVID-19 hospitalization, ICU admission, and death.
Main Methods:
- A large cohort study in England (January-April 2020) included over 7.8 million individuals.
- Smoking status, demographics, and pre-existing conditions were recorded and linked to hospital and death data.
- Cox proportional hazards models were used to assess associations, adjusting for confounding factors.
Main Results:
- Current smokers had a reduced risk of COVID-19 hospitalization, ICU admission, and death compared to never smokers.
- Former smokers exhibited an increased risk of severe COVID-19 outcomes.
- E-cigarette use was not clearly associated with COVID-19 hospitalization, ICU admission, or death.
Conclusions:
- Current smoking is linked to lower severe COVID-19 risk but higher all-cause mortality.
- The association between e-cigarette use and COVID-19 severity remains unclear.
- Investigating potential protective mechanisms of smoking for SARS-CoV-2 infection, including nicotine's role, is warranted.
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