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BMC Infect Dis
. 2025 Feb 3;25(1):161.
doi: 10.1186/s12879-025-10545-x. Estimating the association between cigarette and e-cigarette use patterns and SARS-CoV-2 negative conversion time: retrospective online survey in China
Ying Xie 1 2 3 , Yinghua Li 4 , Zheng Su 2 3 , Xueyan Han 1 , Zhao Liu 2 3 , Zhenxiao Huang 1 2 3 , Anqi Cheng 2 3 , Xinmei Zhou 2 3 , Jinxuan Li 2 3 5 , Rui Qin 2 3 , Xiaowen Wei 2 3 , Yi Liu 2 3 6 , Xin Xia 2 3 6 , Qingqing Song 2 3 5 , Liang Zhao 2 3 , Kian Fan Chung 7 , Dan Xiao 8 9 , Chen Wang 10 11 12
Affiliations
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.
Keywords: COVID-19; China; Dual use; Negative conversion; Smoking; Tobacco.
. 2025 Feb 3;25(1):161.
doi: 10.1186/s12879-025-10545-x. Estimating the association between cigarette and e-cigarette use patterns and SARS-CoV-2 negative conversion time: retrospective online survey in China
Ying Xie 1 2 3 , Yinghua Li 4 , Zheng Su 2 3 , Xueyan Han 1 , Zhao Liu 2 3 , Zhenxiao Huang 1 2 3 , Anqi Cheng 2 3 , Xinmei Zhou 2 3 , Jinxuan Li 2 3 5 , Rui Qin 2 3 , Xiaowen Wei 2 3 , Yi Liu 2 3 6 , Xin Xia 2 3 6 , Qingqing Song 2 3 5 , Liang Zhao 2 3 , Kian Fan Chung 7 , Dan Xiao 8 9 , Chen Wang 10 11 12
Affiliations
- PMID: 39901130
- DOI: 10.1186/s12879-025-10545-x
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.
Keywords: COVID-19; China; Dual use; Negative conversion; Smoking; Tobacco.