BACKGROUND AND PURPOSE:

• Smoking cigarettes is associated with worse COVID-19 outcomes, but it is unclear whether cannabis is also associated with poorer COVID-19 outcomes
• Griffith et al. (JAMA Network Open, 2024) examined adverse COVID-19 outcomes associated with cannabis and tobacco use

METHODS:

• Retrospective cohort study
  • Extracted EHR data
  • Large US midwestern academic medical center    
• Population
  • Patients with COVID-19
• Exposures
  • Current tobacco smoking
  • Current cannabis use
• Study design
  • Multivariable modeling used to calculated odds ratio (OR)
  • Adjustment for
    • Tobacco smoking | Vaccination | Comorbidity | Diagnosis date | Demographic factors
• Primary outcomes
  • Health outcomes of hospitalization
  • ICU admission
  • All-cause mortality following COVID-19 infection

RESULTS:

• 72,501 patients with COVID-19
  • Mean age: 48.9 (SD, 19.3) years | 59.7% female
  • Current smoking: 13.4% | Former smoking: 24.4%
  • Current cannabis use: 9.7%
• For patients with COVID-19, current tobacco smoking was associated with an increased risk of
  • Hospitalization: OR 1.72 (95% CI, 1.62 to 1.82) | P<0.001
  • ICU admission: OR 1.22 (95% CI, 1.10 to 1.34) | P<0.001
  • All-cause mortality: OR 1.37 (95% CI, 1.30 to 1.57) | P<0.001
• Cannabis use was associated with an increased risk of
  • Hospitalization: OR 1.80 (95% CI, 1.68 to 1.93) | P<0.001
  • ICU admission: OR 1.27 (95% CI, 1.14 to 1.41) | P<0.001
• Cannabis use was not associated with all-cause mortality
  • OR 0.97 (95% CI, 0.81 to 1.14) | P=0.69

CONCLUSION:

• Tobacco smoking is linked to an increased risk of poorer COVID-19 outcomes
• Cannabis use also appears to be a risk factor for worse COVID-19 outcomes
• The authors state

Given the recent legalization of recreational marijuana use in more states, including the area served by this academic medical center, further research may aid in guiding interventions, such as substance use prevention and treatment, that would benefit patient outcomes moving forward in the COVID-19 pandemic and the associated heath consequences it will have in our communities

Learn More – Primary Sources:

Cannabis, Tobacco Use, and COVID-19 Outcomes