COVID-19 Resource Center

COVID-19 Resource Center

Perspective from Frank T. Leone, MD, MS
Disclosures: The authors report no relevant financial disclosures.

August 28, 2020
3 min read

E-cigarette users face ‘big’ risk for COVID-19

Perspective from Frank T. Leone, MD, MS
Disclosures: The authors report no relevant financial disclosures.

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact

Adolescents and young adults who used both e-cigarettes and combustible cigarettes were seven times more likely to acquire COVID-19, data show.

Even if young people used e-cigarettes only, they still faced a fivefold risk for COVID-19, researchers added.

Title: ORs for COVID-19 diagnosis among 2,183 young people in the U.S.: Left bar: Those who used both e-cigarettes and combustible cigarettes = 6.97 Right bar: Those who used e-cigarettes only = 5.05
Reference: Gaiha SM, et al. J Adolesc Health. 2020;doi:S1054-139X(20)30399-2.

“We know that youth don’t start using tobacco through cigarettes, they start through e-cigarettes,” Bonnie Halpern-Felsher, PhD, FSAHM, professor of pediatrics at Stanford University, told Healio Primary Care. “That is why even though we show dual use, we are more focused on e-cigs since that is what youth start with and are predominately using.”

Bonnie Halpern-Fisher
Bonnie Halpern-Felsher

Researchers analyzed survey responses from 4,351 individuals in the United States aged 13 to 24 years — including 2,168 who never smoked — to assess the relationship between COVID-19 and dual use (both vaping and smoking), vaping only and combustible cigarette use only. The researchers also accounted for respondents’ sociodemographic factors, BMI and compliance with shelter-in-place orders.

Halpern-Felsher and colleagues found that dual users were seven times (95% CI, 1.98–24.55) more likely to be diagnosed with COVID-19, and young people who used e-cigarettes only were five times more likely to be diagnosed (95% CI, 1.82–13.96). Identifying as male, other/nonbinary gender, Hispanic or other/multiracial was commonly associated with a COVID-19 diagnosis, researchers said.

“This study tells us pretty clearly that youth who are using vapes or are dual-using are at elevated risk, and it’s not just a small increase in risk; it’s a big one,” Shivani Gaiha, PhD, a postdoctoral research fellow in adolescent medicine at Stanford University, said in a press release.

The findings prompted U.S. Rep. Raja Krishnamoorthi, D-Ill., chair of the Subcommittee on Economic and Consumer Policy, to send the FDA a letter requesting that all e-cigarettes be removed from the market during the “coronavirus crisis,” writing that "it is the only responsible path forward."

An FDA spokesperson told Healio Primary Care that the agency responded to Krishnamoorthi’s letter but deferred questions regarding its contents to Krishnamoorthi’s office. The Congressman did not return requests for comment prior to this story’s posting.