Shaaban Ahmed Nabil, Andersson Filip, Thiesmeier Robert, Orsini Nicola, Peña Sebastian, Caspersen Ida Henriette, Magnusson Cecilia, Karvonen Sakari, Magnus Per Minor, Hergens Maria Pia, Qazi Basra, Galanti Maria Rosaria
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Centre for Epidemiology and Community Medicine - Stockholm Region (CES), Stockholm, Sweden.
Eur J Public Health. 2025 Feb 1;35(1):101-107. doi: 10.1093/eurpub/ckae156.
Previous research has suggested an unexpected negative association between smoking and susceptibility to COVID-19. This study, drawing on population-based data from three Nordic countries-Sweden, Norway, and Finland-aims to investigate this association further, capitalizing on diversity introduced by different containment measures. The objective of this research was to examine the association between cigarette smoking and snus (smokeless tobacco) use and the risk of confirmed COVID-19 infection. A pooled analysis integrating original data from 547,685 participants across three countries. We used a multiple imputation approach based on conditional probabilities to impute the systematically missing covariates. The associations between tobacco use and COVID-19 infection were assessed, controlling for potential confounding factors. Current cigarette smokers had a lower risk of a confirmed COVID-19 case, whereas there was an increased risk among snus users. Our sensitivity analysis confirmed that the associations between tobacco use and COVID-19 infection risk are robust, remaining consistent regardless of whether covariate imputation was applied. Findings support a negative association between smoking and SARS-CoV-2 infection, but not the hypothesis that nicotine may be protective against the risk of contracting SARS-CoV-2 infection.
先前的研究表明，吸烟与对新冠病毒的易感性之间存在意想不到的负相关关系。本研究利用来自瑞典、挪威和芬兰这三个北欧国家基于人群的数据，旨在借助不同防控措施带来的多样性进一步探究这种关联。本研究的目的是检验吸烟和使用口含烟（无烟烟草）与确诊感染新冠病毒的风险之间的关联。对来自三个国家的547,685名参与者的原始数据进行了汇总分析。我们使用了基于条件概率的多重插补方法来插补系统性缺失的协变量。在控制潜在混杂因素的情况下，评估了烟草使用与新冠病毒感染之间的关联。当前吸烟者确诊感染新冠病毒的风险较低，而口含烟使用者的风险则有所增加。我们的敏感性分析证实，烟草使用与新冠病毒感染风险之间的关联是稳健的，无论是否应用协变量插补，结果都保持一致。研究结果支持吸烟与感染新冠病毒之间存在负相关关系，但并不支持尼古丁可能对感染新冠病毒具有保护作用这一假设。
