Incidence and Determinants of COVID-19 Among People Who Smoke (2018-2021): Findings From the ITC EUREST-PLUS Spain Surveys

Dolors Carnicer-Pont; Marcela Fu; Yolanda Castellano; Olena Tigova; Pete Driezen; Anne C K Quah; Susan C Kaai; Joan B Soriano; Constantine I Vardavas; Geoffrey T Fong; Esteve Fernández

doi:10.1016/j.arbres.2024.05.037

Incidence and Determinants of COVID-19 Among People Who Smoke (2018-2021): Findings From the ITC EUREST-PLUS Spain Surveys

Arch Bronconeumol. 2024 Nov;60(11):690-697. doi: 10.1016/j.arbres.2024.05.037. Epub 2024 Jun 12.

[Article in English, Spanish]

Authors

Affiliations

¹ Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain.
² Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, University of Barcelona, Barcelona, Spain. Electronic address: [email protected].
³ Tobacco Control Unit, Catalan Institute of Oncology - WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Spain; Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
⁴ Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
⁵ Department of Psychology, University of Waterloo, Waterloo, Canada.
⁶ Centre for Biomedical Research in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain; Pneumology Department, Hospital Universitario de la Princesa, Madrid, Spain.
⁷ School of Medicine, University of Crete, Heraklion, Greece; European Network for Smoking and Tobacco Prevention, Brussels, Belgium; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, United States.
⁸ Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Canada; Ontario Institute for Cancer Research, Toronto, Canada.

PMID: 38944617
DOI: 10.1016/j.arbres.2024.05.037

Abstract

Objective: To estimate the cumulative incidence of COVID-19 and its determinants among a nationally representative sample of adults from Spain who smoke.

Methods: This is a prospective cohort study that uses data from two waves (Wave 2 in 2018 and Wave 3 in 2021) of the ITC EUREST-PLUS Spain Survey. At baseline (Wave 1 in 2016), all respondents were adults (aged ≥18) who smoked. In total, 1008 respondents participated in Wave 2, and 570 out of 888 eligible participants were followed up in Wave 3 (64.2%). We estimated the cumulative incidence and the relative risk of COVID-19 (RR) and 95% confidence intervals (CI) during follow-up using self-reported information on sociodemographic, smoking-related and health-related characteristics and identified associated factors using multivariable Poisson models with robust variance adjusted for the independent variables.

Results: The overall cumulative incidence of self-reported COVID-19 was 5.9% (95% CI: 3.9-8.0%), with no significant differences between males (6.3%; 95% CI: 3.6-9.0%) and females (5.6%; 95% CI: 3.2-8.0%). After adjusting for age, sex, and educational level, COVID-19 incidence was positively associated with moderate nicotine dependence (RR: 2.37; 95% CI: 1.04-5.40) and negatively associated with having a partner who smoked (RR: 0.12; 95% CI: 0.03-0.42), and having friends but not a partner who smoked (RR: 0.28; 95% CI: 0.14-0.56).

Conclusion: The correlates of having had COVID-19 among people who smoke should be considered when tailoring information and targeted non-pharmacological preventive measures.

Keywords: COVID-19; Cohort; Incidence; Smokers; Spain; Tobacco.

MeSH terms

Adolescent
Adult
Aged
COVID-19* / epidemiology
COVID-19* / prevention & control
Female
Humans
Incidence
Male
Middle Aged
Prospective Studies
Risk Factors
SARS-CoV-2
Self Report
Smokers / statistics & numerical data
Smoking / epidemiology
Spain / epidemiology
Young Adult