Researchers Find Nationwide Links Between Vaping and COVID-19

States with more vapers had larger numbers of daily coronavirus cases and deaths in the early weeks of the pandemic — with New York state as a hot spot, according to an analysis by the University of Rochester Medical Center.

Led by Dongmei Li, Ph.D., an expert in biostatistics at URMC, the study adds to growing national data that links vaping and the coronavirus. Although the current analysis does not provide a direct cause-and-effect between the two, it raises more concerns about vaping, which has also been linked to outbreaks of other illnesses and deaths from the chemicals in vaping products.

The journal Preventive Medicine Reports published Li’s findings.

“As the country comes to grips with behaviors that may raise or lower risks of contracting COVID-19,” Li said, “our study supports the possibility that vaping increases the risk.”

Li and her team analyzed integrated population data in each U.S. state from the Centers for Disease Control and Prevention (CDC) 2018 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS annually surveys about 400,000 Americans on health habits and risks. For this project, researchers focused on vaping data. They also gathered coronavirus cases and deaths from CDC data and other reliable sources, and then used statistical models to examine the prevalence of e-cigarette use and coronavirus infections from Jan. 21, 2020 to April 25, 2020.

The study also found that less education played a role in the number of infections. States with a higher proportion of residents without a high school degree, for example, had higher coronavirus death rates.

New York state was at the epicenter of the coronavirus pandemic early in 2020. Li’s study showed that the prevalence of vaping in New York was nearly 5 percent of the population, and the coronavirus incidence rate was nearly 148 per 10,000 people — much higher than many other states in the U.S.

Vaping might also be a means of spreading the coronavirus, Li suggested.

Droplets of virus can escape through the e-cigarette aerosols, or individuals may spread an infection through saliva when they share vaping devices. Contact tracers in Indiana, for example, discovered that several Purdue University students were infected after sharing vaping devices. Locally, Li said, it’s possible that high school and college students who vape may be at higher risk of infecting themselves and others.  

A flurry of other recent studies has warned of the dangers of vaping during the pandemic. For example, the URMC and others reported that vapers and smokers seem to have an abundance of a protein receptor known as ACE2 that acts as a gateway to the virus; and that teenagers and young adults who vape are at substantial risk of coronavirus. Li also recently published a study in the journal PLoS One, showing a link between vaping and cognitive complaints, such as difficulty concentrating and making decisions, in U.S. adults.

Li’s vaping and coronavirus study is co-authored by Daniel Croft, M.D., Deborah Ossip, Ph.D., and Zidian Xie, Ph.D., and was funded by the National Cancer Institute and the Food and Drug Administration Center for Tobacco Products. Li is an associate professor of Clinical and Translational Research at the UR Clinical and Translational Science Institute.