Electronic cigarette use and risk of SARS-CoV-2 infection

Introduction: Some researchers speculated that novel nicotine-containing products, such as electronic cigarettes and heated tobacco products, could lower the risk of SARS-CoV-2 infection. The aim of this study is to investigate the role of electronic cigarettes on SARS-CoV-2 infection. Methods: We conducted a systematic literature review, updated to February 2023, using PubMed/ MEDLINE and Web of Science and a meta-analysis on all the studies providing data on the link between electronic cigarette and SARS-CoV-2 infection. Results: Starting from 553 non-duplicate publications, we selected 13 original articles on the topic of interest. The pooled odds ratio (OR) of SARS-CoV-2 infection for electronic cigarette users vs. electronic cigarette never/non-users, based on 13 studies (4 cohort and 9 cross-sectional studies), was 1.31 (95% confidence interval, CI: 1.09-1.58). Discussion: No evidence was found on the alleged protective role of electronic cigarette use on SARS-CoV-2 infection. On the contrary, electronic cigarette use is significantly associated with a 30% increased risk of infection.