4

Recently a number of reports have surfaced claiming that vaping radically increases susceptibility to COVID-19 infection among the young.

For example, Sky News reports:

Teenagers and young adults who vape may be up to seven times more likely to catch coronavirus, a study has found.

Researchers, who surveyed 4,351 Americans aged 13-24 years in May, found those who had used both e-cigarettes and cigarettes were seven times more likely to be diagnosed with COVID-19.

This report got a lot of media attention and some recommended much more stringent control of vaping as a response to the virus. One congress member wrote to the FDA to demand that vaping products be banned using the report's evidence.

There are some reasons to be skeptical of this report. Several studies have shown some protective effect of nicotine on COVID-19 infection or progression. One review argued the following:

...In light of these findings, they propose that pharmaceutical nicotine may be used as a potential treatment option in COVID-19. ... nicotine is relatively safe for human consumption at low concentrations as nicotine replacement therapy as well as nicotine-containing vaping and heated tobacco products...

That's two diametrically opposed opinions. One calls for nicotine delivery devices to be banned. Another proposes their use as a prophylactic against the virus (based on large studies of people actually ill with the disease). Which is right?

Is the claim from the congressman that vaping increases the risk of catching COVID-19 credible?

Oddthinking
  • 140,378
  • 46
  • 548
  • 638
matt_black
  • 56,186
  • 16
  • 175
  • 373
  • 2
    Are you possibly conflating nicotine with vaping? Indeed, vaping introduces nicotine into the lungs, but it also introduces many other things. Maybe the title and question should focus on vaping. The first and second quotes focus on each of these separately, it seems. –  Aug 14 '20 at 20:11
  • 1
    Maybe I'm ahead of myself here, and an answer should address this. –  Aug 14 '20 at 20:14
  • @fredsbend the second quote was from a review of nicotine containing things including non-smoking routes. But I've changed the title to focus on vaping. But separating the effects from smoking is hard, though it is also hard to see how vaping could be *much worse* than smoking which is effectively what the first report seems to claim. – matt_black Aug 14 '20 at 20:18
  • And the question some researchers seem to be addressing is whether *nicotine* has a notable effect not the particular route of delivering it. – matt_black Aug 14 '20 at 20:19
  • 4
    It might be worth taking into account that vaping also includes behaviors that would increase one's probability of infectious contact. Cigarettes are single-use items generally contained, for the most part, in a package. Vaping uses a reusable device which, if you carry it in a pocket or leave it on a desk, could see multiple infection vectors if an infected individual is near it. Without hard evidence, I also suspect that younger users may be more inclined to share a vaping device with friends than cigarettes. – Cristobol Polychronopolis Aug 14 '20 at 20:42
  • @CristobolPolychronopolis A fascinating hypothesis. But, as you say, show me the data. – matt_black Aug 14 '20 at 20:44
  • 1
    @CristobolPolychronopolis cigarettes and spliffs are commonly shared too, and then as with a vape it may have nothing to do with their content. – Weather Vane Aug 15 '20 at 20:02
  • 3
    I see three issues where this question goes further than the claims. 1) Title has false dilemma: Vaping may increase risk, it may reduce risk, it may do neither, it may do both (with different mechanisms). – Oddthinking Aug 15 '20 at 22:01
  • 2) The initial claim is that there is a correlation, not causation. We can speculate with lots of confounding factors: smokers/vapers cough more, so get tested more. Smokers/vapers take more risks with their health, so don't socially distance and get infected more. Smokers/vapers can't smoke and wear a mask, and so get exposed to more. So the question should be about correlations, not causes. – Oddthinking Aug 15 '20 at 22:04
  • 4
    3) The two claims do NOT contradict. One is claiming more infections. The other is claiming fewer serious consequences of acute lung injury. Vaping might BOTH increase the risk of catching COVID-19 and at the same time make it more likely to be mild (at least with this singular harm). – Oddthinking Aug 15 '20 at 22:07
  • @Oddthinking At a detailed level you might be right that the teenage paper doesn't really contradict other studies. But that wasn't how it was treated in the media. And the idea that a higher rate of infections is caused but people are protected from disease progression is interesting but, to some extent, does contradict the studies measuring the progression of the disease which are based on far fewer smokers seeming to have symptoms. I think an answer could address this and clarify the apparent contradictions. – matt_black Aug 15 '20 at 22:14
  • @Oddthinking The alternative for this site would be to pose two entirely separate questions (is vaping bad? and does nicotine protect?) based on the two claims. But my intuition is that this would disconnect two claims that should be related. To me, a good answer would survey the quality of evidence for the claims and come to a good summary that covers the possible contradictions or more complex explanations. Moreover, I don't think the basic claim is that unclear. The answers might be but the claim isn't. – matt_black Aug 15 '20 at 22:19
  • 1
    You may know my general dislike for covid-Qs here, as it's *still* emerging-disease… Lot's of bad 'studies', even the good ones resulting in sometimes radically changing picture. Have we revisited all the early qs on this site from first quarter of the year? But this is even way more complicated by focus on US vaping: the vaping-related-lung-disease thing from last year; just where is it in Europe, Asia? In the US there is sth in some products that's 'not good'. Tocopherol-acetate say some, nicotine, THC and 'stuff' the crusaders. Last checked: still unresolved, but specific to US? – LangLаngС Aug 16 '20 at 11:19
  • Although: The actual 'new' study here is just *hilarious.* How it's reported just atrocious. I'd really like to dissect it from the very first sentence downwards. But that would increase my risk-factors as well ;) I suggest we just wait a while, it just has to be retracted eventually. – LangLаngС Aug 16 '20 at 11:34
  • 1
    @Oddthinking I'm struggling to see how to make the question clearer. Any suggestions? – matt_black Aug 16 '20 at 13:28
  • 1
    For my tastes the reach of the title is way too big and answers to Q unlikely to 'age well'. This a snapshot of time and imo should be treated as such. You may also start from this putrid outflow of this mess: http://cdn.cnn.com/cnn/2020/images/08/11/2020.08.11.rk.to.fda.re.vaping.and.coronavirus.pdf giving you much 'stronger claims' (alas, that are obviously not 'better', but 'easier')? – LangLаngС Aug 16 '20 at 16:19
  • 1
    @LangLаngС Since people are pushing for actions right now based on that specific report (as your link shows) I still think it is worth addressing. Not least because I'm not sure a self-assessed survey should have the same weight as reviews of many studies of hospitalised patients that comes to a different conclusion. – matt_black Aug 17 '20 at 21:36
  • Yup. Diff things: Title is too long reach (A: weedunnonow) & contrasting studies (1hand: empirical curiosity, well attested, but ultima-unexplained, 2hand: utter bullshit study, well explained: with poor methods, biased aftermarket reporting and very motivated reasoning (see [HerrGlantz'confirmation bias joy without scruples](https://tobacco.ucsf.edu/blogs/sglantz) giving triumphantly *bad* advice) "Vaping LGBTQ users of the past 30 days twice as likely to report Covid symtoms"? (O-study Gaiha) // Can you bring the Q/claim from Gaiha/around into a form that allows for a *lasting* answer? – LangLаngС Aug 18 '20 at 10:46
  • 1
    Might I suggest a change in the title? "*Is it true that vaping increases the likelihood of being seriously ill with COVID 19?*" or words to that effect. But I think no ordinary user on SE can hope answer this question until the pandemic is well over and all the data has been collected, which could take months if not years. – Mari-Lou A Aug 18 '20 at 11:22
  • We have several different claims being quoted: (1) Vaping in teenagers is associated with higher risk of catching COVID-19 [Note: Association. Single study. No mention of nicotine.]. (2) Nicotine can prevent a type of lung injury. (3) Someone has said maybe nicotine could reduce one serious symptom. Not really a claim, and clearly one that no-one knows the answer to yet. No-one says "vaping increases the likelihood of being seriously ill with COVID 19" So what is the claim to be tested here? If other people are abusing these results to make specific recommendations, let's quote them instead. – Oddthinking Aug 18 '20 at 15:12
  • 1
    @Oddthinking I've simplified to focus in the claim in the vaping study. I could ask whether the proposed policy of banning vaping makes sense, but this site, at least historically, hates policy questions. The focus for me is the claims made in the vaping survey which seem multiply dubious given clinical analysis from hospitalised patients, though they ask a different question (I've removed a lot of that detail as it seemed to confuse people instead of clarifying the fact that some evidence is clearly at variance with the survey). – matt_black Aug 18 '20 at 15:35
  • If that 'politician concludes' angle is unwanted then the (sky)news angle may go as well (& I maintain, that both would be easier) may I suggest to directly pit finding against finding, study against study: (Gaiha vs) Polosa: 2nd column, 2nd half, starting with "Their systematic review observed…" focus on incidence & prevalence [Though: There'd still be a problem that 'US-vaping' is sometimes w/o nicotine, but other stuff, whereas smoking is elsewhere rel clearly 'pyrolisis of tobacco for nicotine consumption' and I personally doubt that for both cases confounders *of the two* are controlled – LangLаngС Aug 18 '20 at 15:53

0 Answers0