ArticleTobacco induced diseases2025
Association between long-term smoking cessation and COVID-19 outcomes: Findings from a nationwide crosssectional online survey in China.
Article in Tobacco induced diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSmoking has been identified as a potential risk factor for adverse COVID-19 outcomes. This study aimed to investigate the association between long-term smoking cessation and COVID-19 outcomes.
methodsIn this nationwide, cross-sectional online survey conducted in China (January-February 2023), 22709 adults with COVID-19, confirmed by nucleic acid amplification test (NAAT) or SARS-CoV-2 antigen testing, were included. Smoking status was self-reported and classified as never smokers, long-term ex-smokers (≥10 years), ex-smokers (<10 years), and current smokers. COVID-19 outcomes, including pneumonia, hospitalization, and severe COVID-19, were compared across these groups. Logistic regression models were used to adjust for potential confounders. Sensitivity analyses included all self-reported cases irrespective of test confirmation.
resultsAmong 22709 COVID-19-positive participants, current smokers and ex-smokers <10 years exhibited significantly higher proportion of pneumonia, hospitalization, and severe COVID-19 than never smokers. Current smokers (AOR=3.18; 95% CI: 2.90-3.48) and ex-smokers quit <10 years (AOR=3.48; 95% CI: 2.96-4.09) had increased odds of pneumonia, whereas long-term ex-smokers showed no elevated risk (AOR=1.12; 95% CI: 0.45-2.41). These associations were consistent in sensitivity analyses. Other factors significantly associated with pneumonia included sex, education level, residence, obesity, income, and chronic conditions.
conclusionsLong-term smoking cessation was not associated with an elevated risk of COVID-19-related pneumonia compared to never smokers, whereas ex-smokers (<10 years) and current smokers remained high-risk groups. These findings support the potential benefits of sustained cessation, although further longitudinal studies are needed to confirm and extend these findings.
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