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Multicenter Study
. 2023 Aug 3:11:1210102.
doi: 10.3389/fpubh.2023.1210102. eCollection 2023.

Risk of secondhand smoke exposure and severity of COVID-19 infection: multicenter case-control study

Surekha Kishore  1 , Vandana Shah  2 , Om Prakash Bera  3 , U Venkatesh  4 , Rakesh Kakkar  5 , Pradeep Aggarwal  6 , Pankaj Bhardwaj  7 , C M Singh  8 , Chetna Maliye  9 , Suneela Garg  10 , Geetha R Menon  11 , Puneet Misra  12 , Shival Kishore Verma  13 ; COVID SHS Study Group
Collaborators, Affiliations
Multicenter Study

Risk of secondhand smoke exposure and severity of COVID-19 infection: multicenter case-control study

Surekha Kishore et al. Front Public Health. .

Abstract

Introduction: Exposure to secondhand smoke (SHS) is an established causal risk factor for cardiovascular disease (CVD) and chronic lung disease. Numerous studies have evaluated the role of tobacco in COVID-19 infection, severity, and mortality but missed the opportunity to assess the role of SHS. Therefore, this study was conducted to determine whether SHS is an independent risk factor for COVID-19 infection, severity, mortality, and other co-morbidities.

Methodology: Multicentric case-control study was conducted across six states in India. Severe COVID-19 patients were chosen as our study cases, and mild and moderate COVID-19 as control were evaluated for exposure to SHS. The sample size was calculated using Epi-info version 7. A neighborhood-matching technique was utilized to address ecological variability and enhance comparability between cases and controls, considering age and sex as additional matching criteria. The binary logistic regression model was used to measure the association, and the results were presented using an adjusted odds ratio. The data were analyzed using SPSS version 24 (SPSS Inc., Chicago, IL, USA).

Results: A total of 672 cases of severe COVID-19 and 681 controls of mild and moderate COVID-19 were recruited in this study. The adjusted odds ratio (AOR) for SHS exposure at home was 3.03 (CI 95%: 2.29-4.02) compared to mild/moderate COVID-19, while SHS exposure at the workplace had odds of 2.19 (CI 95%: 1.43-3.35). Other factors significantly related to the severity of COVID-19 were a history of COVID-19 vaccination before illness, body mass index (BMI), and attached kitchen at home.

Discussion: The results of this study suggest that cumulative exposure to secondhand cigarette smoke is an independent risk factor for severe COVID-19 illness. More studies with the use of biomarkers and quantification of SHS exposure in the future are needed.

Keywords: COVID-19; secondhand smoke; smoking; substance abuse; vaccination.

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Conflict of interest statement

VS was employed by Campaign for Tobacco-Free Kids. OB was employed by Global Health Advocacy Incubator. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Sites that participated in the study.
See this image and copyright information in PMC

References

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