{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:10:11Z","timestamp":1778224211738,"version":"3.51.4"},"reference-count":25,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>It is unclear whether cannabis use is associated with adverse health outcomes in patients with COVID-19 when accounting for known risk factors, including tobacco use.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine whether cannabis and tobacco use are associated with adverse health outcomes from COVID-19 in the context of other known risk factors.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective cohort study used electronic health record data from February 1, 2020, to January 31, 2022. This study included patients who were identified as having COVID-19 during at least 1 medical visit at a large academic medical center in the Midwest US.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Current cannabis use and tobacco smoking, as documented in the medical encounter.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Health outcomes of hospitalization, intensive care unit (ICU) admission, and all-cause mortality following COVID-19 infection. The association between substance use (cannabis and tobacco) and these COVID-19 outcomes was assessed using multivariable modeling.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 72\u202f501 patients with COVID-19 were included (mean [SD] age, 48.9 [19.3] years; 43\u202f315 [59.7%] female; 9710 [13.4%] had current smoking; 17\u202f654 [24.4%] had former smoking; and 7060 [9.7%] had current use of cannabis). Current tobacco smoking was significantly associated with increased risk of hospitalization (odds ratio [OR], 1.72; 95% CI, 1.62-1.82; P<\/jats:italic>\u2009&amp;lt;\u2009.001), ICU admission (OR, 1.22; 95% CI, 1.10-1.34; P<\/jats:italic>\u2009&amp;lt;\u2009.001), and all-cause mortality (OR, 1.37, 95% CI, 1.20-1.57; P<\/jats:italic>\u2009&amp;lt;\u2009.001) after adjusting for other factors. Cannabis use was significantly associated with increased risk of hospitalization (OR, 1.80; 95% CI, 1.68-1.93; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and ICU admission (OR, 1.27; 95% CI, 1.14-1.41; P<\/jats:italic>\u2009&amp;lt;\u2009.001) but not with all-cause mortality (OR, 0.97; 95% CI, 0.82-1.14, P<\/jats:italic>\u2009=\u2009.69) after adjusting for tobacco smoking, vaccination, comorbidity, diagnosis date, and demographic factors.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this cohort study suggest that cannabis use may be an independent risk factor for COVID-19\u2013related complications, even after considering cigarette smoking, vaccination status, comorbidities, and other risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.17977","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T15:34:21Z","timestamp":1718984061000},"page":"e2417977","source":"Crossref","is-referenced-by-count":9,"title":["Cannabis, Tobacco Use, and COVID-19 Outcomes"],"prefix":"10.1001","volume":"7","author":[{"given":"Nicholas B.","family":"Griffith","sequence":"first","affiliation":[{"name":"Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy B.","family":"Baker","sequence":"additional","affiliation":[{"name":"Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan T.","family":"Heiden","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri"},{"name":"Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Smock","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giang","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Yu","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert M.","family":"Lai","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Hogue","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura J.","family":"Bierut","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Shiun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri"},{"name":"Alvin J. 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