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Studies of the association between use of smokeless tobacco and COVID-19 would help refining this hypothesis. We analysed data from 424,386 residents in the Stockholm Region, Sweden, with information on smoking and smokeless tobacco (<jats:italic>snus<\/jats:italic>) use prior to the pandemic obtained from dental records. Diagnoses of COVID-19 between February and October 2020 were obtained from health-care registers. We estimated the risk of receiving a diagnosis of COVID-19 for current smokers and for current <jats:italic>snus<\/jats:italic> users relative to non-users of tobacco, adjusting for potential confounders (aRR). The aRR of COVID -19 was elevated for current <jats:italic>snus<\/jats:italic> users (1.09 ;95%CI\u2009=\u20090.99\u20131.21 among men and 1.15; 95%CI\u2009=\u20091.00\u20131.33 among women). The risk for women consuming more than 1 can\/day was twice as high as among non-users of tobacco. Current smoking was negatively associated with risk of COVID-19 (aRR\u2009=\u20090.68; 95% CI\u2009=\u20090.61\u20130.75); including hospital admission (aRR\u2009=\u20090.60; 95% CI\u2009=\u20090.47\u20130.76) and intensive care (aRR\u2009=\u20090.43; 95% CI\u2009=\u20090.21\u20130.89). The hypothesis of a protective effect of tobacco nicotine on COVID-19 was not supported by the findings. The negative association between smoking and COVID-19 remains unexplained.<\/jats:p>","DOI":"10.1038\/s41598-023-28091-4","type":"journal-article","created":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T11:02:49Z","timestamp":1674298969000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Current tobacco use and COVID-19 diagnoses in a cohort of adult clients of public dental clinics in Sweden"],"prefix":"10.1038","volume":"13","author":[{"given":"M. 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None of the coauthors declares conflict of interest associated with commercial enterprises or non-financial competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1204"}}