Differences in Oral Lesions Associated with Tobacco Smoking, E-Cigarette Use and COVID-19 Infection among Adolescents and Young People in Nigeria

COVID-19 infection is associated with oral lesions which may be exacerbated by tobacco smoking or e-cigarette use. This study assessed the oral lesions associated with the use of e-cigarettes, tobacco smoking, and COVID-19 among adolescents and young people in Nigeria. A national survey recruited 11–23-year-old participants from the 36 States of Nigeria and the Federal Capital Territory, Abuja. Data were collected using Survey Monkey®. Binary logistic regression analysis was conducted. Statistical significance was set at p-value less than 0.05. There were 2870 participants, of which 386 (13.4%) were tobacco smokers, 167 (5.8%) e-cigarette users, and 401 (14.0%) were both e-cigarette and tobacco users;and 344 (12.0%) had ever tested positive to COVID-19. Adolescents and young people who smoked tobacco had more than twice the odds of reporting gingival inflammation, oral ulcers, dry mouth, and changes in taste than those who did not smoke. Those who used e-cigarettes had 1.5 times higher odds of reporting oral lesions. Respondents who had COVID-19 infection had higher odds of reporting gingival inflammation and lower odds of reporting dry mouth than those who did not have COVID-19 infection. These findings were significant, and may help clinicians to screen for tobacco use and COVID-19 among adolescents and young people in Nigeria.

Differences in risk indicators associated with electronic cigarette use and tobacco smoking among adolescents and young people in Nigeria.

INTRODUCTION: The study determined the proportion of adolescents and young persons (AYP) in Nigeria who use e-cigarettes and smoke tobacco; and identified factors associated with the use of e-cigarettes and tobacco smoking. METHODS: AYP aged 11-23 years were recruited to participate in an online survey. The independent variables were respondents' health, HIV and COVID-19 status and their level of anxiety. The dependent variables were tobacco smoking and use of e-cigarettes. Binary logistic regression was used to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, educational level and vulnerability status). RESULTS: There were 2206 respondents of which 568 (19.8%) used e-cigarettes and 787 (27.4%) smoked tobacco. Individual (18-23 years, having a health condition, high anxiety and being vulnerable) and familial (having father, mother, siblings or friends who used e-cigarettes) factors were associated with both the use of e-cigarettes and tobacco smoking. Tobacco smoking was a significant risk indicator for e-cigarettes use and vice versa. COVID-19 infection (adjusted OR, AOR: 3.602) and living with HIV (AOR: 1.898) were associated with higher odds of using e-cigarettes. Males (AOR: 1.577), 15-17 years (AOR: 6.621) and moderate anxiety (AOR: 2.500) were associated with higher odds of tobacco smoking. AYP with health conditions had higher odds of using e-cigarettes (AOR: 1.514) while AYP with moderate anxiety had lower odds of using e-cigarettes (AOR: 0.627). CONCLUSION: The proportion of AYP in Nigeria who used e-cigarettes and smoked tobacco is high. Public health interventions that target the common risk factors for e-cigarettes use and tobacco smoking among AYP in Nigeria are urgently needed.

Differences in Oral Lesions Associated with Tobacco Smoking, E-Cigarette Use and COVID-19 Infection among Adolescents and Young People in Nigeria.

COVID-19 infection is associated with oral lesions which may be exacerbated by tobacco smoking or e-cigarette use. This study assessed the oral lesions associated with the use of e-cigarettes, tobacco smoking, and COVID-19 among adolescents and young people in Nigeria. A national survey recruited 11-23-year-old participants from the 36 States of Nigeria and the Federal Capital Territory, Abuja. Data were collected using Survey Monkey®. Binary logistic regression analysis was conducted. Statistical significance was set at p-value less than 0.05. There were 2870 participants, of which 386 (13.4%) were tobacco smokers, 167 (5.8%) e-cigarette users, and 401 (14.0%) were both e-cigarette and tobacco users; and 344 (12.0%) had ever tested positive to COVID-19. Adolescents and young people who smoked tobacco had more than twice the odds of reporting gingival inflammation, oral ulcers, dry mouth, and changes in taste than those who did not smoke. Those who used e-cigarettes had 1.5 times higher odds of reporting oral lesions. Respondents who had COVID-19 infection had higher odds of reporting gingival inflammation and lower odds of reporting dry mouth than those who did not have COVID-19 infection. These findings were significant, and may help clinicians to screen for tobacco use and COVID-19 among adolescents and young people in Nigeria.