Journal of Addictive DiseasesJan 13, 2026

Long COVID’s psychological and physical effects in people who use tobacco

Updated Jun 27, 2026

Abstract

Essence

Adults with tobacco use disorder had worse psychological symptoms, sleep, quality of life, and cortisol changes four months after long COVID.

Evidence

This prospective cohort study reevaluated 104 adults with tobacco use disorder before the pandemic and four months after long COVID diagnosis using psychological, quality-of-life, sleep, stress, and serum cortisol measures.

Caveat

The single cohort design links post-long COVID changes to worse outcomes but does not isolate long COVID from other causes or include a comparison group in the abstract.

Simplified

BACKGROUND: Individuals with tobacco use disorder (TUD) may be particularly vulnerable to the challenges following long COVID.

OBJECTIVE: This study assessed whether individuals with TUD and no prior neuropsychiatric conditions developed new symptoms following long COVID-19 infection.

METHODS: A cohort of 104 adults with TUD completed psychological and biological assessments before the COVID-19 pandemic and were reevaluated four months post-long COVID diagnosis. Evaluations covered mood symptoms, sleep, perceived stress, quality of life, and serum cortisol.

RESULTS: The participants exhibited marked increases in depressive symptoms, anxiety, insomnia, and perceived stress, accompanied by significant declines in sleep quality and quality of life (all-values < 0.001). Serum cortisol levels decreased significantly, indicating altered HPA axis activity. p

CONCLUSION: This study suggests that long COVID may disproportionately influence addictive disorders, not only by exacerbating existing vulnerabilities, but potentially contributing to the onset of new mental health challenges.