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Although the studies included in our paper (published as of May 25, 2020) reflect the first wave of COVID-19 pandemic, our results (OR 1.59, 95% CI 1.331.89, p = 0.001) are consistent with a meta-analyses published after our paper was submitted in September 2020 based on 109 studies from when the pandemic started [58] to February 2021 (1.55, 95% CI 1.411.71) [59]

Users can activate the device with a button to begin inhaling vapor from the pod

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however, cigar use has increased, by not as much, but enough to be a problem