The news media plays an important role in informing the public about COVID-19

Since the beginning of 2020 the world has grappled with the COVID- 19 pandemic and there has been a continued effort to investigate risk factors for infection and severe COVID-19 pathology, particularly those modifiable through public health interventions. Two of the pro- posed risk factors for COVID-19 infection and diseases severity are tobacco and cannabis use, although the evidence base for these associations is inconclusive. Some of the hypothesized risk association is thought to be through behaviors, e.g. sharing smoking paraphernalia  or touching one’s mouth during smoking  which puts users at heightened risk for COVID-19 infection due to the exchange of respiratory droplets and saliva carrying the virus. Another concern is that tobacco and cannabis use may pose an in- creased risk of COVID-19 infection and severity of disease through physical health related damage  caused by use of the substances . However, the scientific claims for these re- ports have been subject to debate, mobile vertical farm with two early reviews on tobacco users reaching different conclusions .

Subsequent systematic reviews and meta-analyses concluded that smoking tobacco products is a risk factor for more severe progression of COVID-19 . Contradictory results have also been published related to e- cigarettes with some studies finding an increased risk of COVID-19 infection and severity among e-cigarette users , while others fail to confirm such an association . Similarly to tobacco use, cannabis is typically administrated by smoking or vaping and associated with similar physiological damage as that caused by smoked tobacco . Nevertheless, comparatively few studies have investigated the relation- ship between cannabis smoking/vaping and COVID-19 infection and disease severity . The association between cannabis use and COVID-19 is particularly controversial as there is an empirical basis to suggest that, alongside potential adverse effects, cannabis use may confer beneficial effects. For example, cannabidiol present in the cannabis plant, may reduce inflammation, which may reduce the risk of severe COVID-19 disease prognosis in some individuals .

However, this was not confirmed in clinical trials ,vertical farming racks and scientists have warned against unfounded claims about CBD’s protective effects related to COVID-19 . Other studies have proposed that cannabis may help alleviate the severity of depressive symptoms, thus helping vulnerable groups cope with mental health is- sues caused by the pandemic.However, news media coverage may confuse or mislead the public, particularly when the scientific basis for the information evolves over time and ap- pears to be contradictory . For example, early studies on the link between smoking and COVID-19 infection among Chinese patients reported that smoking had a protective effect, but did not adjust for relevant covariates and had other major methodological flaws. These studies were reported on by journalists before undergoing adequate peer review and presented in a causal framework rather than as correlations . Furthermore, twitter messages frequently cite news reports to spread false or unsupported messages about the protective effect of inhaled CBD and nicotine related to COVID-19 . To our knowledge, this study is the first attempt to investigate the way in which news media coverage described the link between COVID- 19 risk and use of tobacco and cannabis.

The study focuses on Israeli news reports as Israel represents a unique case study for various reasons. First, Israel houses one of the world’s longest running medical cannabis programs . Second, while recreational cannabis use is illegal in Israel, cannabis use rates are relatively high in Israel  compared to other western countries . Third, while tobacco use prevalence rates have been declining in Israel , they remain high compared to many other high-income countries . Fourth, the Israeli response to the COVID-19 pandemic was unique in that it was one of the first nations to close its borders and quarantine travelers returning from abroad . Israel imposed strict lockdown measures early on in the pandemic and it was the first country to roll out a national mass vaccination program against COVID-19 . Understanding how news outlets in Israel report on tobacco and cannabis in relation to risk of COVID-19 infection and disease severity is important as it may influence the public’s attitudes and behavior related to the sub- stances . As a unique case, Israel represents a potentially insightful case for future studies to compare and contrast with.