The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review.

1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.