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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 62109

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Special Issue Editors

Dr. Judith J. Prochaska

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Guest Editor

Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, CA 94305, USA
Interests: addiction; nicotine; tobacco; vaping; cannabis; mental health; treatment

Dr. Kathleen Gali

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Assistant Guest Editor

Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, CA 94305, USA
Interests: tobacco; cannabis; disparities; risk perceptions;

Dr. Erin A. Vogel

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Assistant Guest Editor

Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, CA 94305, USA
Interests: tobacco; cannabis; multiple health risk behaviors; digital health; social media;

Dr. Kelly C. Young-Wolff

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Assistant Guest Editor

Division of Research, Kaiser Permanente Northern California, Oakland CA 94612
Interests: tobacco; cannabis; vaping; policy; vulnerable populations;

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic has had widespread effects. Restrictions on social and occupational activities have dramatically altered daily routines; retailers have been restricted; and personal experiences with isolation, illness, and economic effects have led to uncertainty, immense stress, and grief. While prior evidence indicates smoking is associated with a greater risk of developing respiratory illness and a more difficult time recovering from respiratory illness effects, initial reports (non-peer-reviewed) analyzing data from China indicate tobacco smoking may be associated with decreased risk of COVID-19 severity. Other studies, peer-reviewed, indicate worse outcomes among individuals with co-occurring disorders such as chronic obstructive pulmonary disease (COPD), for which the prevailing risk factor is chronic tobacco smoking. In the months just prior to COVID-19, EVALI (e-cigarette or vaping product use associated lung injury) raised national attention and concern about nicotine and cannabis vaping effects on respiratory function, morbidity, and mortality. To inform health policy, public health guidance, and treatment interventions, peer-reviewed research is needed on the effects of smoking and vaping in relation to lung health and COVID-19. Specifically, research is needed to identify smoking- and vaping-related risk factors for COVID-19 development, severity, and progression. This Special Issue in IJERPH has a focus on smoking and vaping of tobacco/nicotine and cannabis products and spans epidemiology to treatment, policy, and the retail environment. Areas of interest include:

Prevalence of COVID-19 among those who smoke or vape;
COVID-19 related risk perceptions among those who smoke or vape;
COVID-19 related changes in access to smoking or vaping products and shifts in the retailer environment (e.g., essential business designation, home delivery, vaping/flavor bans);
COVID-19 disease progression and severity in the presence of smoking or vaping;
Secondhand smoke exposure in relation to COVID-19 shelter-in-place restrictions;
Treatment seeking, quit attempts, and sustained cessation of smoking and vaping associated with COVID-19 risk perceptions and restrictions.

Dr. Judith J. Prochaska
Dr. Kathleen Gali
Dr. Erin A. Vogel
Dr. Kelly C. Young-Wolff
Guest Editors

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Keywords

COVID-19
novel coronavirus
nicotine
tobacco
e-cigarettes
vaping
cannabis
addiction
policy
treatment
risk perceptions

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Published Papers (14 papers)

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14 pages, 535 KiB

Open AccessArticle

Smoking Behaviors, Mental Health, and Risk Perceptions during the Beginning of the COVID-19 Pandemic among Mexican Adult Smokers

by Emily E. Loud, Katia Gallegos-Carrillo, Inti Barrientos-Gutiérrez, Edna Arillo-Santillán, Victoria C. Lambert, Luis Zavala-Arciniega and James F. Thrasher

Int. J. Environ. Res. Public Health 2021, 18(20), 10905; https://doi.org/10.3390/ijerph182010905 - 17 Oct 2021

Cited by 11 | Viewed by 2682

Abstract

Mexico is one of the countries most affected by COVID-19. Studies have found that smoking behaviors have been impacted by the pandemic as well; however, results have varied across studies, and it remains unclear what is causing the changes. This study of an open cohort of smokers recruited from a consumer panel (n = 2753) examined changes in cigarettes per day (CPD), daily vs. non-daily smoking, recent quit attempts, perceived stress, depression, and perceived severity of COVID-19 at two points during the pandemic: March and July 2020. Differences in CPD between waves were estimated with Poisson regression using generalized estimating equations (GEE). Differences in perceived stress were estimated with linear regression using GEE, and differences in recent quit attempts, depression, and perceived severity of COVID-19 were estimated using separate logistic regression GEE models. Rates of depression were higher in July compared to March (AOR = 1.55, 95% C.I. 1.31–1.85), and the likelihood of recent quit attempt was lower in July compared to March (AOR = 0.85, 95% C.I. 0.75–0.98). There was no statistically significant change in CPD, daily smoking, or perceived stress. Perceived COVID-19 severity for oneself increased significantly (AOR: 1.24, 95% C.I. 1.02–1.52); however, the perceived COVID-19 severity for smokers remained constant. Our study suggests that as the COVID-19 pandemic expanded in Mexico, smoking frequency remained stable, and quit attempts decreased, even as adult smokers increasingly perceived infection with COVID-19 for themselves as severe. These results can aid in the development of health communication strategies to educate smokers about their risk for COVID-19, potentially capitalizing on concerns that stem from this syndemic of communicable and smoking-related non-communicable disease. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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9 pages, 327 KiB

Open AccessArticle

High Perceived Susceptibility to and Severity of COVID-19 in Smokers Are Associated with Quitting-Related Behaviors

by Yajie Li, Tzu Tsun Luk, Yongda Wu, Derek Yee Tak Cheung, William Ho Cheung Li, Henry Sau Chai Tong, Vienna Wai Yin Lai, Sai Yin Ho, Tai Hing Lam and Man Ping Wang

Int. J. Environ. Res. Public Health 2021, 18(20), 10894; https://doi.org/10.3390/ijerph182010894 - 17 Oct 2021

Cited by 11 | Viewed by 2943

Abstract

A growing body of evidence shows smoking is a risk factor for coronavirus disease (COVID-19). We examined the associations of quitting-related behaviors with perceived susceptibility to and severity of COVID-19 in smokers. We conducted a telephone survey of 659 community-based adult smokers (81.7% male) in Hong Kong, where there was no lockdown. Exposure variables were perceptions that smoking can increase the risk of contracting COVID-19 (perceived susceptibility) and its severity if infected (perceived severity). Outcome variables were quit attempts, smoking reduction since the outbreak of the pandemic, and intention to quit within 30 days. Covariates included sex, age, education, heaviness of smoking, psychological distress, and perceived danger of COVID-19. High perceived susceptibility and severity were reported by 23.9% and 41.7% of participants, respectively. High perceived susceptibility was associated with quit attempts (prevalence ratio (PR) 2.22, 95% CI 1.41–3.49), smoking reduction (PR 1.75, 95% CI 1.21–2.51), and intention to quit (PR 2.31, 95% CI 1.40–3.84). Perceived severity of COVID-19 was associated with quit attempts (PR 1.64, 95% CI 1.01–2.67) but not with smoking reduction or intention to quit. To conclude, the perceived susceptibility to and severity of COVID-19 in smokers were associated with quitting-related behaviors in current smokers, which may have important implications for smoking cessation amid the pandemic. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

14 pages, 324 KiB

Open AccessArticle

Perceived Susceptibility to and Seriousness of COVID-19: Associations of Risk Perceptions with Changes in Smoking Behavior

by Erin A. Vogel, Lisa Henriksen, Nina C. Schleicher and Judith J. Prochaska

Int. J. Environ. Res. Public Health 2021, 18(14), 7621; https://doi.org/10.3390/ijerph18147621 - 17 Jul 2021

Cited by 21 | Viewed by 3985

Abstract

During the COVID-19 pandemic, studies have documented increased and decreased cigarette smoking among adults. Individual differences in the perceived susceptibility and seriousness of the virus, for people who smoke in general and for oneself personally, may relate to changes in smoking. Using the Health Belief Model (HBM) as a theoretical framework, we examined associations with self-reported increasing and decreasing smoking a lot during the COVID-19 stay-at-home period. Adults in 30 large U.S. cities who smoked cigarettes daily completed an online survey between 14 July and 30 November 2020. The analytic sample (N = 2768) was 54.0% male and 68.3% white with 23.7% reporting increasing and 11.3% decreasing smoking (6% reported both). Younger age, a diagnosis of COVID-19, and greater pandemic-related stress were associated with greater odds of both increased and decreased smoking. Increased smoking also was associated with heavier nicotine dependence, greater desire to quit, and greater perceived susceptibility and lower perceived seriousness of COVID-19 for people who smoke, while pandemic-related job-loss, lower nicotine dependence, and greater self-efficacy were associated with decreased smoking. Among respondents who had not contracted COVID-19 (n = 2418), correlates were similar with the addition of greater perceived personal susceptibility to COVID-19 associated with both increased and decreased smoking, while greater perceived personal seriousness of COVID-19 was associated with increased smoking. Findings for risk perceptions were largely in directions that contradict the HBM. Circumstances surrounding behavior change during the pandemic are complex and may be especially complex for nicotine addiction. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

14 pages, 319 KiB

Open AccessArticle

‘I Was Smoking a Lot More during Lockdown Because I Can’: A Qualitative Study of How UK Smokers Responded to the Covid-19 Lockdown

by Rachel O’Donnell, Douglas Eadie, Martine Stead, Ruaraidh Dobson and Sean Semple

Int. J. Environ. Res. Public Health 2021, 18(11), 5816; https://doi.org/10.3390/ijerph18115816 - 28 May 2021

Cited by 25 | Viewed by 4820

Abstract

This study explored how Covid-19 lockdown restrictions affected people’s daily smoking routines and behaviours, including adherence and modifications to pre-established smoking restrictions in the home. Semi-structured telephone interviews were conducted with smokers and non-smokers from smoking households 19 to 27 weeks after the first full UK lockdown ended in May 2020. A non-probability purposive sample representing 25 adults aged 21 or over living in households with at least 1 smoker were recruited to the study. A quota sampling strategy was used, according to age, gender, smoking status, family status, household composition, householder access to outdoor space, and change to work-life status. Most participants found lockdown increased the amount of time spent at home, where stresses associated with confinement, curtailment of social routines, removal of barriers and distractions to smoking due to home working, and feelings of boredom all contributed to increased smoking. Fewer factors were identified as reducing smoking during lockdown. Prominent examples included disruption to habitual smoking patterns and distraction from smoking associated with spending more time doing outdoor activities. Pressures placed on physical space and lack of privacy due to the confinement at home were responsible for displacement of smoking within the home, leading to breaking of smoke-free rules and family tensions, and in some cases to greater awareness amongst parents that their children smoked. Changes in daily routines associated with lockdown affected and displaced smoking behaviour both positively and negatively. Health improvement interventions could seek to harness positive changes in smoking associated with any future lockdown approaches. New home-working norms highlight the need for employers to support staff to reduce their smoking and to remain smoke-free. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

12 pages, 1171 KiB

Open AccessArticle

A Qualitative Study of the Impact of COVID-19 on Smoking Behavior for Participants in a Post-Hospitalization Smoking Cessation Trial

by Kristina Schnitzer, Sarah Jones, Jennifer H. K. Kelley, Hilary A. Tindle, Nancy A. Rigotti and Gina R. Kruse

Int. J. Environ. Res. Public Health 2021, 18(10), 5404; https://doi.org/10.3390/ijerph18105404 - 19 May 2021

Cited by 9 | Viewed by 2888

Abstract

(1) Background: COVID-19 has substantially altered individual environments and behaviors. We aim to explore the impact of COVID-19 on the smoking behavior of individuals trying to quit tobacco. (2) Methods: This study presents a qualitative analysis of individual interviews focused on perceived impacts of the COVID-19 pandemic on tobacco use among 39 participants in the Helping HAND 4 (HH4) post-hospitalization smoking cessation trial (NCT03603496). (3) Results: Emergent impacts of COVID-19 included change in routine, isolation, employment changes, and financial challenges; these in turn were associated with boredom, altered cravings and triggers, and increased stress. The availability of effective coping mechanisms instead of smoking to deal with stress heavily influenced subsequent smoking behavior. These results were triangulated with the Transactional Model of Stress, providing a framework to elucidate connections between factors such as perceived control, self-efficacy, and dispositional coping style, and highlighting potential areas for intervention. (4) Conclusions: Results suggest that stress during the COVID-19 pandemic may undermine effective coping skills among individuals enrolled in a post-hospitalization smoking cessation trial. Strengthening effective coping skills (e.g., minimizing the use of tobacco as a default stress response) and increasing perceived control and self-efficacy are promising intervention targets. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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9 pages, 310 KiB

Open AccessArticle

Smokers Are More Likely to Smoke More after the COVID-19 California Lockdown Order

by Mariaelena Gonzalez, Anna E. Epperson, Bonnie Halpern-Felsher, Deanna M. Halliday and Anna V. Song

Int. J. Environ. Res. Public Health 2021, 18(5), 2582; https://doi.org/10.3390/ijerph18052582 - 5 Mar 2021

Cited by 31 | Viewed by 6542

Abstract

To determine if cigarette smoking, electronic cigarette use, and rate of consumption of these products differed before and after a pandemic lockdown order, two convenience samples of adults in Central California were recruited and surveyed before (March 2020) and after (May 2020) COVID-19 lockdown orders were implemented in California (n = 2571). Multivariable logistic and negative binomial regression models tested the association between adults recruited pre- or post-California lockdown and past month cigarette use, past month electronic cigarette use, past month cigarette consumption, and past month e-cigarette consumption among current users, controlling for demographic differences. Adults pre- and post-lockdown had equal odds of using cigarettes during the past month. Cigarette users who responded post-lockdown had higher cigarette consumption rates compared to cigarette users who responded pre-lockdown (IRR = 1.13, 95% CI = 1.15, 1.23). Adults who responded post-lockdown had lower odds of using electronic cigarettes during the past month compared to participants surveyed before the order (OR = 0.66, 95% CI: 0.55, 0.78). Cigarette users may be using more cigarettes during the state mandated lockdown. Possible causes for this increase in cigarette use may include increased stress, the change in workplace smokefree protections coverage, and increased opportunities for smoking or vaping. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

12 pages, 346 KiB

Open AccessArticle

Changes in Smoking Behaviour and Home-Smoking Rules during the Initial COVID-19 Lockdown Period in Israel

by Yael Bar-Zeev, Michal Shauly, Hannah Lee and Yehuda Neumark

Int. J. Environ. Res. Public Health 2021, 18(4), 1931; https://doi.org/10.3390/ijerph18041931 - 17 Feb 2021

Cited by 41 | Viewed by 4633

Abstract

The COVID-19 pandemic has caused devastating impacts globally. To mitigate virus spread, Israel imposed severe restrictions during March–April 2020. An online cross-sectional survey was conducted in April 2020 among current and ex-smokers to explore changes in smoking behaviour and home-smoking rules during this period. Bivariate analysis and multivariate logistic regression examined associations between sociodemographic characteristics and perceived risk of infection and quitting smoking during the initial COVID-19 period. Current smoking was reported by 437 (66.2%) of the 660 participants, 46 (7%) quit during the initial restriction period, and 177 (26.8%) were ex-smokers. Nearly half (44.4%) of current smokers intensified their smoking, and 16% attempted to quit. Quitting during the COVID-19 period was significantly associated with higher education (adjusted odds ratio (aOR): 1.97, 95% CI: 1.0–3.8), not living with a smoker (aOR: 2.18, 95% CI: 1.0–4.4), and having an underlying chronic condition that increases risk for COVID-19 complications (aOR: 2.32, 95% CI: 1.1–4.6). Both an increase in smoking behaviour and in attempts to quit smoking during the initial COVID-19 pandemic were evident in this sample of adult Israeli smokers. Governments need to use this opportunity to encourage smokers to attempt quitting and create smoke-free homes, especially during lockdown conditions, while providing mental and social support to all smokers. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

11 pages, 907 KiB

Open AccessArticle

Tobacco Use Changes and Perceived Health Risks among Current Tobacco Users during the COVID-19 Pandemic

by Jessica M. Yingst, Nicolle M. Krebs, Candace R. Bordner, Andrea L. Hobkirk, Sophia I. Allen and Jonathan Foulds

Int. J. Environ. Res. Public Health 2021, 18(4), 1795; https://doi.org/10.3390/ijerph18041795 - 12 Feb 2021

Cited by 56 | Viewed by 8389

Abstract

COVID-19 has become a global pandemic, with over 81 million cases worldwide. To assess changes in tobacco use as a result of the pandemic, we surveyed a convenience sample of current tobacco users between April and June 2020. The sample was taken from a tobacco user research registry (n = 3396) from the Penn State College of Medicine in Hershey, Pennsylvania, USA. Participants who responded to the survey and were eligible for this study (n = 291) were 25.6% male, 93% white, and had a mean age of 47.3 (SD = 11.6) years. There were no reports of participants testing positive for COVID-19, but 21.7% reported experiencing symptoms associated with the virus. Most participants (67%) believed that their risk of contracting COVID-19 was the same as non-tobacco users, but 57.7% believed that their risk of serious complications, if infected, was greater compared to non-tobacco users. A total of 28% reported increasing their cigarette use during the pandemic. The most common reasons for increased use were increased stress, more time at home, and boredom while quarantined. Nearly 15% reported decreasing their tobacco use. The most common reasons for reduced use were health concerns and more time around non-smokers (including children). A total of 71 (24.5%) users reported making a quit attempt. Characterizing these pandemic-related changes in tobacco use may be important to understanding the full scope of subsequent health outcomes resulting from the pandemic. Tobacco cessation resources should be tailored to allow for safe, appropriate access for those interested in quitting. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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10 pages, 673 KiB

Open AccessArticle

First Report on Smoking and Infection Control Behaviours at Outdoor Hotspots during the COVID-19 Pandemic: An Unobtrusive Observational Study

by Yuying Sun, Tai Hing Lam, Yee Tak Derek Cheung, Man Ping Wang, Yongda Wu, Jianjiu Chen, Xiaoyu Zhang, William H. C. Li and Sai Yin Ho

Int. J. Environ. Res. Public Health 2021, 18(3), 1031; https://doi.org/10.3390/ijerph18031031 - 25 Jan 2021

Cited by 13 | Viewed by 3378

Abstract

This study was to observe smoking behaviours and infection control behaviours in smokers at outdoor smoking hotspots during the COVID-19 pandemic in Hong Kong. We conducted unobtrusive observations at nine hotspots during 1 July 2019–31 January 2020 (pre-outbreak, 39 observations), 1 February–30 April 2020 (outbreak, eight observations), and 1 May–11 June 2020 (since-outbreak, 20 observations). Sex, age group, type of tobacco products used, duration of stay, group smoking behaviours, face mask wearing and infection control behaviours of smokers, and mask wearing of non-smoking pedestrians were observed. Compared with pre-outbreak, lower volumes of smokers were observed during outbreak and since-outbreak. Smokers gathered more in a group (24.5% and 25.8% vs. 13.4%, respectively) and stayed longer (91.5% and 83.6% vs. 80.6% stayed ≥1 min) during outbreak and since-outbreak than pre-outbreak. Ninety-six percent smokers possessed a face mask. While smoking, 81.6% of smokers put the mask under the chin and 13.8% carried it in the hand, 32.4% did not wear a mask immediately after smoking, 98.0% did not sanitize hands, and 74.3% did not keep a distance of at least one metre. During the COVID-19 pandemic, smokers gathered closely and stayed longer at the hotspots, and few practised hand hygiene, all of which may increase the risk of infection. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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12 pages, 338 KiB

Open AccessArticle

Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

by Andrea A. Joyce, Grace M. Styklunas, Nancy A. Rigotti, Jordan M. Neil, Elyse R. Park and Gina R. Kruse

Int. J. Environ. Res. Public Health 2021, 18(3), 1011; https://doi.org/10.3390/ijerph18031011 - 24 Jan 2021

Cited by 14 | Viewed by 4272

Abstract

The impact of the COVID-19 pandemic on US adults’ smoking and quitting behaviors is unclear. We explored the impact of COVID-19 on smoking behaviors, risk perceptions, and reactions to text messages during a statewide stay-at-home advisory among primary care patients who were trying to quit. From May–June 2020, we interviewed smokers enrolled in a 12-week, pilot cessation trial providing text messaging and mailed nicotine replacement medication (NCT04020718). Twenty-two individuals (82% white, mean age 55 years), representing 88% of trial participants during the stay-at-home advisory, completed exit interviews; four (18%) of them reported abstinence. Interviews were thematically analyzed by two coders. COVID-19-induced environmental changes had mixed effects, facilitating quitting for some and impeding quitting for others. While stress increased for many, those who quit found ways to cope with stress. Generally, participants felt at risk for COVID-19 complications but not at increased risk of becoming infected. Reactions to COVID-19 and quitting behaviors differed across age groups, older participants reported difficulties coping with isolation (e.g., feeling disappointed when a text message came from the study and not a live person). Findings suggest that cessation interventions addressing stress and boredom are needed during COVID-19, while smokers experiencing isolation may benefit from live-person supports. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

12 pages, 322 KiB

Open AccessArticle

The Perceived Impact of COVID-19 among Treatment-Seeking Smokers: A Mixed Methods Approach

by Zoe Rosoff-Verbit, Erin Logue-Chamberlain, Jessica Fishman, Janet Audrain-McGovern, Larry Hawk, Martin Mahoney, Alexa Mazur and Rebecca Ashare

Int. J. Environ. Res. Public Health 2021, 18(2), 505; https://doi.org/10.3390/ijerph18020505 - 9 Jan 2021

Cited by 20 | Viewed by 3579

Abstract

The consequences of the COVID-19 pandemic on behavioral health, including tobacco use, are not fully known. The current study sought to measure the perceived impact of COVID-19 and the resulting stay-at-home orders in Philadelphia, Pennsylvania and Buffalo, New York on smokers enrolled in four smoking cessation trials between March 2020 and July 2020. The survey collected quantitative data regarding life changes due to COVID-19, health/exposure status, and the impact on their cessation attempt (e.g., motivation to quit, change in triggers). The questionnaire collected qualitative data to better understand how such changes could explain changes in smoking behavior. Of the 42 participants surveyed, approximately half indicated that COVID-19 changed their motivation and ability to quit or remain quit. Among those who reported that it was easier to quit following the stay-at-home orders (n = 24), most attributed this to concerns regarding the severity of COVID-19 among smokers. Among those who reported more difficulty quitting (n = 15), most attributed this to their increased stress due to the pandemic and the inability to access activities, places, or people that could help them manage triggers. Given public health warnings of continued surges in COVID-19, these data provide insight into who may benefit from further smoking cessation support should existing restrictions or new stay-at-home orders be enacted. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

8 pages, 620 KiB

Open AccessArticle

Impact of COVID-19 on the Hong Kong Youth Quitline Service and Quitting Behaviors of Its Users

by Laurie Long Kwan Ho, William Ho Cheung Li, Ankie Tan Cheung, Wei Xia, Man Ping Wang, Derek Yee Tak Cheung and Tai Hing Lam

Int. J. Environ. Res. Public Health 2020, 17(22), 8397; https://doi.org/10.3390/ijerph17228397 - 13 Nov 2020

Cited by 20 | Viewed by 3460

Abstract

Tobacco use is a possible risk factor for contracting and spreading COVID-19. We aimed to describe the impact of the COVID-19 pandemic on the Youth Quitline service and quitting behaviors of its users in Hong Kong. We conducted a telephone survey involving 201 participants of the Youth Quitline service, and retrospectively analyzed the operation and use of Quitline since the COVID-19 outbreak in Hong Kong. The number of incoming calls to the Youth Quitline and the participants′ quit rate has increased since the COVID-19 outbreak in Hong Kong. Many participants (68%) did not realize that tobacco use potentially increased their risk for developing and spreading COVID-19; however, 43% agreed that the pandemic motivated their intention to quit, and 83% changed their smoking habits during the pandemic. These changes were mainly due to wearing masks (30%), closure of bars/pubs (25%), suspension of classes (14%), and being unable to socialize with friends (24%). Overall, 58% reduced their tobacco use; of these participants, 66% reported a ≥50% reduction in daily cigarette consumption. The participants reduced their smoking during the COVID-19 pandemic despite lacking knowledge about the potentially increased risk for contracting COVID-19 from continued smoking. The pandemic could create new opportunities to motivate young smokers to quit smoking, especially those seeking support for smoking cessation, and may further contribute to reducing the risks posed by COVID-19. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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15 pages, 1529 KiB

Open AccessArticle

Impacts of COVID-19 on Electronic Cigarette Purchasing, Use and Related Behaviors

by Eric K. Soule, Shannon Mayne, William Snipes, Mignonne C. Guy, Alison Breland and Pebbles Fagan

Int. J. Environ. Res. Public Health 2020, 17(18), 6762; https://doi.org/10.3390/ijerph17186762 - 16 Sep 2020

Cited by 31 | Viewed by 4755

Abstract

Background: COVID-19 has caused health impacts and disruptions globally. Electronic cigarette (ECIG) users may face additional impacts. This study examined impacts of COVID-19 on ECIG users. Methods: Concept mapping, a mixed-methods approach, was used to identify COVID-19 impacts on adult ECIG users. ECIG users (n = 93) provided statements completing a prompt: “A specific way Coronavirus/COVID-19 has affected my vaping/e-cigarette use, my vaping/e-cigarette related purchasing, or other vaping/e-cigarette related behaviors or issues is…”. Participants generated 85 unique statements, sorted statements into groups of similar content and rated each statement on how true they were. Multidimensional scaling and hierarchical cluster analysis identified thematic clusters. Mean cluster ratings were compared between sample subgroups. Results: Ten clusters were identified: Stocking up and Bulk Purchasing, Challenges in Obtaining ECIG Supplies, Alternative Purchasing Procedures, Increased ECIG use, Disruption of Routine and ECIG Use, Efforts to Decrease ECIG Use, Improving ECIG Skills, COVID-19 Health Concerns, Perceptions of ECIG Use and COVID-19, and COVID-19 Protection. More dependent ECIG users and dual users of ECIGs and cigarettes rated clusters higher than less dependent ECIG users and non-dual users. Conclusions: ECIG users may experience or perceive they face additional COVID-19 impacts, such as increased exposure, financial burdens, stress, and health risks. Full article

(This article belongs to the Special Issue Smoking, Vaping and COVID-19)

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12 pages, 313 KiB

Open AccessBrief Report

Cigarette and E-Cigarettes Dual Users, Exclusive Users and COVID-19: Findings from Four UK Birth Cohort Studies

by Daniel Tzu-Hsuan Chen and Christina N. Kyriakos

Int. J. Environ. Res. Public Health 2021, 18(8), 3935; https://doi.org/10.3390/ijerph18083935 - 8 Apr 2021

Cited by 17 | Viewed by 3829

Abstract

Introduction: The relationship between current cigarette and electronic cigarette (e-cigarette) dual use, exclusive use and COVID-19-related measures are still unclear. This study aims to assess the association between different tobacco use patterns and coronavirus disease 2019 (COVID-19) symptoms, testing, self-reported infection and social distancing behaviors in the United Kingdom (UK). Methods: Data come from the first wave of the Centre for Longitudinal Studies (CLS) COVID-19 survey, comprising four birth cohorts (N = 13,077, aged 20–63 years) surveyed between 2 to 31 May 2020, during the COVID-19 pandemic. Sociodemographic characteristics and COVID-19-related outcomes (symptoms, testing, diagnosis and social distancing behaviors) were compared across different product user groups (non-users, exclusive cigarette users, exclusive e-cigarettes users and dual use) using Cochran–Mantel–Haenszel χ2 test. Multivariable logistic regression models were used to explore associations between COVID-19-related outcomes and different smoking patterns. Results: Across all four cohorts, 12.6% and 4.9% of the respondents were current exclusive cigarette and e-cigarette users, respectively, with approximately 3% of the respondents being dual users. Significant differences in prevalence were observed between different tobacco use patterns and COVID-19 symptoms (p = 0.02), self-reported infection (p = 0.04) and social distancing behaviors (p < 0.001). Current cigarette and e-cigarette dual use was associated with 2.15-fold higher odds for reporting COVID-19 infection (aOR = 2.15; CI [1.15–4.05]). Compliance of social distancing behaviors were the lowest for current dual users (aOR = 0.58; CI [0.41–0.83]) and exclusive cigarette users (aOR = 0.72; CI [0.63–0.92]). Conclusions: The findings highlight dual users’ higher prevalence of having COVID-19 symptoms, infection and incompliance of social distancing behaviors. Self-reported infection was associated with dual product use; dual users and exclusive cigarette users were linked to poor adherence to social distancing behaviors. Smoking cessation support and further monitoring on multiple tobacco use among these populations should be reinforced as preventive measures to tackle the pandemic. Full article

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