Changes in Smoking Behavior Since the Declaration of the COVID-19 State of Emergency in Japan: A Cross-sectional Study From the Osaka Health App.

Shihoko Koyama,Hisaya Shirai,Takahiro Tabuchi,Sumiyo Okawa,Takeshi Nakatani,Takayoshi Kadobayashi,Isao Miyashiro

doi:10.2188/jea.je20200533

Shihoko Koyama, Hisaya Shirai + Show 5 more

Open Access

https://doi.org/10.2188/jea.je20200533

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Abstract

BackgroundIn April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency.MethodsAn online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates.ResultsWe found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men: PR 1.38; 95% confidence interval [CI], 1.17–1.62) and participants aged ≥65 years: PR 2.45; 95% CI, 1.92–3.12) and significantly lower PR of increased smoking (men: PR 0.85; 95% CI, 0.78–0.93 and participants ≥65 years: PR 0.38; 95% CI, 0.29–0.49). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home: PR 1.29; 95% CI, 1.17–1.41 and living alone: PR 1.23; 95% CI, 1.10–1.38) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR 0.150; 95% CI, 0.039–0.582).ConclusionsWe suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.

Highlights

The 2019 coronavirus disease (COVID-19) outbreak was first reported in Wuhan City, Hubei Province, China in late December 2019
In terms of changes in smoking behavior during the COVID-19 state of emergency, we found that 32.1% of current smokers had increased the number of cigarettes smoked per day, while 11.9% had quit
2.2% changed from smoking cigarettes to heated tobacco products (HTPs), and 0.6% of current smoker changed from HTPs to cigarettes

Summary

Introduction

The 2019 coronavirus disease (COVID-19) outbreak was first reported in Wuhan City, Hubei Province, China in late December 2019. Each national government has introduced infection control measures for COVID-19, such as school and workplace closures, stay-at-home restrictions, income support, and debt relief.[4] These measures influenced “COVID19-infected people” and the entire general population, including non-infected people. Smoking cessation and working-from-home were among the suggested measures which form the “new normal lifestyle”.5,6. In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency

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