Abstract
Objectives: To provide initial insight into how the COVID-19 pandemic could affect smoking behaviors and cessation efforts that were underway at its onset.Methods: An additional survey was added to follow-up assessments in an ongoing smoking cessation study for nondaily smokers: a measure of impact of COVID-19 and a subset of previously administered scales measuring smoking, emotional well-being, and alcohol use. Pre–post tests were conducted (84 ± 28 days apart).Results: Participants (81/100 of enrolled; 67% female, 75% white, 10% Hispanic, 37 ± 11 years old) reported experiencing changes regarding work (35% income reduction/loss; 35% remote work) and living situation (15% consolidated residences). Participants reported their motivation to quit smoking “slightly” increased after COVID-19 (p < 0.001), more so in those having achieved 30-day abstinence (p = 0.0045). Worry, fear, and a desire to support the greater good increased (ps < 0.05). Increases in motivation to quit correlated positively with prosocial and wellness changes. Data from pre- to post-COVID-19 onset showed decreases in emotional well-being (increased stress, negative affect, decreased coping, positive affect, all ps < 0.01), but not changes in smoking abstinence (p = 0.65), readiness to quit (p = 0.16), smoking frequency (p = 0.96), or cigarettes per day (p = 0.96). Heavy drinking decreased (p < 0.01). Trying e-cigarettes increased (p = 0.04).Conclusions: Nondaily smokers participating in a smoking cessation study during the COVID-19 pandemic reported worsened emotional well-being without effects on smoking outcomes and said their motivation to quit was slightly increased. Correlations of motivation to quit with prosocial and wellness changes suggest that targeting these constructs may be particularly helpful during a pandemic.
Highlights
The COVID-19 pandemic and resulting social distancing could affect smoking behaviors and cessation efforts that were underway at its onset
Because strong evidence links the experience of stress to smoking behaviors,[5,6,7] concerns about pandemic-related increases in negative emotions leading to increased smoking are highlighted on the Centers for Disease Control and Prevention (CDC) COVID-19-specific website.[8]
A survey of nicotine users spanning five countries affected by COVID-19 (Italy, India, South Africa, the United Kingdom, and the United States) found that nicotine products were the primary stress and anxiety coping tool for users during this time,[9] and many health care workers fear that the negative mental health consequences resulting from the COVID-19 pandemic will result in the relapse of those who have quit smoking in the past.[10]
Summary
The COVID-19 pandemic and resulting social distancing could affect smoking behaviors and cessation efforts that were underway at its onset. Understanding this impact may be useful to clinical practice efforts and can provide context for ongoing smoking cessation trials. The COVID-19 pandemic and social distancing efforts are expected to have substantial impacts on the general population’s mental health. There is strong reason to expect smoking cessation efforts to be adversely affected by the COVID19 pandemic
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