Abstract

This study explored subjective changes in tobacco product use during the COVID-19 pandemic. The online survey included 828 tobacco product users and was implemented from 20 August to 27 August 2021. Participants were classified based on currently used products (cigarettes, heated tobacco products (HTPs), and e-cigarettes) and categorized as single, dual, or triple users. Subjective changes in product use over the past year were designated as “no chang”, “increase”, or “decreased”. Single use was most common, as reported by 447 participants (male 249, female 198), while 283 (male 164, female 119) and 98 (male 59, female 39) participants reported dual and triple use, respectively. Age, income, and triple use were associated with increased cigarette use, whereas living with family was associated with decreased use. Gender, age, income, and triple use were associated with the changed use of HTPs. No factors were significantly associated with an increase in e-cigarette use, whereas age and income were associated with decreased use. Similar to many COVID-19-related changes in cultural, social, and economic aspects of life, users’ patterns of tobacco product use have also changed. Increasing tobacco product taxes, effective messaging, and customized cessation services might help prevent or limit tobacco product usage.

Highlights

  • Income, and triple use were associated with increased cigarette use, whereas living with family was associated with decreased use

  • Age, income, and triple use were associated with the changed use of heated tobacco products (HTPs)

  • A study conducted in South Korea in September 2017 showed that all HTP users use both cigarettes and e-cigarettes [23], whereas a study conducted in December 2018, among 1530 tobacco users, showed that 12.7% of the participants were triple users [24], similar to the figure reported in this study (11.8%)

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Summary

Introduction

Persistent smoking is a major cause of death by cancer, cardiovascular disease, and respiratory disease [5]; these conditions adversely affect health and place a huge socioeconomic burden on the nation, as they are associated with a decrease in productivity due to premature death [6]. For this reason, many countries have implemented various tobacco control measures, such as raising taxes, expanding no-smoking zones, and placing health warning graphics on cigarette packs, in addition to promotion, marketing, and education aimed at preventing smoking and inducing smokers to quit [7]

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