Tobacco use pattern and quitting behaviour among healthcare professionals during the COVID-19 pandemic: Insights from a pan India online survey

Bijaya Nanda Naik,Bijit Biswas,Chandramani Singh,Sanjay Pandey,Santosh Kumar Nirala,Neha Chaudhary

doi:10.1016/j.cegh.2021.100838

Bijaya Nanda Naik, Bijit Biswas + Show 4 more

Open Access

https://doi.org/10.1016/j.cegh.2021.100838

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Abstract

BackgroundHealthcare professionals (HCPs) have a definite role in tobacco control and can help immensely by setting examples. The current study aimed to study the tobacco use pattern and quitting behaviour among HCPs of India during the COVID-19 pandemic. MethodsWe addressed the research objective using a cross-sectional, anonymous online survey using ‘google form” among 687 HCPs of India during December 2020. Descriptive and inferential statistics were performed using SPSS. ResultsOverall, 32.6% of the HCPs were ever tobacco user while 23.4% and 16.9% were current and daily tobacco user. During the COVID-19 pandemic, 51.7% and 43.1% of HCPs cut down the frequency and amount of tobacco use respectively while for 24.1% COVID-19 pandemic exerted no effect on their tobacco use. Presence of vulnerable population at home [ adjusted odds ratio (AOR): 17.5 (95% confidence interval (CI): 3.3–92.2)], ever tobacco quit attempt [AOR: 13.5 (95% CI:2.7–67.7)] and history of COVID-19 disease [AOR: 5.1 (95% CI:1.3–20.7)] significantly determined reduced tobacco use (60.3%) during the pandemic. Similarly, reduced tobacco use during the pandemic [AOR: 4.8 (95% CI:1.7–13.5)] and perception of both smoking and smokeless tobacco form to be harmful for COVID-19 [AOR: 4.8 (95% CI:1.7–13.5)] were the independent correlates of tobacco quit attempt (50.0%) during the pandemic. ConclusionTobacco use was quite rampant among the HCPs with every fourth and sixth being a current and daily tobacco user respectively. During the COVID-19 pandemic three in every five HCPs surveyed reduced tobacco use while every second HCP made a quit attempt.

Highlights

Reduced tobacco use during the pandemic [adjusted odds ratio (AOR): 4.8 (1.7–13.5)] and perception of both smoking and smokeless tobacco form to be harmful for COVID-19 [AOR: 4.8 (1.7–13.5)] were the multivariable associates of tobacco quit attempt during the pandemic [R2 = 35.8%; predictive accuracy rate (PAR) = 73.3%] (Table 4)
Variable Type of tobacco products consumed: Cigarette Bidi Gutka Khaini Zarda Others Preferred tobacco form: Smoking Smokeless Nicotine Dependence: Low to moderate Moderate to high Preference of tobacco use: With friends or colleagues Alone Ever tried to quit tobacco: (Yes) Made tobacco quit attempt during the COVID*-19 pandemic: (Yes) Perceived tobacco as risk factor for COVID*-19 disease causation: (Yes) Perceived tobacco as risk factor for COVID*-19 disease severity: (Yes) Perceived tobacco form that increases the risk of COVID*-19: Only smoking Only Smokeless tobacco Both smoking and smokeless tobacco None Ever came in unprotected contact with a suspect or confirmed COVID-19 case: (Yes) Ever diagnosed with COVID-19: (Yes)
Tobacco use was quite rampant among the Healthcare professionals (HCPs) with every fourth and sixth being a current and daily tobacco user respectively

Summary

Introduction

Tobacco use is unwarranted as it is known to increase risk of various communicable (i.e., pneumonia, tuberculosis etc.) and noncommunicable diseases (i.e., asthma, chronic obstructive pulmonary disease, lung cancer etc.).[1,2,3] There is lack of evidence which can establish tobacco as risk factor for corona virus disease-19 (COVID-19).[4,5] various researches labelled tobacco as cause of higher disease severity in hospitalized COVID-19 patients.[6,7] World Health Organization (WHO) and various other organizations has discouraged tobacco use from very onset of the COVID-19 pandemic despite lack of concrete evidence suggesting its causal role.[4,5] This caution on tobacco use might have been issued based on prevailing knowledge on tobacco as risk factor for various infectious respiratory illnesses.[1,3,8]Being one of the largely affected countries in the COVID-19 pandemic, acceleration of tobacco control measures in India is need of the hour.[9]. The current study aimed to study the tobacco use pattern and quitting behaviour among HCPs of India during the COVID-19 pandemic. Presence of vulnerable population at home [ adjusted odds ratio (AOR): 17.5 (95% confidence interval (CI): 3.3–92.2)], ever tobacco quit attempt [AOR: 13.5 (95% CI:2.7–67.7)] and history of COVID-19 disease [AOR: 5.1 (95% CI:1.3–20.7)] significantly determined reduced tobacco use (60.3%) during the pandemic. Conclusion: Tobacco use was quite rampant among the HCPs with every fourth and sixth being a current and daily tobacco user respectively. During the COVID-19 pandemic three in every five HCPs surveyed reduced tobacco use while every second HCP made a quit attempt. A quarter (25.0%) of the participants were found to have moderate to severe dependence on nicotine and the rest (75.0%) have low to moderate dependence on nicotine (Table 3)

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