Abstract
Only a few studies investigated changes in electronic cigarette (e-cigarette) and heated tobacco product (HTP) use during pandemic restrictions. We conducted a web-based cross-sectional study of a representative sample of 6,003 Italian adults during the strictest phase of the Covid-19 lockdown (April–May 2020). Participants were asked to report changes in e-cigarette and HTP use compared to before the pandemic. E-cigarette users increased from 8.1% to 9.1% and HTP users from 4.0% to 4.5%. Among e-cigarette non-users before lockdown, 1.8% started using e-cigarettes during lockdown. New users were more frequently younger (p for trend 0.001), men (odds ratio, OR 1.56; 95% confidence interval, CI: 1.03–2.34), cannabis users (OR 2.35; 95% CI: 1.33–4.13), gamblers (OR 3.34; 95% CI: 2.18–5.11) and individuals with anxiety symptoms (OR 1.58; 95% CI: 1.00–2.52). 1.0% of HTP non-users started using it during lockdown. New users were less frequently current than never cigarette smokers (OR 0.19; 95% CI: 0.06–0.61) and more frequently gamblers (OR 2.23; 95% CI: 1.22–4.07). E-cigarettes and HTPs played little role as smoking cessation tools for hardcore smokers but rather provided opportunities for young never smokers to engage in socially acceptable activities, perhaps reflecting the obstacles they faced in obtaining other addictive substances during confinement.
Highlights
A few studies investigated changes in electronic cigarette (e-cigarette) and heated tobacco product (HTP) use during pandemic restrictions
An Italian web-based survey conducted in April 2020 on a convenience sample of 1825 subjects, found that both exclusive e-cigarette users and exclusive HTP users slightly increased their consumption during the lockdown[11]
The aim of this study is to evaluate the effects of Covid-19 lockdown on e-cigarette and HTP use in Italian adults, using data from a large representative cross-sectional study conducted within the LOckdown and lifeSTyles IN ITALY p roject[3,15]
Summary
A few studies investigated changes in electronic cigarette (e-cigarette) and heated tobacco product (HTP) use during pandemic restrictions. Few studies have investigated the impact of the Covid-19 lockdown on the use of e-cigarettes and even fewer on the use of heated tobacco products (HTP). These studies—mainly small online surveys based on convenience samples—found a major impact on e-cigarette use, with 50–60% of vapers reporting changes in their use (either starting or quitting or increasing or decreasing consumption)[6,7,8,9,10]. An Italian web-based survey conducted in April 2020 (i.e., during the lockdown) on a convenience sample of 1825 subjects, found that both exclusive e-cigarette users and exclusive HTP users slightly increased their consumption during the lockdown[11]
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