The Impact of the Covid-19 Pandemic on Smoking Among Vulnerable Populations

Author:

Wiley Rhiannon C123ORCID,Oliver Anthony C13ORCID,Snow Miranda B13,Bunn Janice Y14,Barrows Anthony J13,Tidey Jennifer W5,Lee Dustin C6,Sigmon Stacey C123,Gaalema Diann E123,Heil Sarah H123,Markesich Catherine12,Villanti Andrea C123ORCID,Higgins Stephen T123

Affiliation:

1. Vermont Center on Behavior and Health, Larner College of Medicine, University of Vermont , Burlington, VT

2. Department of Psychological Science, University of Vermont , Burlington, VT

3. Department of Psychiatry, Larner College of Medicine, University of Vermont , Burlington, VT

4. Department of Medical Biostatistics, Larner College of Medicine, University of Vermont , Burlington, VT

5. Center for Alcohol and Addiction Studies, Brown University , Providence, RI

6. Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine , Baltimore, MD

Abstract

Abstract Aim While accumulating evidence suggests that people modified their smoking during the ongoing COVID-19 pandemic, it remains unclear whether those most at risk for tobacco-related health disparities did so. The current study examined changes in smoking among several vulnerable smoker populations during the COVID-19 pandemic. Methods A web-based survey was distributed in 2020 to 709 adults with socioeconomic disadvantage, affective disorders, or opioid use disorder who participated in a previous study investigating the effects of very low nicotine content (VLNC) cigarettes on smoking. Current smoking status and rate, and adoption of protective health behaviors in response to the pandemic (eg social distancing, mask wearing) were examined. Results Among 332 survey respondents (46.8% response rate), 84.6% were current smokers. Repeated measures ANOVA showed that current cigarettes/day (CPD) was higher during COVID than pre-COVID (12.9 ± 1.0 versus 11.6 ± 1.0; p < .001). Most respondents had adopted protective health behaviors to prevent infection (>79% for all behaviors). More than half indicated that they were still leaving their homes specifically to buy cigarettes (64.6%) and were buying more packs per visit to the store (54.5%) than pre-COVID. Individuals unemployed at the time of the survey experienced greater increases in CPD (from 11.4 ± 1.4 to 13.3 ± 1.4, p = .024) as did those with higher levels of anxiety (from 11.5 ± 1.1 to 13.6 ± 1.1, p < .001). Conclusions Smoking increased during the COVID-19 pandemic in this sample of adults from vulnerable populations, even while most adopted protective health measures to prevent infection. Unemployment and anxiety might identify those at greatest risk for increases in tobacco use. Implications Individuals from populations especially vulnerable to smoking might be at risk for greater harm from cigarette smoking during times of pandemic-related stress. Public health interventions are warranted to ameliorate increases in smoking among these populations. Special attention should be paid to those experiencing unemployment and high anxiety.

Funder

Food and Drug Administration

National Institute on Drug Abuse

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

Reference40 articles.

1. Smoking is independently associated with an increased risk for COVID-19 mortality: a systematic review and meta-analysis based on adjusted effect estimates;Hou;Nicotine Tob Res.,2021

2. Cigarette smoking makes comeback during coronavirus pandemic.;Maloney;Wall Str J.,2020

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