Google Trends Assessment of Keywords Related to Smoking and Smoking Cessation During the COVID-19 Pandemic in 4 European Countries: Retrospective Analysis (Preprint)

Abstract

BACKGROUND Smoking is a modifiable risk factor for Coronavirus SARS-CoV-2 infection. Evidence of smoking behavior during the pandemic is ambiguous. Most investigations report an increase in smoking. In this context, Google Trends data monitors real-time public information-seeking behavior and is therefore useful to characterize smoking-related interest over the trajectory of the pandemic. OBJECTIVE Google Trends data was used to evaluate the transition into the pandemic on public interest regarding smoking and cessation. Special attention was paid to the influence of lockdowns, vaccinations, and incidence. Intensification of cessation aid might be crucial in times of pandemic to improve public health. METHODS The weekly relative search volume was retrieved from Google Trends for England, Germany, Italy, and Spain during the period from 31-12-2017 to 18-4-2021. Data was collected for keywords concerning cessation, treatment, and consumption. Trend curves were generated, and the relative search volume of keywords before and during the pandemic was compared. To address short-term changes linked to lockdowns or vaccination campaigns flexible scan statistics were used to identify clusters. Subsequently, the numbers of clusters after the onset of the pandemic were compared. RESULTS Country-wise minor differences were observed while overarching tendencies prevailed. Overall trend curves and statistical comparison revealed a decline in interest in cessation. Also, e-cigarettes and most consumption-related keywords showed decreased relative search volume during the pandemic. Substantial clusters of increased interest were sparsely linked to lockdowns, vaccination campaigns, or incidence. Generally, fewer clusters for cessation were present during the pandemic. CONCLUSIONS This study reports a substantial decline in overall relative search volume and clusters for cessation interest. These results underline the importance of intensifying cessation aid during times of crisis. Lockdowns, vaccination, and incidence had less impact on information-seeking behavior. Other public measures that positively affect smoking behavior remain to be determined. CLINICALTRIAL n.a.