Perceived risk, attitudes, and behavior of cigarette smokers and nicotine vapers receiving buprenorphine treatment for opioid use disorder during the COVID-19 pandemic

Streck, Joanna M.; Kalkhoran, Sara; Bearnot, Benjamin; Gupta, Priya; Kalagher, Kelly M.; Regan, Susan; Wakeman, Sarah E.; Rigotti, Nancy A.

doi:10.1016/j.drugalcdep.2020.108438

Cited by 29 publications

(36 citation statements)

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“…Two smaller US surveys also found similar associations between perceived vulnerability to COVID-19 and interest in reducing tobacco use. 20 , 21 Our finding of stress as an important factor influencing smoking behavior during the pandemic is corroborated by Dutch and Australian surveys. 22 , 23 …”

Section: Discussionsupporting

confidence: 68%

“…This study’s findings corroborate and expand on the limited prior work on this topic. 20 – 25 A web-based US survey in April 2020 limited to dual cigarette and e-cigarette users also observed an association between perceived COVID-19 risk and motivation to quit and found a variable effect of COVID-19 on tobacco product use. 26 Our survey includes all cigarette smokers and e-cigarette users and a broader array of covariates.…”

Section: Discussionmentioning

confidence: 99%

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Cigarette Smoking and Risk Perceptions During the COVID-19 Pandemic Reported by Recently Hospitalized Participants in a Smoking Cessation Trial

et al. 2021

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Background Cigarette smoking is a risk factor for severe COVID-19 disease. Understanding smokers’ responses to the pandemic will help assess its public health impact and inform future public health and provider messages to smokers. Objective To assess risk perceptions and change in tobacco use among current and former smokers during the COVID-19 pandemic. Design Cross-sectional survey conducted in May–July 2020 (55% response rate) Participants 694 current and former daily smokers (mean age 53, 40% male, 78% white) who had been hospitalized pre-COVID-19 and enrolled into a smoking cessation clinical trial at hospitals in Massachusetts, Pennsylvania, and Tennessee. Main Measures Perceived risk of COVID-19 due to tobacco use; changes in tobacco consumption and interest in quitting tobacco use; self-reported quitting and relapse since January 2020. Key Results 68% (95% CI, 65–72%) of respondents believed that smoking increases the risk of contracting COVID-19 or having a more severe case. In adjusted analyses, perceived risk was higher in Massachusetts where COVID-19 had already surged than in Pennsylvania and Tennessee which were pre-surge during survey administration (AOR 1.56, 95% CI, 1.07–2.28). Higher perceived COVID-19 risk was associated with increased interest in quitting smoking (AOR 1.72, 95% CI 1.01–2.92). During the pandemic, 32% (95% CI, 27–37%) of smokers increased, 37% (95% CI, 33–42%) decreased, and 31% (95% CI, 26–35%) did not change their cigarette consumption. Increased smoking was associated with higher perceived stress (AOR 1.49, 95% CI 1.16–1.91). Overall, 11% (95% CI, 8–14%) of respondents who smoked in January 2020 (pre-COVID-19) had quit smoking at survey (mean, 6 months later) while 28% (95% CI, 22–34%) of former smokers relapsed. Higher perceived COVID-19 risk was associated with higher odds of quitting and lower odds of relapse. Conclusions Most smokers believed that smoking increased COVID-19 risk. Smokers’ responses to the pandemic varied, with increased smoking related to stress and increased quitting associated with perceived COVID-19 vulnerability. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06913-3.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and Risk Perceptions During the COVID-19 Pandemic Reported by Recently Hospitalized Participants in a Smoking Cessation Trial

et al. 2021

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“…Overall, COVID-19 is increasing perceived risks among the public from using the four types of tobacco products. Consistent with the initial evidence [11][12][13] , the perceived risk of tobacco use on COVID-19 severity was much higher than the perceived risk of COVID-19 infection, and the majority of participants endorsed that tobacco use increases COVID-19 severity. Females and people with higher income or education level were more likely to perceive the risks of tobacco use than their counterparts.…”

Section: Discussionsupporting

confidence: 64%

Perceived health risks associated with the use of tobacco and nicotine products during the COVID-19 pandemic

Yang¹,

Lindblom²,

Salloum³

et al. 2021

Tob. Induc. Dis.

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Perceptions of health risks and harms are associated with tobacco product experimentation, initiation, frequency, and intensity of use, as well as quit attempts [1][2][3] . In tobacco regulatory science, findings of health risk misperceptions that can promote harmful tobacco use behaviors are used to prompt and inform corrective action through new public education efforts or new requirements relating to product characteristics (e.g. flavors or appearance), product packaging, and labeling design, advertising and other marketing, warning labels, and educational package inserts 4,5 .Perceived health risks of tobacco products may change during the ongoing COVID-19 pandemic, given the uncertainty surrounding the association between smoking, vaping, and COVID-19 incidence and outcomes. Preliminary evidence indicates that although smoking may be associated with a higher mortality rate and suffering more severe consequences of COVID-19 6,7 , it is not clear if current smoking is associated with a reduced risk of COVID-19 infection [8][9][10] . This initial research seems to contradict the hypothesis that smokers are at higher ABSTRACT INTRODUCTION The perceived health risks of tobacco products may change during the ongoing COVID-19 pandemic. This study aimed to examine the perceived risks of tobacco use on COVID-19 infection and severity, and possible COVID-related changes in perceptions of tobacco use and overall health. METHODS We conducted an online survey of adults in the United States in June 2020 (n=2097). The survey covered cigarettes, cigars, e-cigarettes, and hookah. We also assessed changes in the use of any of the four tobacco products. Multivariate logistic regression models were used to estimate the odds of agreeing with the perceived risks for each risk and each product, with the adjustment of demographic and COVID-19 related variables. RESULTS For all four tobacco products, the perceived risks to general health were slightly higher during the pandemic than before the pandemic (77% vs 79.5% for cigarettes) and the perceived risk of COVID-19 severity was larger than the perceived risk of COVID-19 infection (73.3% vs 56.2% for cigarettes). All risk measures varied with tobacco products consistently, with the risks highest for cigarettes, then cigars, followed by e-cigarettes and hookah. Females and people with higher income or education were more likely to endorse the risks of tobacco use than their counterparts. People who perceived higher risks of using cigarettes (OR=1.65; 95% CI: 1.20-2.27) and cigars (OR=1.63; 95% CI: 1.17-2.27) to COVID-19 severity were more likely to have decreased or quit their use. CONCLUSIONS Tobacco/nicotine use was perceived to increase the risk of COVID-19 severity and the perceived risk of tobacco/nicotine use to general health was high during the pandemic, particularly for cigarettes. The change of perceived risks appeared to be prompting harm-reducing changes in tobacco product use.

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“…We found that 33% of combustible cigarette smokers and 23% of e-cigarette users increased their product use, similar to prior studies. 12,15 Prior studies have found that while some e-cigarette users had concerns about product access during the COVID-19 pandemic, many were still able to obtain the products either through stockpiling of products, online purchasing, or from their usual channels either through vape shop non-compliance with or circumventing of business closure orders. 16–18 We found factors associated with various forms of stress – total stress, worry about financial problems, and increased working hours - to be associated with increased combustible cigarette smoking during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…Increased interest in quitting product use was reported by 35% of combustible cigarette smokers and 43% of e-cigarette users during the COVID-19 pandemic, consistent with other, non-representative samples of U.S. adults surveyed earlier in the pandemic. 12,15 Therefore, the pandemic may be a time of increased receptiveness to help for smoking or vaping cessation. A study in the UK found higher odds of trying to quit and of quitting among past-year smokers after a COVID-19 lockdown, and while smokers were no more likely to use evidence-based smoking cessation treatment after the lockdown, use of remote smoking cessation support in the form of telephone support, websites, or telephone applications increased during this time.…”

Section: Discussionmentioning

confidence: 99%

Smoking and Vaping Among a National Sample of U.S. Adults During the COVID-19 Pandemic

Kalkhoran

Levy

Rigotti

2021

Preprint

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IntroductionWith concerns about cigarette smoking being a risk factor for severe disease from COVID-19, understanding nicotine and tobacco use patterns is important for preventive efforts. We aimed to understand changes in product use behaviors among U.S. adult combustible cigarette smokers and electronic cigarette (e-cigarette) users.MethodsIn August 2020, we conducted a cross-sectional survey of a nationally-representative sample of adults age >18 in NORC’s AmeriSpeak Panel who reported past 6-month use of combustible cigarettes or e-cigarettes. Multivariable logistic regression assessed factors associated with increased product use and quit attempts since hearing about COVID-19.Results1024 past 6-month cigarette smokers and/or e-cigarette users were surveyed. Among cigarette smokers, 45% reported no change in cigarette smoking and 33% increased cigarette smoking since hearing about COVID-19. Higher stress was associated with increased cigarette smoking. Among e-cigarette users, 41% reported no change in and 23% reported increasing e-cigarette use. 26% of cigarette smokers and 41% of e-cigarette users tried to quit because of COVID-19. Higher perceived risk of COVID-19 was associated with attempts to quit combustible cigarettes (AOR 2.37, 95% CI 1.59-3.55) and e-cigarettes (AOR 3.14, 1.73-5.70).ConclusionsCigarette and e-cigarette use patterns varied in response to the COVID-19 pandemic. Most cigarette smokers and e-cigarette users perceived product use as increasing COVID-19-related health risks, and this was associated with attempts to quit. Others, especially those reporting higher stress, increased product use. Proactive provision of cessation support to smokers and e-cigarette users may help mitigate stress-related increases in product use during the COVID-19 pandemic.

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Perceived risk, attitudes, and behavior of cigarette smokers and nicotine vapers receiving buprenorphine treatment for opioid use disorder during the COVID-19 pandemic

Cited by 29 publications

References 29 publications

Cigarette Smoking and Risk Perceptions During the COVID-19 Pandemic Reported by Recently Hospitalized Participants in a Smoking Cessation Trial

Cigarette Smoking and Risk Perceptions During the COVID-19 Pandemic Reported by Recently Hospitalized Participants in a Smoking Cessation Trial

Perceived health risks associated with the use of tobacco and nicotine products during the COVID-19 pandemic

Smoking and Vaping Among a National Sample of U.S. Adults During the COVID-19 Pandemic

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