Pulling Your Mask down to Smoke: Qualitative Themes from Young Adults on Nicotine Use during a Pandemic

Abstract

Introduction:The COVID-19 pandemic may have resulted in a change in life routines for tobacco users, but little is known about the rationale underlying these changes. Methods: A convenience sample of young adults ages 21-28 (n ¼ 29) were recruited online May-July 2020 to participate in semi-structured interviews about nicotine use behaviors specific to cigarillos and e-cigarettes. Audio-recorded interviews were 60-90 min long and were conducted remotely. Participants were asked opinions and behavioral effects of the COVID-19 pandemic on tobacco use. Verbatim transcripts and field notes from each interview were coded by a trained researcher using a codebook developed using inductive and deductive approaches. Thematic analysis was used to examine product access, use frequency, stress and use triggers. Results: Most current users reported tobacco use stayed the same or increased since the pandemic and attributed this to being home more with greater time/boredom. COVID-19 impacted purchasing behaviors such as purchasing products in greater quantities, through the Internet, or at a different store due to perceived cleanliness. Few reported using tobacco products less frequently and not smoking in public due to the perception of risks associated with smoking and COVID-19, plus having to take off their mask to smoke. Lack of social use modified shared product use, flavors selected, and setting of use. Financial impacts included increased product costs and job loss. Few mentioned wanting to quit due to the pandemic. Discussion: Current tobacco users have experienced major changes in their tobacco use routines during the COVID-19 pandemic.

Perceived Susceptibility to and Seriousness of COVID-19: Associations of Risk Perceptions with Changes in Smoking Behavior

“…Prior research has also documented both increased and decreased smoking during the pandemic [9,10,12], with people reporting a variety of reasons for changes in their smoking, such as disrupted schedules and social situations [12,[14][15][16], financial and logistical constraints [12,15,16], and stress [12,[14][15][16]. While health concerns of smoking and COVID-19 contributed to decreased smoking [12,[14][15][16], other factors were also influential. Other studies using the HBM to predict behavior and behavioral intentions during the pandemic [21][22][23][24][25][26][27][28][29][30] have also produced mixed results.…”

“…Perceived stress from the pandemic was significantly associated with both increased smoking and decreased smoking. Prior research has also documented both increased and decreased smoking during the pandemic [ 9 , 10 , 12 ], with people reporting a variety of reasons for changes in their smoking, such as disrupted schedules and social situations [ 12 , 14 , 15 , 16 ], financial and logistical constraints [ 12 , 15 , 16 ], and stress [ 12 , 14 , 15 , 16 ]. While health concerns of smoking and COVID-19 contributed to decreased smoking [ 12 , 14 , 15 , 16 ], other factors were also influential.…”

“…Data from the Nielsen National Consumer Panel, representative of U.S. consumers, showed a 13.2% increase in tobacco sales during 1 April–30 June 2020, compared to the same dates in 2019 [ 13 ]. Across adults of varying ages in the U.S. and Belgium, the reported reasons for decreasing smoking include spending more time around one’s children [ 14 ], spending less time in social situations that promote smoking [ 12 , 14 , 15 , 16 ], difficulty obtaining or affording cigarettes [ 12 , 15 , 16 ], and health concerns [ 12 , 14 , 15 , 16 ]. The reported reasons for increased smoking include increased stress [ 12 , 14 , 15 , 16 ], boredom [ 10 , 12 , 14 , 15 ], less social support for quitting smoking [ 15 ], and having greater flexibility in one’s schedule [ 14 , 16 ].…”

Lived experiences of older adults during the first COVID-19 lockdown: A qualitative study

“…While a growing body of literature has qualitatively explored the psychological and societal impact of the COVID-19 outbreak, age-specific data, particularly regarding older age, is still lacking [15]. Most studies have addressed the impact of COVID-19 on health-care providers, patients, caregivers and children [20][21][22][23][24][25]. However, most studies were conducted in China with very small samples.…”

‘I Was Smoking a Lot More during Lockdown Because I Can’: A Qualitative Study of How UK Smokers Responded to the Covid-19 Lockdown

“…Some studies have reported increases in cessation and quit attempts [ 9 ], and increased motivation to quit for some study participants [ 10 ], potentially reflecting concerns about contracting Covid-19 and becoming severely ill as a result [ 7 , 8 ]. A few studies have reported changes in tobacco purchasing patterns, with some cigarette smokers having large stocks of cigarettes at home to avoid leaving the house every day to purchase more [ 10 , 11 ].…”