Smoking Behaviors, Mental Health, and Risk Perceptions during the Beginning of the COVID-19 Pandemic among Mexican Adult Smokers

Abstract

Mexico is one of the countries most affected by COVID-19. Studies have found that smoking behaviors have been impacted by the pandemic as well; however, results have varied across studies, and it remains unclear what is causing the changes. This study of an open cohort of smokers recruited from a consumer panel (n = 2753) examined changes in cigarettes per day (CPD), daily vs. non-daily smoking, recent quit attempts, perceived stress, depression, and perceived severity of COVID-19 at two points during the pandemic: March and July 2020. Differences in CPD between waves were estimated with Poisson regression using generalized estimating equations (GEE). Differences in perceived stress were estimated with linear regression using GEE, and differences in recent quit attempts, depression, and perceived severity of COVID-19 were estimated using separate logistic regression GEE models. Rates of depression were higher in July compared to March (AOR = 1.55, 95% C.I. 1.31–1.85), and the likelihood of recent quit attempt was lower in July compared to March (AOR = 0.85, 95% C.I. 0.75–0.98). There was no statistically significant change in CPD, daily smoking, or perceived stress. Perceived COVID-19 severity for oneself increased significantly (AOR: 1.24, 95% C.I. 1.02–1.52); however, the perceived COVID-19 severity for smokers remained constant. Our study suggests that as the COVID-19 pandemic expanded in Mexico, smoking frequency remained stable, and quit attempts decreased, even as adult smokers increasingly perceived infection with COVID-19 for themselves as severe. These results can aid in the development of health communication strategies to educate smokers about their risk for COVID-19, potentially capitalizing on concerns that stem from this syndemic of communicable and smoking-related non-communicable disease.

Mental Health Impact of the COVID-19 Pandemic on Mexican Population: A Systematic Review

“…There were 10 articles excluded due to their study methodology, not being related to the main objective, not having enough data or because they were reviews. After a meticulous review of each article, 15 studies met the inclusion criteria [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”

“…Finally, many factors were associated with higher levels of anxiety during the COVID-19 pandemic in Mexico, such as being female [ 13 , 16 , 19 , 22 , 23 ], younger age [ 16 , 22 ], history of direct or indirect contact with a COVID-19 confirmed case [ 16 , 23 ] and the presence of specific physical symptoms [ 16 ]. However, in some studies, no differences between genders or age concerning anxiety were identified [ 14 , 17 , 24 , 25 , 26 , 27 ].…”

“…Symptoms of depression were analyzed in 9 out of the 11 studies [ 13 , 14 , 16 , 17 , 19 , 22 , 23 , 24 , 27 ]. The prevalence of depressive symptoms ranged from 5.2% to 86.6% in the Mexican population.…”

“…Two studies examined longitudinal differences in the severity of depression. Loud et al [ 24 ] indicated that depression was higher in July compared to March 2020; 19.9% of participants presented symptoms of depression in March, which increased to 27% in July. After adjusting for sociodemographic variables and smoking characteristics, all the participants were more likely to report symptoms of depression in July than at the beginning of the COVID-19 pandemic.…”

“…Of the total studies included, nine analyzed stress levels [ 13 , 16 , 18 , 20 , 23 , 24 , 25 , 26 , 27 ], and three evaluated psychological distress [ 14 , 16 , 21 ]. The prevalence of stress-related symptoms was >19%.…”