The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea

Abstract

OBJECTIVES: It is necessary to investigate tobacco or nicotine product(TNP) use which acts as a risk factor for COVID-19 infection. Especially, mask wearing is difficult to practice when using TNP. Therefore, this study aimed to examine the association between TNP use behaviors and noncompliance with mask wearing in COVID-19 pandemic.METHODS: The samples of 208,618 Korean adults aged 19 years or older were used. As an independent variable, TNP use behaviors such as TNP use status, changes in TNP use after COVID-19, TNP types, and attempt to quit were used. Logistic regression was performed on sex-stratified participants.RESULTS: Among men, Odds ratio(OR) of current TNP users was 2.00(95%CI [1.66, 2.40]), and OR of former users was 1.32[1.09, 1.60] compared to never users. In women, OR was 1.50[1.00-2.26] for former users. Cigarette use was more associated with not wearing a mask than NCTNP use (OR=1.53[1.12, 2.08]). Men whose TNP use decreased had lower non-compliance (OR=0. 52[0.36, 0.74]). Women whose TNP use increased had lower non-compliance (OR= 0.13[0.07, 0.26]).CONCLUSIONS: Current and former users were less likely to wear masks. Cigarette use was more associated with not wearing a mask than non-cigarette tobacco or nicotine products(NCTNP) use.Changes in TNP use showed association, but in opposite direction for men and women. Therefore, we suggest that more attention should be paid to TNP use prevention and cessation support during the epidemic of respiratory infectious diseases. In addition, it is necessary to identify risk factors of cigarette users in compliance with mask wearing.