Tobacco Quit Intentions and Behaviors among Cigar Smokers in the United States in Response to COVID-19

Abstract

Combustible tobacco users appear to be at greater risk for serious complications from COVID-19. This study examined cigar smokers’ perceived risk of COVID-19, quit intentions, and behaviors during the current pandemic. We conducted an online study between 23 April 2020 to 7 May 2020, as part of an ongoing study examining perceptions of different health effects of cigars. All participants used cigars in the past 30 days (n = 777). Three-quarters of the sample (76.0%) perceived they had a higher risk of complications from COVID-19 compared to non-smokers. The majority of participants (70.8%) intended to quit in the next six months due to COVID-19, and almost half of the sample (46.5%) reported making a quit attempt since the start of the COVID-19 pandemic. Far more participants reported increasing their tobacco use since COVID-19 started (40.9%) vs. decreasing their tobacco use (17.8%). Black or African American participants, participants who reported using a quitline, and participants with higher COVID-19 risk perceptions had higher intentions to quit using tobacco due to COVID-19, and higher odds of making a quit attempt since COVID-19 started. More research is needed to understand how tobacco users are perceiving COVID-19 risks and changing their tobacco use behaviors.

The Impact of COVID-19 on Smoking Patterns in Pakistan: Findings From a Longitudinal Survey of Smokers

“…Our findings are consistent with previous studies reporting a bidirectional effect of COVID-19 observed in smokers. 6,10,11 In one of these, Klemperer et al found that in response to COVID-19, the motivation to quit increased in 35.6% but reduced in 16.2% of smokers; 11 fear of COVID-19 was associated with a change in motivation. Likewise, 22.9% smokers made at least one quit attempt, 28.3% decreased their cigarette use, but another 30.3% increased its use since COVID-19.…”

“…11 In Downloaded from https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntaa207/5919351 by University of Edinburgh user on 24 November 2020 A c c e p t e d M a n u s c r i p t another group of cigar users, while two-third participants intended to quit and nearly half made a quit attempt, far more smokers reported increasing their smoking than those reporting a decline. 10 Our paper describes self-reported changes in smoking behaviour in a large sample of a nationally representative cohort of smokers. To our knowledge, this is the only study that reports relapse rates among those who stopped soon after COVID-19 outbreak.…”

“…9 Similarly, for some tobacco users, mental stress, anxiety, social isolation, and lack of access to cessation support might have resulted in increased consumption. 10 The evidence, mostly from high-income countries, suggests that while an unusual number of smokers have been motivated to quit during the pandemic 11 and have either cut down smoking or made quit attempts, 9 there are some who increased smoking. 12 There is little information so far on those quitting after the outbreak and maintaining abstinence.…”

Exploring changes in cigar smoking patterns and motivations to quit cigars among black young adults in the time of COVID-19

“…Evidence from the U.S. and other countries has demonstrated that tobacco use is associated with COVID-19 progression, including higher mortality rates from COVID-19 ( Patanavanich & Glantz, 2020 ), prompting health authorities to strongly urge the public to quit tobacco smoking during the pandemic ( Australian Government Department of Health, 2020 , National Cancer Institute, 2020 , World Health Organization, 2020 ). Recent research has indicated increased intentions of quitting tobacco among current consumers to avoid having progressed COVID-19 outcomes ( Klemperer et al, 2020 , Kowitt et al, 2020 , Yach, 2020 ).…”

“…Conversely, the COVID-19 pandemic may lead to increased tobacco consumption as smokers use more tobacco to cope with pandemic-induced stress and anxiety ( Kowitt et al, 2020 , Luk et al, 2020 , Rolland et al, 2020 , Yach, 2020 ). Former studies have shown that experiencing traumatic life events (e.g., the September 11 attacks) may lead to acute stress disorders ( Biggs et al, 2010 ), and those events have significant influences on increased tobacco and substance use behavior and dependence over time ( Biggs et al, 2010 , Bruns and Geist, 1984 , Parslow and Jorm, 2006 ).…”