The Impact of The COVID-19 Pandemic on Smoking Cessation

Year 2023, Volume: 9 Issue: 4, 652 - 661, 29.10.2023

Emine Serap Yılmaz Selen Karaoğlanoğlu Nurhan Köksal

https://doi.org/10.19127/mbsjohs.1298898

Abstract

Objective: In our study, we aimed to reveal the number of applications made to the smoking cessation clinic in our hospital, smoking cessation behavior, and the relationship between this situation and the status of being diagnosed with COVID-19 in the nine months before and after March 11, 2020, when the first case with a diagnosis of COVID-19 was detected in our country.
Methods: Individuals over 18 who applied to the Ministry of Health’s Ordu University Training and Research Hospital smoking cessation outpatient clinic within nine months before (Group A) and after the COVID-19 pandemic (Group B) were included in our study. Age, gender, chronic diseases, Fagerström addiction scores, and treatment they received for smoking cessation were noted through the tobacco addiction treatment monitoring system (TÜBATİS), and their smoking status was questioned by reaching them three months after their application to us. In the first year of the pandemic, the patients in Group A were reached again and questioned about whether they had been diagnosed with COVID-19 (PCR positivity).
Results: It was determined that there were 320 patients in Group A and 60 patients in Group B, and there was a statistically significant difference in age and smoking cessation behavior between the two groups (p < 0.05). While 20.6% of Group A was 55 years old and over and 8.1% was under 25 years old, these rates were 13.3% and 21.7% in Group B, respectively (p = 0.041). The percentage of those who quit smoking was 48.9% in Group A and 30.9% in Group B (p = 0.029). When the patients in Group A were re-evaluated in the first year of the pandemic, the rate of having COVID-19 was 6.6% in those who quit smoking, 6.3% in those who did not quit, and 31.2% in those who quit and started again (p = 0.001).
Conclusion: Health services have had to give up their workforce to fight the epidemic during the pandemic process, and therefore, there has been a decrease in patient admissions in smoking cessation polyclinics. During the restriction periods, there was an increase in the tendency to smoke due to reasons such as social isolation, increased mental and physical slowdown, psychological effects, and economic concerns, and a decrease in the application to health centers due to the risk of transmission, especially in elderly patients with chronic diseases. We think the decrease in our smoking cessation rates and especially in the applications of patients over 55 years old compared to the pre-pandemic period may be due to this reason. Smoking cessation studies should be carried out more decisively, and information should be provided about the combined risks associated with smoking, even in regular outpatient clinic meetings.

Keywords

COVID-19 infection, smoking addiction, smoking cessation clinic

References

• Li F, Li W, Farzan M, Harrison SC. Structure of SARS coronavirus spike receptor-binding domain complexed with receptor. Science. 16 Eylül 2005;309(5742):1864-8.
• Brake SJ, Barnsley K, Lu W, McAlinden KD, Eapen MS, Sohal SS. Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J Clin Med. 20 Mart 2020;9(3):841.
• Cai G, Bossé Y, Xiao F, Kheradmand F, Amos CI. Tobacco Smoking Increases the Lung Gene Expression of ACE2, the Receptor of SARS-CoV-2. Am J Respir Crit Care Med. 15 Haziran 2020;201(12):1557-9.
• Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. Mayıs 2020;17(5):259-60.
• Samet JM. Tobacco Products and the Risks of SARS-CoV-2 Infection and COVID-19. Nicotine Tob Res. 01 Aralık 2020;22(Supplement_1):S93-5.
• Sifat AE, Nozohouri S, Villalba H, Vaidya B, Abbruscato TJ. The Role of Smoking and Nicotine in the Transmission and Pathogenesis of COVID-19. J Pharmacol Exp Ther. 01 Aralık 2020;375(3):498-509.
• Nordman JC, Muldoon P, Clark S, Damaj MI, Kabbani N. The α4 nicotinic receptor promotes CD4+ T-cell proliferation and a helper T-cell immune response. Mol Pharmacol. Ocak 2014;85(1):50-61.
• Dye JA, Adler KB. Effects of cigarette smoke on epithelial cells of the respiratory tract. Thorax. Ağustos 1994;49(8):825-34.
• Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. Nisan 2020;8(4):e20.
• Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, vd. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. Temmuz 2020;75(7):1730-41.
• Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, vd. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 30 Nisan 2020;382(18):1708-20.
• Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review with Bayesian meta-analyses (version 7). Addiction. 2021;116(6):1319-68.
• Leung JM, Yang CX, Tam A, Shaipanich T, Hackett TL, Singhera GK, vd. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur Respir J. Mayıs 2020;55(5):2000688.
• Liu W, Tao ZW, Wang L, Yuan ML, Liu K, Zhou L, vd. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl). 05 Mayıs 2020;133(9):1032-8.
• Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulm Med. 2020;2020:6175964.
• Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, vd. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. Mayıs 2020;55(5):2000547.
• Lippi G, Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. Mayıs 2020;75:107-8.
• Changeux JP, Amoura Z, Rey FA, Miyara M. A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications. C R Biol. 05 Haziran 2020;343(1):33-9.
• Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Res. Haziran 2020;178:104787.
• Krause RM, Buisson B, Bertrand S, Corringer PJ, Galzi JL, Changeux JP, vd. Ivermectin: a positive allosteric effector of the alpha7 neuronal nicotinic acetylcholine receptor. Mol Pharmacol. Şubat 1998;53(2):283-94.
• Kayhan Tetik B, Gedik Tekinemre I, Taş S. The Effect of the COVID-19 Pandemic on Smoking Cessation Success. J Community Health. Haziran 2021;46(3):471-5.
• Gallus S, Scala M, Possenti I, Jarach CM, Clancy L, Fernandez E, vd. The role of smoking in COVID-19 progression: a comprehensive meta-analysis. Eur Respir Rev Off J Eur Respir Soc. 31 Mart 2023;32(167):220191.