Changes in Smoking Behavior in the COVID-19 Pandemic: A Single Center Study in Family Practice

Year 2024, , 11 - 20, 03.05.2024

Kamber Kaşali , Mehmet Doğan , Hacı Ahmet Aydemir , Mustafa Bayraktar

https://doi.org/10.62425/rtpharma.1462458

Abstract

Objective: There are controversial studies on smoking addiction in the COVID-19 pandemic. While some studies show increased tobacco use during the pandemic, others report increased smoking cessation attempts. This study examined changes in tobacco use and quit intentions during the COVID-19 pandemic compared to pre-pandemic.
Methods: A cross-sectional study was designed and three groups were formed by including patients over 18 years of age, who were smokers, and who presented to the Education Family Health Center and had RT-PCR test results for COVID-19. Among these patients, patients with COVID-19 symptoms and complaints and positive RT-PCR test results constituted the COVID-19 positive group, patients who were COVID-19 negative but isolated due to their contacts constituted the contact group, and healthy people without any COVID-19 contact and symptoms constituted the healthy group. Demographic characteristics, smoking status before the COVID-19 pandemic, change in smoking status after COVID-19 test result or contact, and Fagerström nicotine dependence test results were compared.
Results: Of the total 131 participants enrolled in the study, 70 were in the healthy group, 31 were in the COVID-19 negative group, and 30 were in the COVID-19 positive group. Men were predominant in three groups (60%, 83.9%, and 73.3% in normal, COVID-19-neg, and COVID-19-positive groups, respectively) with a small significant difference (p=0.048). The mean ages were 41.09±12.85, 38.21±11.69, and 39.47±11.66 years in the healthy, COVID-19 negative, and COVID-19 positive groups, respectively, with no significant difference (p>0.05). Fagerström dependence scores were 1.82±1.05, 1.53±0.86, and 1.40±0.72 in the healthy, COVID-19 negative, and COVID-19 positive groups, respectively, and were not statistically different (p>0.05). Smoking prevalence decreased by 1.13 (±4.17) cigarettes per day in the healthy group, by 3.97 (±5.31) cigarettes in the COVID negative group, and by 10.14 (±7.86) cigarettes in the COVID positive group, with a statistically significant decrease in smoking prevalence in all three groups (p<0.01). Those in the COVID-19 positive group were statistically significantly more likely to want to stop smoking.
Conclusion: Our study found that people significantly reduced smoking and considered quitting during the COVID-19 pandemic. Every individual who quits smoking is an asset to society. To achieve this goal, it should be aimed at raising awareness and providing counseling to quit smoking by studying smoking and nicotine dependence in all situations.

Keywords

COVID-19, family practice, nicotine dependence, smoking

Ethical Statement

Prior to the study, study permission was obtained from the Ministry of Health with the application number 2021-09-13T10_07_01. Afterwards, ethical approval was obtained from Atatürk University Faculty of Medicine Clinical Research Ethics Committee.

Supporting Institution

None.

References

• Berlin, I., Thomas, D., Le Faou, A.-L., & Cornuz, J. (2020). COVID-19 and smoking. Nicotine and Tobacco Research, 22(9), 1650-1652.
• Carreras, G., Lugo, A., Stival, C., Amerio, A., Odone, A., Pacifici, R., Gallus, S., & Gorini, G. (2022). Impact of COVID-19 lockdown on smoking consumption in a large representative sample of Italian adults. Tob Control, 31(5), 615-622.
• Changeux, J.-P., Amoura, Z., Rey, F. A., & Miyara, M. (2020). A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications. Comptes Rendus. Biologies, 343(1), 33-39.
• Eisenberg, S.-L., & Eisenberg, M. J. (2020). Smoking cessation during the COVID-19 epidemic. Nicotine and Tobacco Research, 22(9), 1664-1665.
• Farsalinos, K., Barbouni, A., Poulas, K., Polosa, R., Caponnetto, P., & Niaura, R. (2020). Current smoking, former smoking, and adverse outcome among hospitalized COVID-19 patients: a systematic review and meta-analysis. Therapeutic advances in chronic disease, 11, 2040622320935765. Freire, A., Medina, B. A. S., Leite, M. R., Lopes, T. O., Santos, E. T., Ferreira, M. M., Silva, B. S. A., Cavalcante, M. A., & Pacagnelli, F. L. (2022). Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study. Tob Prev Cessat, 8, 17. https://doi.org/10.18332/tpc/146545 García-Álvarez, L., De La Fuente-Tomás, L., Sáiz, P. A., García-Portilla, M. P., & Bobes, J. (2020). Will changes in alcohol and tobacco use be seen during the COVID-19 lockdown?/? Se observaran cambios en el consumo de alcohol y tabaco durante el confinamiento por COVID-19? Adicciones, 32(2), 85-90.
• Heatherton, T. F., Kozlowskı, L. T., Frecker, R. C., & Fagerstrom, K.-O. (1991). The Fagerström Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119-1127. https://doi.org/https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
• Lanctot, J. Q., Stockton, M. B., Mzayek, F., Read, M., McDevitt-Murphy, M., & Ward, K. (2008). Effects of disasters on smoking and relapse: an exploratory study of Hurricane Katrina victims. American journal of health education, 39(2), 91-94.
• Matsungo, T. M., & Chopera, P. (2020). Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe. BMJ Nutrition, Prevention & Health, 3(2), 205. O'Keeffe, L. M., Taylor, G., Huxley, R. R., Mitchell, P., Woodward, M., & Peters, S. A. E. (2018). Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis. BMJ Open, 8(10), e021611. https://doi.org/10.1136/bmjopen-2018-021611
• Ornell, F., Moura, H. F., Scherer, J. N., Pechansky, F., Kessler, F. H. P., & von Diemen, L. (2020). The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment. Psychiatry research, 289, 113096.
• Osaki, Y., Maesato, H., Minobe, R., Kinjo, A., Kuwabara, Y., Imamoto, A., Myoga, Y., Matsushita, S., & Higuchi, S. (2020). Changes in smoking behavior among victims after the great East Japan earthquake and tsunami. Environmental Health and Preventive Medicine, 25(1), 1-8.
• Ozamiz-Etxebarria, N., Dosil-Santamaria, M., Picaza-Gorrochategui, M., & Idoiaga-Mondragon, N. (2020). Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cadernos de saude publica, 36.
• Ozcelik, N., & Yilmaz Kara, B. (2021). Effect of coronaphobia on smoking habits. J Addict Dis, 39(2), 241-247. https://doi.org/10.1080/10550887.2020.1849950
• Paleiron, N., Mayet, A., Marbac, V., Perisse, A., Barazzutti, H., Brocq, F.-X., Janvier, F., Dautzenberg, B., & Bylicki, O. (2021). Impact of tobacco smoking on the risk of COVID-19: a large scale retrospective cohort study. Nicotine and Tobacco Research, 23(8), 1398-1404.
• Parslow, R. A., & Jorm, A. F. (2006). Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults. Addiction, 101(7), 1044-1050.
• Patanavanich, R., & Glantz, S. A. (2020). Smoking is associated with COVID-19 progression: a meta-analysis. Nicotine and Tobacco Research, 22(9), 1653-1656.
• Patanavanich, R., & Glantz, S. A. (2020). Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine Tob Res, 22(9), 1653-1656. https://doi.org/10.1093/ntr/ntaa082
• Pettigrew, S., Jun, M., Roberts, I., Bullen, C., Nallaiah, K., & Rodgers, A. (2020). Preferences for tobacco cessation information and support during Covid-19. Journal of Addiction Medicine, 14(6), e362-e365.
• Rahman, M. A., Hoque, N., Alif, S. M., Salehin, M., Islam, S. M. S., Banik, B., Sharif, A., Nazim, N. B., Sultana, F., & Cross, W. (2020). Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. Global Health, 16(1), 95. https://doi.org/10.1186/s12992-020-00624-w
• Reddy, R. K., Charles, W. N., Sklavounos, A., Dutt, A., Seed, P. T., & Khajuria, A. (2021). The effect of smoking on COVID-19 severity: A systematic review and meta-analysis. J Med Virol, 93(2), 1045-1056. https://doi.org/10.1002/jmv.26389
• Strzelak, A., Ratajczak, A., Adamiec, A., & Feleszko, W. (2018). Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review. Int J Environ Res Public Health, 15(5). https://doi.org/10.3390/ijerph15051033
• Svicher, A., Cosci, F., Giannini, M., Pistelli, F., & Fagerström, K. (2018). Item Response Theory analysis of Fagerström Test for Cigarette Dependence. Addict Behav, 77, 38-46. https://doi.org/10.1016/j.addbeh.2017.09.005
• Tsigaris, P., & Teixeira da Silva, J. A. (2020). Smoking Prevalence and COVID-19 in Europe. Nicotine Tob Res, 22(9), 1646-1649. https://doi.org/10.1093/ntr/ntaa121
• Uysal, M. A., Kadakal, F., Karşidağ, C., Bayram, N. G., Uysal, O., & Yilmaz, V. (2004). Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks, 52(2), 115-121.
• van Zyl-Smit, R. N., Richards, G., & Leone, F. T. (2020). Tobacco smoking and COVID-19 infection. The Lancet Respiratory Medicine, 8(7), 664-665.
• Veldhuizen, S., Selby, P., Wong, B., & Zawertailo, L. (2021). Effect of COVID-19 on smoking cessation outcomes in a large primary care treatment programme: an observational study. BMJ Open, 11(8), e053075. https://doi.org/10.1136/bmjopen-2021-053075
• Vlahov, D., Galea, S., Resnick, H., Ahern, J., Boscarino, J. A., Bucuvalas, M., Gold, J., & Kilpatrick, D. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. American journal of epidemiology, 155(11), 988-996.