Smokers' cognitive and behavioural reactions during the early phase of the COVID-19 pandemic: Findings from the 2020 ITC Four Country Smoking and Vaping Survey.
Smokers' cognitive and behavioural reactions during the early phase of the COVID-19 pandemic: Findings from the 2020 ITC Four Country Smoking and Vaping Survey.
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DOI：
10.1371/journal.pone.0252427
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Fong GT
中科院分区：
文献类型：
--
作者：
Gravely S;Craig LV;Cummings KM;Ouimet J;Loewen R;Martin N;Chung-Hall J;Driezen P;Hitchman SC;McNeill A;Hyland A;Quah ACK;O'Connor RJ;Borland R;Thompson ME;Boudreau C;Fong GT
COVID-19主要是一种呼吸系统疾病，吸烟对呼吸系统和免疫系统产生不利影响;因此，这种融合可能会激励吸烟者戒烟。本研究在第一次全球COVID-19浪潮期间在四个高收入国家进行，研究了COVID-19与以下因素之间的关系：（1）关于戒烟的想法;（2）吸烟的变化（戒烟尝试，减少或增加吸烟，或无变化）;以及（3）基于健康信念模型的适应性框架的与积极变化（进行戒烟尝试或减少吸烟）相关的因素。这项横断面研究包括6870名成年吸烟者，他们参加了在澳大利亚、加拿大、英国和美国进行的第三波（2020年）ITC四国吸烟和电子烟调查。这四个国家的政府和公共卫生部门对疫情的反应各不相同，从建议自愿保持社交距离到实施国家和国家以下各级的阶段性封锁。考虑到这些不同的反应，以及确诊病例和死亡人数的差异（英格兰和美国最多，澳大利亚最低），与COVID-19相关的吸烟行为可能在各国之间存在差异。还探索了可能与COVID-19导致的吸烟变化相关的其他因素（例如，社会人口统计学、尼古丁依赖、对吸烟对COVID-19的个人和一般风险的看法）。对加权数据进行回归分析。总体而言，46.7%的吸烟者表示由于COVID-19而考虑戒烟，这一比例因国家而异（p<0.001）：英格兰最高（50.9%），澳大利亚最低（37.6%）。由于COVID-19而考虑戒烟的情况在以下人群中更为常见：女性、少数民族、经济压力较大的人群、目前使用电子烟的人群、依赖性较低的吸烟者（非每日吸烟者和每日吸烟较少的吸烟者）、更担心个人感染易感性的人群以及认为COVID-19对吸烟者更为严重的人群。COVID-19导致的吸烟行为变化为：1.1%尝试戒烟，14.2%减少吸烟，14.6%增加吸烟（70.2%报告无变化）。15.5%的吸烟者报告了积极的行为改变（尝试戒烟/减少吸烟），这在不同国家之间存在差异（p = 0.02），其中澳大利亚的比例明显低于其他三个国家。吸烟者更有可能发生积极的吸烟行为改变：依赖性较低，对个人感染易感性的担忧更大，并认为COVID-19对吸烟者来说更严重。尽管近一半的吸烟者报告说，由于COVID-19，他们考虑戒烟，但绝大多数人并没有改变他们的吸烟行为。如果吸烟者更担心与吸烟有关的COVID-19的易感性和严重性，他们更有可能尝试戒烟或减少吸烟。澳大利亚的吸烟者减少或尝试戒烟的可能性最低，这可能与COVID-19在疫情早期的影响相对于其他国家显著较低有关。
COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries.
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