SHORT REPORT
The double-edged relationship between COVID-19 stress and
smoking: Implications for smoking cessation
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1
The Netherlands Expertise
Centre for Tobacco Control,
Trimbos Institute, Utrecht, The
Netherlands
2
Tobacco Research
and Treatment Center,
Massachusetts General
Hospital, Boston, United
States
3
Department of Health
Promotion, Maastricht
University, Maastricht, The
Netherlands
4
Department of Psychology,
University of Waterloo,
Waterloo, Canada
5
School of Public Health and
Health Systems, University of
Waterloo, Waterloo, Canada
6
Ontario Institute for Cancer
Research, Toronto, Canada
Submission date: 2020-06-27
Final revision date: 2020-07-20
Acceptance date: 2020-07-20
Publication date: 2020-07-27
Corresponding author
Jeroen Bommelé
The Netherlands Expertise
Centre for Tobacco Control,
Trimbos Institute, PO Box 725 - 3500 AS, Utrecht,
The Netherlands
Tob. Induc. Dis. 2020;18(July):63
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Although recent research shows that smokers respond differently to
the COVID-19 pandemic, it offers little explanation of why some have increased
their smoking, while others decreased it. In this study, we examined a possible
explanation for these different responses: pandemic-related stress.
Material and Methods:
We conducted an online survey among a representative sample of Dutch
current smokers from 11–18 May 2020 (n=957). During that period, COVID-19 was six weeks past the (initial) peak of cases and deaths in the Netherlands.
Included in the survey were measures of how the COVID-19 pandemic had
changed their smoking, if at all (no change, increased smoking, decreased
smoking), and a measure of stress due to COVID-19.
Results:
Overall, while 14.1% of smokers reported smoking less due to the COVID-19 pandemic, 18.9% of smokers reported smoking more. A multinomial logistic
regression analysis revealed that there was a dose-response effect of stress:
smokers who were somewhat stressed were more likely to have either increased
(OR=2.37; 95% CI: 1.49–3.78) or reduced (OR=1.80; 95% CI: 1.07–3.05) their
smoking. Severely stressed smokers were even more likely to have either increased
(OR=3.75; 95% CI: 1.84–7.64) or reduced (OR=3.97; 95% CI: 1.70–9.28) their
smoking. Thus, stress was associated with both increased and reduced smoking,
independently from perceived difficulty of quitting and level of motivation to quit.
Conclusions:
Stress related to the COVID-19 pandemic appears to affect smokers
in different ways, some smokers increase their smoking while others decrease it.
While boredom and restrictions in movement might have stimulated smoking, the
threat of contracting COVID-19 and becoming severely ill might have motivated
others to improve their health by quitting smoking. These data highlight the
importance of providing greater resources for cessation services and the
importance of creating public campaigns to enhance cessation in this dramatic
time.
CONFLICTS OF INTEREST
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. J. Bommelé, P. Hopman, B. Hipple Walters, E. Croes and M. Willemsen, report grants from Dutch Ministry of Public Health, Welfare, and Sport, during the conduct of the study.
C. Geboers reports grants from Longfonds, Hartstichting, KWF Kankerbestrijding, Trombosestichting, Diabetesfonds, during the conduct of the study. G.T. Fong reports grants from Ontario Institute for Cancer Research, during the conduct of the study and that he has served as an expert witness on behalf of governments in litigation involving the tobacco industry. A.C.K. Quah reports grants from Canadian Institutes of Health Research, during the conduct of the study.
FUNDING
This work was supported by the Dutch Ministry of Public Health,
Welfare, and Sport. G.T.F. was supported by a Senior Investigator Grant
from the Ontario Institute for Cancer Research. A.C.K.Q. was supported
by the Canadian Institutes of Health Research Foundation Grant (FDN-
148477). The sponsors had no role in the study design, data collection,
interpretation of the data, writing of the article or the decision to
submit it for publication.
AUTHORS' CONTRIBUTIONS
All authors contributed to the design of the study and its conduct.
JB, PH and MW designed the questionnaire. JB analyzed the data
and drafted the first manuscript. All authors actively contributed to
subsequent drafts, and they all read and approved the final manuscript.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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Changes in Tobacco Use in the Early Phase of Coronavirus Disease 2019 Pandemic in Hong Kong: A Qualitative Study
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The Impact of the COVID-19 Pandemic on Smoking Consumption: A Systematic Review of Longitudinal Studies
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Substance Use Among Residents of Homeless Shelters During the COVID-19 Pandemic: Findings From France
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Impact of a Coronavirus Pandemic on Smoking Behavior in University Students: An Online Survey in Türkiye
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COVID-19 Lockdown Effects on Mood, Alcohol Consumption, Academic Functioning, and Perceived Immune Fitness: Data from Young Adults in Germany
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Changes in Cigarette Smoking and Smokeless Tobacco Use During the Coronavirus Disease 2019 Lockdown Period Among Youth and Young Adults in Denmark
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Smoking and smoking addiction in future physicians during the COVID-19 pandemic; an example of a medical school in Turkey
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Assessment of Mediterranean Diet Adherence and Lifestyle Change during COVID-19 National Lockdown in Tunisian Adult Population
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Substance Use and Mental Health during the First COVID-19 Lockdown in Germany: Results of a Cross-Sectional Survey
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Barriers against and Motivations for Quitting Smoking during the COVID-19 Health Crisis: Results of a Qualitative Study in France
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Racial and ethnic differences in distress, discrimination, substance use coping, and nicotine use among parents during COVID-19
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Changes in individuals’ eating habits and mood, sleep quality, and lifestyle during COVID-19
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The Impact of the COVID-19 Pandemic on Stress, Isolation, Smoking Behaviors, and Motivation to Quit in People with HIV Who Smoke
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The Impact of the COVID-19 Pandemic on Smoking, Vaping, and Smoking Cessation Services in the United Kingdom: A Qualitative Study
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The impact of the COVID-19 pandemic on cardiovascular health behaviors and risk factors: A new troubling normal that may be here to stay
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Remote Screening for Alcohol, Smoking, and Substance Involvement by Sex, Age, Lockdown Condition, and Psychological Care-Seeking in the Primary Care Setting during the COVID-19 Pandemic in México
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Accelerating tobacco control at the national level with the Smoke-free Generation movement in the Netherlands
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Associations of changes in smoking-related practices with
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Changes in tobacco and e-cigarette consumption in Spanish
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COVID-19 and Tobacco Cessation: Lessons from India
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