ABSTRACT
BACKGROUND: Existing evidence suggests that while the COVID-19 pandemic triggered quit attempts among many smokers, it led some to smoke more and others to relapse back to smoking. These diverse effects have the potential to have a long-term impact on individuals' smoking and vaping behaviours. This study explored the effect of COVID-19 on smokers and vapers, vape shops and stop smoking services. METHODS: 39 semi-structured interviews were conducted with stop smoking practitioners, tobacco control leads, smokers and/or vapers, and vape shop owners. Interviews were transcribed verbatim and analysed thematically. RESULTS: Four themes were identified: Lockdown as a barrier to becoming/remaining smoke free; COVID as a catalyst for quitting and remaining smoke free; changes in vaping and challenges for vapers and vape shops; and changes and challenges for stop smoking support. Fear of COVID resulting in severe health implications for smokers facilitated behaviour change; however the boredom and monotony of lockdown and associated stress created difficulties in remaining a smoke-free. Results showed that the enforced switch from face-to-face to remote provision of stop smoking services was beneficial for improving engagement, particularly for vulnerable groups such as pregnant women. Stop smoking professionals and vapers disagreed with the forced closure of vape shops because it created unnecessary difficulties for vapers to access supplies. CONCLUSIONS: COVID-19 was both a barrier and facilitator for smoking cessation. Remote provision of stop smoking services implemented due to lockdown was beneficial for hard-to-reach groups; services should look to incorporate these changes into day-to-day practice. IMPLICATIONS: This study is one of the first to explore how the COVID-19 pandemic directly affected smokers, vapers, stop smoking services, tobacco control leads and vape shops. It provides evidence for the continued use of remote provision of smoking cessation services to increase engagement among hard-to-reach groups and provides information on how pandemics can be a catalyst for health behaviour change. This study is unique in that it incorporates the views of different stakeholders.