Perceptions of COVID-Related Risks Among People Who Smoke: A Mediation Model

The COVID-19 pandemic provides both reasons to quit smoking as well as stress that may promote increased cigarette consumption. Perceptions of COVID-19 risk related to smoking may motivate cessation among smokers. At the same time, other evidence shows that affective perceptions (i.e., worry) could lead to increased smoking as a coping mechanism. Using a sample drawn from a rural region of California (N = 295), we examined the relationship between perceptions about health risks for smokers during the pandemic and both reported increases in smoking frequency and intentions to quit smoking. We also examined whether worry about health risks mediated these relationships. High perceived risk was associated both with reported increases in smoking frequency as well as greater intentions to quit smoking. Worry partially mediated both these relationships, with worry accounting for 29.11% of the variance in the relationship between high risk perceptions and increased smoking as well as 20.17% of the relationship between risk perceptions and intentions to quit smoking. These findings suggest that while smokers' awareness about their increased risk of COVID-19 can motivate intent to quit smoking in the future, smokers may require greater support to act on these intentions.

The Role of Risk Perceptions and Affective Consequences in COVID-19 Protective Behaviors.

BACKGROUND: Slowing the spread of the novel coronavirus (COVID-19) requires behavioral changes such as physical distancing (e.g., staying a 6-foot distance from others, avoiding mass gatherings, reducing houseguests), wearing masks, reducing trips to nonessential business establishments, and increasing hand washing. Like other health behaviors, COVID-19 related behaviors may be related to risk representations. Risk representations are the cognitive responses a person holds about illness risk such as, identity (i.e., label/characteristics of risk), cause (i.e., factors causing condition), timeline (i.e., onset/duration of risk), consequences (i.e., intrapersonal/interpersonal outcomes), behavioral efficacy (i.e., if and how the condition can be controlled/treated), and illness risk coherence (i.e., extent to which representations, behaviors, and beliefs are congruent). The current study applies the Common-Sense Model of Self-Regulation (CSM-SR) to evaluate how risk representations may relate to COVID-19 protective and risk behaviors. METHODS: Participants include 400 workers from Amazon's Mechanical Turk aged ≥ 18 years and US residents. Participants completed an online survey measuring risk representations (B-IPQ) and COVID-19 related behaviors, specifically, physical distancing, hand washing, and shopping frequency. RESULTS: Risk coherence, consequences, timeline, emotional representation, and behavioral efficacy were related to risk and protective behaviors. CONCLUSIONS: Risk representations vary in their relationship to COVID-19 risk and protective behaviors. Implications include the importance of coherent, targeted, consistent health communication, and effective health policy in mitigating the spread of COVID-19.

Smokers Are More Likely to Smoke More after the COVID-19 California Lockdown Order.

To determine if cigarette smoking, electronic cigarette use, and rate of consumption of these products differed before and after a pandemic lockdown order, two convenience samples of adults in Central California were recruited and surveyed before (March 2020) and after (May 2020) COVID-19 lockdown orders were implemented in California (n = 2571). Multivariable logistic and negative binomial regression models tested the association between adults recruited pre- or post-California lockdown and past month cigarette use, past month electronic cigarette use, past month cigarette consumption, and past month e-cigarette consumption among current users, controlling for demographic differences. Adults pre- and post-lockdown had equal odds of using cigarettes during the past month. Cigarette users who responded post-lockdown had higher cigarette consumption rates compared to cigarette users who responded pre-lockdown (IRR = 1.13, 95% CI = 1.15, 1.23). Adults who responded post-lockdown had lower odds of using electronic cigarettes during the past month compared to participants surveyed before the order (OR = 0.66, 95% CI: 0.55, 0.78). Cigarette users may be using more cigarettes during the state mandated lockdown. Possible causes for this increase in cigarette use may include increased stress, the change in workplace smokefree protections coverage, and increased opportunities for smoking or vaping.