The impact of the COVID-19 pandemic on alcohol and tobacco consumption: Evidence from Peru.

The COVID-19 pandemic has introduced dramatic adversities for public health around the world, especially in low and middle-income countries. While research has shown the pandemic to have direct effects on a variety of major economic and health crises, its impact on health-related behaviors is not clear. In this paper, I examine how exposure to the pandemic affects alcohol use and smoking in Peru, which experienced one of the highest COVID-related death rates albeit implementing one of the strictest lockdown policies in the world. I find that post pandemic consumption of alcohol and smoking in the last 30 days decreases by 41.3% and 44.1% respectively when compared to pre-pandemic rates. I also conclude that the intensity of engaging in these behaviors change such that the frequency of consuming alcohol in the last 30 days, binge drinking and the probability of smoking daily falls. While drinking behavior returns to pre-pandemic levels, the negative effect on smoking weakens but remains for almost two years preceding the pandemic.

Awareness and use of tobacco products among underage individuals: findings from the altria client services underage tobacco use survey 2020-2022.

BACKGROUND: Tobacco use among underage individuals is a public health concern. Timely data about tobacco products, especially emerging products such as novel oral nicotine products (NPs), can provide critical information for the prevention of underage tobacco use. With a recent federal law raising the legal age of purchase of tobacco products from 18 to 21, it is of interest to benchmark awareness and use of tobacco products in the new underage population, young adults 18-20 years old. This study provides estimates on awareness and use of tobacco products among underage individuals 13-20 years old during May 2020 to August 2022 in the United States. METHODS: Altria Client Services Underage Tobacco Use Survey (UTUS) is a repeated cross-sectional survey conducted every quarter-year. A stratified random sampling approach was used to draw nationally representative samples of household dwelling individuals 13-20 years old. Information about the awareness and use of tobacco products was obtained via online self-administration or phone interviews after a consent/assent process. RESULTS: A sizable portion of underage individuals were aware of NPs (~ 40% among youth and ~ 50% among underage young adults), although past 30-day use was low (< 2%). The lowest levels of awareness and use were observed for heated tobacco products and snus. E-cigarettes were the most used tobacco products among underage individuals. Underage young adults (i.e., 18-20 year olds) were more likely to use tobacco products than youth (i.e., 13-17 year olds). There was no substantial change over time in the awareness and use of tobacco products during the study period despite a slight increase in past 30-day prevalence of e-cigarette use among youth between quarter 1 of 2021 and quarter 2 of 2022. CONCLUSIONS: The awareness and use of tobacco products remained relatively stable between May 2020 and August 2022. There is a notable level of awareness of novel NPs among underage individuals.

Current tobacco use and COVID-19 diagnoses in a cohort of adult clients of public dental clinics in Sweden.

Smoking has been linked with both increased and decreased risk of COVID-19, prompting the hypothesis of a protective role of nicotine in the pathogenesis of the disease. Studies of the association between use of smokeless tobacco and COVID-19 would help refining this hypothesis. We analysed data from 424,386 residents in the Stockholm Region, Sweden, with information on smoking and smokeless tobacco (snus) use prior to the pandemic obtained from dental records. Diagnoses of COVID-19 between February and October 2020 were obtained from health-care registers. We estimated the risk of receiving a diagnosis of COVID-19 for current smokers and for current snus users relative to non-users of tobacco, adjusting for potential confounders (aRR). The aRR of COVID -19 was elevated for current snus users (1.09 ;95%CI = 0.99-1.21 among men and 1.15; 95%CI = 1.00-1.33 among women). The risk for women consuming more than 1 can/day was twice as high as among non-users of tobacco. Current smoking was negatively associated with risk of COVID-19 (aRR = 0.68; 95% CI = 0.61-0.75); including hospital admission (aRR = 0.60; 95% CI = 0.47-0.76) and intensive care (aRR = 0.43; 95% CI = 0.21-0.89). The hypothesis of a protective effect of tobacco nicotine on COVID-19 was not supported by the findings. The negative association between smoking and COVID-19 remains unexplained.

Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era.

Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.

Tobacco use and risk of COVID-19 infection in the Finnish general population.

Empirical evidence, primarily based on hospital-based or voluntary samples, suggests that current smokers have a lower risk of COVID-19 infection than never smokers. In this study, we used nationally representative data to examine the association between tobacco use and the risk of having a confirmed COVID-19 case. We explored several forms of tobacco use, contributing to separate the role of nicotine from smoking. We used data from 44,199 participants from three pooled national health surveys in Finland (FinSote 2018-2020). The primary outcome was a confirmed COVID-19 case. We examined current smoking, moist smokeless tobacco (snus), e-cigarettes with and without nicotine and nicotine replacement therapy products. Current daily smokers had a relative risk of 1.12 of a confirmed COVID-19 case (95% CI 0.65; 1.94) in fully adjusted models compared with never smokers. Current snus use was associated with a 68% higher risk of a confirmed COVID-19 case (RR 1.68, 95% CI 1.02; 2.75) than never users. We did not find conclusive evidence of associations between e-cigarettes with and without nicotine and nicotine replacement therapy products and the risk of confirmed COVID-19 cases. Our findings suggest that nicotine might not have a protective role in the risk of COVID-19 as previously hypothesized.

The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: Posttraumatic stress symptoms (PTSSs) and alcohol, tobacco, or nicotine use are frequently associated conditions. The COVID-19 pandemic has been a stressful situation globally and has worsened mental health conditions and addictions in the population. Our systematic review explores the links between PTSSs and (1) alcohol use and (2) tobacco or nicotine use during the COVID-19 pandemic. METHODS: We searched the PubMed, PsycINFO, and Web of Science databases for studies published between January 2020 and 16 December 2021. We included studies published in English concerning adults or adolescents. Included articles dealt simultaneously with the COVID-19 pandemic, PTSSs, and alcohol, tobacco, or nicotine use. The reports included were cross-sectional, longitudinal, or cohort studies. We categorized the reports according to the population explored. Our main outcomes are the impacts of PTSSs on (1) alcohol use and (2) tobacco and nicotine use and their relation to COVID-19-related stressors (worries, exposure, lockdown, and infection, either of self or relatives). RESULTS: Of the 503 reports identified, 44 were assessed for eligibility, and 16 were included in our review, encompassing 34,408 participants. The populations explored were the general population, healthcare workers, war veterans, patients with substance use disorders, and other vulnerable populations. Most studies were online surveys (14) with cross-sectional designs (11). Every study explored alcohol use, while only two assessed tobacco use. In most populations explored, a high level of PTSSs was associated with alcohol use increase. COVID-19-related stress was frequently correlated with either high PTSSs or alcohol use. In healthcare workers, PTSSs and alcohol use were not associated, while COVID-19 worries were related to both PTSSs and alcohol use. DISCUSSION: 1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.

Cambios en los patrones de consumo de alcohol y tabaco antes y durante la pandemia de Covid-19. Ensanut 2018 y 2020.

OBJETIVO: Examinar los cambios en la prevalencia de con-sumo de alcohol y tabaco antes y durante la pandemia de Covid-19 en México. Material y métodos. Se utilizaron datos de las Ensanut 2018 y 2020 para adolescentes y adultos y se obtuvieron prevalencias de consumo actual y excesivo de alcohol y de fumadores actuales y exfumadores. Resul-tados. El consumo de alcohol en mujeres incrementó de 33.5% en 2018 a 42.5% en 2020, mientras que en los hom-bres no hubo cambios significativos. En el mismo periodo, la prevalencia de consumo excesivo de alcohol disminuyó de 11.1 a 5.5% en mujeres y de 36.7 a 18.3% en hombres. La prevalencia de mujeres fumadoras disminuyó de 9.5 a 7.2%. En adolescentes, no se encontraron diferencias significativas en la prevalencia de consumo de alcohol y tabaco. Conclusión. El consumo de alcohol y tabaco continúa siendo elevado en adolescentes y adultos mexicanos. Urge la implementación de las medidas SAFER y MPOWER para abatir sinérgicamente estas epidemias.

Tobacco epidemic in Jordan: the time to act is now.

Tobacco use still represents a major threat to global public health and this calls for extensive efforts to control tobacco products and advocate harm-reduction policies. Recent global trends of prevalence rates in smoking are promising, as trajectories show a decline in all World Health Organization regions. Yet, this decline varies significantly at the national level. Jordan, as a country in the Eastern Mediterranean Region, has been in a long battle against tobacco. Despite that, the country is found to have one of the highest prevalence rates of tobacco use in the region and the world. Many challenges slow down effective and successful anti-tobacco policy implementation in Jordan, most notably cultural influences on smoking and the interference of the tobacco industry in tobacco policy making. Decision makers in Jordan should consider strengthening of anti-tobacco measures to avoid a public health catastrophe if tobacco use keeps rising at the current pace.

Introduction to the Special Issue "Emerging Trends in Combustible Tobacco and Vaping Product Use".

Tobacco use remains a leading cause of preventable death and disease worldwide [...].

Nativity Status and Poly Tobacco Use among Young Adults in the United States.

Introduction: Young adults are the second largest segment of the immigrant population in the United States (US). Given recent trends in later age of initiation of tobacco use, we examined variation in use of tobacco products by nativity status for this population group. Methods: Our study included young adults 18-30 years of age sampled in the National Health Interview Survey (2015-2019), a nationally representative sample of the US population. We calculated prevalence of use of any and two or more tobacco products (cigarettes, cigars, pipes, e-cigarettes, and smokeless tobacco) for foreign-born (n = 3096) and US-born (n = 6811) young adults. Logistic regression models were adjusted for age, sex, race-ethnicity, education, and poverty, while accounting for the complex survey design. Results: Foreign-born young adults were significantly less likely to use any tobacco product (Cigarette = 7.3% vs. 10.7%; Cigar = 1.8% vs. 4.8%; E-cigarette = 2.3% vs. 4.5%, respectively; p < 0.01) or poly tobacco use (1.9% vs. 4.2%; p < 0.01) than US-born young adults. Adjusted regression models showed lower odds of poly tobacco use among the foreign-born than their US-born counterparts (Odds Ratio = 0.41, (95% Confidence Interval: 0.26-0.63)). Conclusions: The findings highlight the importance of targeted interventions by nativity status and further tobacco prevention efforts needed for the US-born.

Self-reported changes in alcohol and tobacco use during COVID-19: findings from the eastern part of WHO European Region.

BACKGROUND: The COVID-19 pandemic might impact substance use behaviours around the globe. In this study, we investigate changes in alcohol and tobacco use in the second half of 2020 in countries of the eastern part of the WHO European Region. METHODS: Self-reported changes in alcohol and tobacco use among 11 295 adults from 18 countries in the eastern part of the WHO European Region were collected between August 2020 and January 2021. The non-probabilistic sample was weighted for age, gender and education. For each country, proportions of respondents reporting a decrease, no change or increase in substance use over the past 3 months were examined, and multinomial regression models were used to test associations with age, gender and past-year alcohol use. RESULTS: In most countries, about half of the respondents indicating past-year alcohol or tobacco use reported no change in their substance use. Of those alcohol users who reported changes in their alcohol use, a larger proportion reported a decrease than an increase in most countries. The opposite was true for tobacco use. Women, young adults and past-year harmful alcohol users were identified as being more likely to change their substance use behaviour. CONCLUSION: We found diverging overall trends for alcohol and tobacco use in the second half of 2020. The patterns of change vary according to age, gender and past-year substance use. Individuals at risk to increase their substance use during the COVID-19 pandemic require most policy considerations.

[Factors associated with tobacco use in patients with asthma during the confinement due to COVID-19 in an urban region with high numbers of SARS-CoV-2 infections]. / Factores asociados al tabaquismo en pacientes con asma durante el confinamiento por COVID-19 en una región urbana con cifras elevadas de infecciones por SARS-CoV-2.

OBJECTIVE: To determine the prevalence and risk factors associated with tobacco use during the period of confinement in light of the COVID-19 pandemic. METHODS: Through an analytical and cross-sectional study, the data of 2, 372 participants were analyzed. The information was collected through a self-administered questionnaire that was built with the Google Forms tool, which was distributed and applied via email and WhatsApp; the private messaging platform. The relationship between the independent variables and the outcome was determined by multivariate logistic regression analysis. RESULTS: Out of the total population, 69.3 % were women, the median age was 20.11±2.01 years, the prevalence of asthma was 12.2 %, and the active tobacco use was 13.3 %. There was a higher number of patients with asthma who smoked (14.2 vs. 13.2 %) than of those who didn't have asthma. The multivariate logistic regression analysis showed that factors like considering that COVID-19 does not exist and not being confined were related to tobacco use in patients with asthma during the implementation of the contingency plan that the COVID-19 pandemic represents. CONCLUSIONS: During confinement to home for COVID-19, the prevalence of tobacco use is higher in patients with asthma than in individuals without this ailment; the factors that favor the aforementioned are present in the family environment.

Objetivo: Determinar la prevalencia y factores de riesgo asociados al tabaquismo durante el periodo de confinamiento ante la pandemia de COVID-19. Métodos: Mediante un estudio analítico y transversal se analizaron los datos de 2372 participantes. La recolección de la información se realizó con un cuestionario autoadministrado construido con la herramienta Google Forms, el cual se distribuyó y aplicó a través de correo electrónico y de la plataforma de mensajería privada WhatsApp. La relación entre las variables independientes y la resultante fue determinada a través de regresión logística multivariada. Resultados: De la población total, 69.3 % fue del sexo femenino, la edad media de 20.11 ± 2.01 años, la prevalencia de asma de 12.2 % y la de tabaquismo activo, de 13.3 %. Una mayor proporción de pacientes con asma fumaba (14.2 versus 13.2 %), en comparación con quienes no padecían asma. La regresión logística multivariante mostró que considerar que COVID-19 no existe y no cumplir con el confinamiento se relacionaron con el tabaquismo en pacientes con asma durante la aplicación del plan de contingencia que representa la pandemia de COVID-19. Conclusiones: Durante el confinamiento en casa por COVID-19, la prevalencia de tabaquismo es mayor en pacientes con asma comparados con los individuos sin esta enfermedad. Los factores que favorecen lo anterior están presentes en el entorno familiar.

Perceived Change in Tobacco Use and Its Associated Factors among Older Adults Residing in Rohingya Refugee Camps during the COVID-19 Pandemic in Bangladesh.

This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06-0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06-1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03-1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period.

Patterns of cigarette, hookah and other tobacco product consumption habits among undergraduate students of the University of Sarajevo before the COVID-19 outbreak in Bosnia and Hercegovina, a cross-sectional study.

Background: Tobacco products represent a major health risk factor and a potent way to help transmission of COVID-19. Current data regarding consumption of these products in the region are scarce. The aim of this study was to evaluate patterns of cigarette, hookah and other tobacco products consumption among undergraduate students from the University of Sarajevo before the COVID-19 outbreak in the country. Methods: This cross-sectional study based on a National Youth Tobacco Survey (NYTS) was conducted among undergraduate students from the University of Sarajevo in Bosnia and Hercegovina via an online questionnaire from 22nd to 26th of January 2020. Results: Out of 605 students involved in the study, most of them were female (N=429, 70.9%); 363 (60.0%) were enrolled in medical sciences; 159 (26.3%) were attending the 3rd year of their curriculum; 224 (37%) were original from Canton Sarajevo and 514 (84.9%) were living in urban environment. Two hundred thirty five students out of 605 (38.8%) were current smokers and 117 (19.3%) hookah smokers. Being female (OR=0.539, 95% CI 0.368-0.790, p=0.002), in the 1st or 2nd year of study (OR=0.805, 95% CI 0.667-0.972, p=0.024) and living in a rural environment (OR=0.335, 95% CI 0.191-0.585, p<0.001) were associated with reduced risk of cigarette consumption, while older age (22+ years) (OR=1.287, 95% CI 1.122-1.476, p<0.001) increased the same risk. On the other side, being female (OR=0.595, 95% CI 0.380-0.930, p=0.023), of younger age (18-21 years) (OR=0.832, 95% CI 0.743-0.932, p=0.001) and medical science student (OR=0.567, 95% CI 0.328-0.978, p=0.041) were associated with decreased risk of consuming hookah. Conclusions: This study provides an insight in prevalence of smoking among students at the University of Sarajevo. More antismoking efforts are needed, especially in urban environments; and a follow-up study, to be planned in the near future, should determine whether COVID-19 pandemic (and all the modifications of lifestyles connected with it) have eventually changed tobacco consumption patterns among undergraduate students.

Factors associated with alcohol and tobacco consumption as a coping strategy to deal with the coronavirus disease (COVID-19) pandemic and lockdown in Spain.

AIM: To provide a population-based characterization of sociodemographic and clinical risk and protective factors associated with consumption of alcohol, tobacco, or both as a coping strategy in a sample of the Spanish general population during the early phase of the COVID-19 pandemic. METHODS: Cross-sectional study based on an online snowball recruiting questionnaire. The survey consisted of an ad hoc questionnaire comprising clinical and sociodemographic information and the Spanish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Impact of Event Scale (IES). RESULTS: The final sample included 21,207 individuals [mean age (SD) = 39.7 (14.0); females: 14,768 (69.6%)]. Up to 2867 (13.5%) of participants reported using alcohol, 2545 (12%) tobacco and 1384 (6.5%) both substances as a strategy to cope with the pandemic. Sex-related factors were associated with alcohol consumption as a coping strategy [female, OR = 0.600, p < 0.001]. However, education level, work status, and income played different roles depending on the substance used to cope. Having a current mental disorder was associated only with tobacco consumption as a coping strategy [OR = 1.391, p < 0.001]. Finally, sex differences were also identified. CONCLUSIONS: Sociodemographic, clinical, and psychological factors were associated with consumption of alcohol, tobacco, or both as a coping method for the COVID-19 pandemic and lockdown. Our findings may help develop specific intervention programs reflecting sex differences, which could minimize negative long-term outcomes of substance use after this pandemic.

The Effects of the Lockdown during the COVID-19 Pandemic on Alcohol and Tobacco Consumption Behavior in Germany.

BACKGROUND: Similar to other countries, the government of Germany has implemented various restrictions of social life in March 2020 to slow the spread of COVID-19 pandemic. This results in millions of people being isolated for long periods, which may increase feelings of worry and anxiety. As the consumption of alcohol and tobacco is an often used dysfunctional strategy to cope with such feelings, these restrictions might cause an increase of consumption. Already at the beginning of the COVID-19 pandemic, the World Health Organization (WHO) warned that increased alcohol consumption during the lockdown can increase the prevalence of alcohol use disorders in the future. However, up to now little is known about the changes in alcohol-drinking behavior and tobacco smoking in the general population during the COVID-19 pandemic. METHODS: To address this theme, we investigated the changes in alcohol and tobacco consumption in the German population aged between 18 and 80 years via an online survey. RESULTS: In total, 3,245 persons participated in the survey; 35.5% of them reported an increase in drinking during the lockdown (42.9% did not change their drinking behavior, 21.3% drank less, and 0.3% started drinking). The odds of consuming more alcohol during lockdown were associated with middle age, higher subjective stress due to the COVID-19 pandemic, a lower agreement with the importance of the restrictions, and consuming alcohol more than once per week before the lockdown. Also, 45.8% of the participants increased their smoking during the lockdown. The odds of smoking more during lockdown were associated with higher subjective stress due to the COVID-19 pandemic. CONCLUSION: These findings suggest that it is important to start campaigns to inform the general population about potential long-term effects of increased alcohol and tobacco consumption and to raise the health-care professionals' awareness of this topic.