Article ID: JE20200533
OBJECTIVES: In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency.
METHODS: An online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers, before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates.
RESULTS: We found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men; PR=1.38(1.17-1.62), 65 years old+; PR=2.45(1.92-3.12)) and significantly lower PR of increased smoking (men; PR=0.85(0.78-0.93), 65 years old+; PR=0.38(0.29-0.49)). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home; PR=1.29(1.17-1.41), living alone; PR=1.23(1.10-1.38)) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR=0.15(0.04-0.58)).
CONCLUSIONS: We suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.
