Impact of the COVID-19 Pandemic on Changes in Tobacco Use Behavior: A Longitudinal Cohort Study in Japan

Abstract

Background: Use of novel tobacco products, such as heated tobacco products, has recently increased as a result of being promoted less harmful alternatives to cigarettes. The impact of the coronavirus disease 2019 (COVID-19) pandemic on tobacco use may differ depending on the type of tobacco.

Methods: We longitudinally investigated changes in tobacco use over a 1-year period using internet-based and self-reported questionnaires among Japanese aged 15 to 79 years. The study was conducted from 2019 to 2021, with participants before the COVID-19 pandemic in February 2020 as the pre-pandemic group and participants after that as the pandemic group. Accounting for population bias, we used sampling probability weighting referring to the nationwide data. The association between cessation and the COVID-19 pandemic was evaluated separately for each type of tobacco using logistic regression analysis.

Results: After conducting sampling probability weighting, 1,920 were in the pre-pandemic group and 2,681 were in the pandemic group. More participants in the pandemic group than in the pre-pandemic group achieved cessation after 1 year (13.8% vs 10.2%, P < 0.001). Dual users were more likely to quit during the pandemic than pre-pandemic (adjusted odds ratio [aOR] 2.56, P < 0.001), whereas exclusive novel tobacco users were less likely to quit during the pandemic (aOR 0.66, P = 0.041). Tobacco cessation was more frequently achieved among those who had intended to quit at baseline survey among conventional tobacco users (aOR 1.77, P < 0.001) and dual users (aOR 2.52, P < 0.001); however, this trend was not observed among novel tobacco users (aOR 1.49, P = 0.090).

Conclusion: Conventional and novel tobacco use patterns varied in response to the COVID-19 pandemic.