• NAQC pre-NCTOH Workshops! Register Today!

• Register for NEW season of TOPS!
• May 24 Webinar -  ChangeLab FrameWorks Institute. 
• May 26 Webinar: The Great State Update: Effective Partnerships to Treat Tobacco Addiction in Behavioral Health Settings.
• June 14 Webcast - Upcoming American Lung Association Webcast: When Quitting Adds Up: Tobacco Cessation and Quality Measures.
• SelfMade Health Network (SMHN) Webinar Series.
• New! Coordinator Camp Ancillary NCTOH Meeting on June 27.

• Deadline of July 5: Public Commenting Period Open on FDA Proposed Menthol Ban.
• SCLC Has FREE CMEs Just For You!
• New SCLC National Toolkit AVAILABLE NOW!
• APNA Offers Free Online Training Sessions for Treating Tobacco Use.
• Vape Shops Respond to Tightening E-cigarette Regulations with more Online Marketing and Expansion to CBD Products.

Quitlines

Fahey MC, Talcott WG, Robinson LA, Mallawaarachchi I, Klesges RC, Little MA.
Predictors of Cessation Outcomes among Older Adult Smokers Enrolled in a Proactive Tobacco Quitline Intervention.
[published online ahead of print, 2022 May 4]. J Aging Health. 2022;8982643221097679. doi:10.1177/08982643221097679

Objectives. To identify predictors of older adults' likelihood of quitting following engagement in a proactive tobacco quit line.
Methods. Older (>60 years) participants (N = 186) enrolled in a four-session quit line with 8-weeks of nicotine replacement therapy reported demographics, beliefs, and information about tobacco use. Point prevalence abstinence was reported at 3 and 12-months.
Results. In final models, endorsement of quitting to take control of one's life and confidence in quitting were positively associated with 3-month cessation (OR = 1.74, 95% CI = 1.16, 2.62; OR = 1.75, 95% CI = 1.21, 2.52, respectively). At 12 months, stronger endorsement of quitting to take control of one's life and decreased nicotine dependence were associated with higher cessation (OR = 1.51, 95% CI = 1.05, 2.17; OR = 0.84, 95% CI = 0.71,0.99, respectively).
Discussion. For tobacco cessation among older adults, programs should provide additional support to those with higher nicotine dependence, promote quitting self-efficacy, and encourage quitting as means to gain control of life and health.

Goodwin RD, Shevorykin A, Carl E, et al.
Daily Cannabis Use is a Barrier to Tobacco Cessation among Tobacco Quitline Callers at 7-month Follow-up.
[published online ahead of print, 2022 Apr 13]. Nicotine Tob Res. 2022;ntac096. doi:10.1093/ntr/ntac096

Introduction. Cannabis use is increasing among cigarette smokers in the United States (US). Prior studies suggest that cannabis use may be a barrier to smoking cessation. Yet, the extent to which this is the case among adults seeking to quit tobacco use remains unclear. Tobacco quitlines are the most common provider of no-cost treatment for adults who use smoke in the US. This study investigated the association of cannabis use with smoking cessation outcomes among Quitline callers.
Methods. Participants included callers to the New York State Smokers' Quitline, who were seeking to quit smoking cigarettes and were contacted for outcome assessment 7 months after intake. Thirty-day point prevalence abstinence rates were calculated and compared among cannabis use groups, based on frequency of past-30-day cannabis use at baseline (none: 0 days, occasional: 1-9 days, regular: 10-19 days and daily: 20-30 days.
Results. Approximately 8.3% (n=283) of participants (n=3,396) reported past-30-day cannabis use at baseline. Callers with daily cannabis use (20-30 days per month) had significantly lower odds of 30-day abstinence, relative to those who did not use cannabis (odds ratio=0.5; 95% confidence interval (0.3, 0.9)).
Conclusions. Daily cannabis use appears to be associated with poorer smoking cessation treatment outcomes among adults seeking to quit smoking cigarettes via a quitline. Because quitlines are among the most accessible, affordable and frequently utilized community-based treatments available in the US, and prevalence of cannabis use is increasing among cigarette smokers, detailed inquiry into cannabis use might enhance knowledge about its impact on smoking cessation.

Shi L, Mayorga M, Su D, Li Y, Martin E, Zhang D.
Generation 1.5: Years in the United States and Other Factors Affecting Smoking Behaviors among Asian Americans.
Ethn Dis. 2022;32(2):75-80. Published 2022 Apr 21. doi:10.18865/ed.32.2.75

Introduction. Generation 1.5, immigrants who moved to a different country before adulthood, are hypothesized to have unique cognitive and behavioral patterns. We examined the possible differences in cigarette smoking between Asian subpopulations who arrived in the United States at different life stages.
Methods. Using the Asian subsample of the 2015 Tobacco Use Supplement to the Current Population Survey, we tested this Generation 1.5 hypothesis with their smoking behavior. This dataset was chosen because its large sample size allowed for a national-level analysis of the Asian subsamples by sex, while other national datasets might not have adequate sample sizes for analysis of these subpopulations. The outcome variable was defined as whether the survey respondent had ever smoked 100 cigarettes or more, with the key independent variable operationalized as whether the respondent was: 1) born in the United States; 2) entered the United States before 12; 3) entered between 12 and 19; and 4) entered after 19. Logistic regressions were run to examine the associations with covariates including the respondent's age, educational attainment, and household income.
Results. Asian men who entered before 12 were less likely to have ever smoked 100 cigarettes than those who immigrated after 19; for Asian women, three groups (born in the United States, entered before 12, entered between 12 and 19) were more likely to have smoked 100 cigarettes than those who immigrated after 19.
Conclusions. While Asian men who came to the United States before 12 were less at risk for cigarette smoking than those who immigrated in adulthood, the pattern was the opposite among Asian women. Those who spent their childhood in the United States were more likely to smoke than those who came to the United States in adulthood. These patterns might result from the cultural differences between US and Asian countries, and bear policy relevance for the tobacco control efforts among Asian Americans.

Wang Y, Duan Z, Emery SL, et al.
Intentions and Attempts to Quit Smoking among Sexual Minoritized Adult Smokers After Exposure to the Tips From Former Smokers Campaign.
JAMA Netw Open. 2022;5(5):e2211060. Published 2022 May 2. doi:10.1001/jamanetworkopen.2022.11060

Importance. Significant disparities exist in smoking behaviors by sexual minority status in the US.
Objective. To examine potential differences in the associations between exposure to the Tips From Former Smokers (Tips) campaign and intentions and attempts to quit smoking by sexual minority status.
Design, setting, and participants. This cross-sectional study used data from the wave 5 survey of the Population Assessment of Tobacco and Health study. Data from 8072 adults who were currently established cigarette smokers were collected from December 2018 to November 2019 and analyzed in August 2021. The Population Assessment of Tobacco and Health study is an ongoing cohort study representative of the noninstitutionalized US population. Sample weights were applied to account for the complex sampling strategies.
Exposures. Dichotomized self-reported frequent Tips exposure (often and very often) and infrequent exposure (never, rarely, and sometimes).
Main outcomes and measures. Outcomes were intention to quit within 12 months, any serious quit attempts in the past 12 months, and number of serious quit attempts in the past 12 months. Multivariate logistic and ordinal logistic regressions were used to estimate the weighted associations between exposure and each outcome. Interactions between Tips exposure and sexual minority status were examined to explore potential differences.
Results. A total of 8072 participants (mean [SD] age, 44.7 [14.8] years; 3888 [53.2%] male; 4962 [67.4%] non-Hispanic White; and 915 [9.5%] sexual minoritized individuals [ie, those who identified as lesbian, gay, bisexual, or another minoritized sexual identity]) were included. Frequent Tips exposure was associated with higher odds of quit intentions and attempts overall (adjusted odds ratio [aOR], 1.25; 95% CI, 1.07-1.46 for intention to quit within 12 months; aOR, 1.26; 95% CI, 1.08-1.47 for serious quit attempts in the past 12 months; and aOR, 1.24; 95% CI, 1.06-1.44 for number of serious quit attempts in the past 12 months). These associations were significantly stronger for heterosexual smokers than sexual minoritized smokers, as indicated by the significant interaction terms (aOR, 0.58; 95% CI, 0.36-0.96 for intention to quit within 12 months; aOR, 0.41; 95% CI, 0.24-0.70 for serious quit attempts in the past 12 months; and aOR, 0.40; 95% CI, 0.24-0.67 for number of serious quit attempts in the past 12 months). Subgroup analysis showed that heterosexual smokers who reported frequent Tips exposure were more likely to intend to quit within 12 months (aOR, 1.29; 95% CI, 1.10-1.53), have had any serious quit attempts in the past 12 months (aOR, 1.34; 95% CI, 1.13-1.58), and have had more serious quit attempts (aOR, 1.32; 95% CI, 1.12-1.54) than heterosexual smokers who reported infrequent exposure. In contrast, there was no association for sexual minoritized smokers (aOR, 0.82; 95% CI, 0.52-1.30 for intention to quit within 12 months; aOR, 0.65; 95% CI, 0.39-1.07 for serious quit attempts in the past 12 months; and aOR, 0.62; 95% CI, 0.38-1.00 for number of serious quit attempts in the past 12 months).
Conclusions and relevance. These findings suggest that significant differences exist in the associations between Tips exposure and quit intentions or attempts by sexual minority status. More targeted campaign content for sexual minoritized smokers may be needed to increase quit intentions and attempts among this group.

Lin SC, Gathua N, Thompson C, Sripipatana A, Makaroff L.
Disparities in Smoking Prevalence and Associations with Mental Health and Substance Use Disorders in Underserved Communities Across the United States.
Cancer. 2022;128(9):1826-1831. doi:10.1002/cncr.34132

Background. Smoking contributes to the top 3 deadliest cancers, cancers of the lung, colon, and pancreas, which account for nearly 40% of all cancer-related deaths in the United States. Despite historicly low smoking rates, substantial disparities remain among people with mental health conditions and substance use disorders (SUDs).
Methods. The study examined the prevalence of smoking among adults from underserved communities who are served at federally qualified health centers through an analysis of the 2014 Health Center Patient Survey. Furthermore, the study assessed associations of smoking with co-occurring mental health conditions and SUDs among adult smokers (n = 1735).
Results. The prevalence of smoking among health center patients was 28.1%. Among current smokers, 59.1% had depression and 45.4% had generalized anxiety. Non-Hispanic Black smokers had more than 2 times the odds of reporting SUDs (adjusted odds ratio [aOR], 2.13; 95% confidence interval [CI], 1.06-4.30). Individuals at or below 100% of the federal poverty level had more than 2 times the odds of having mental health conditions (aOR, 2.55; 95% CI, 1.58-4.11), and those who were unemployed had more than 3 times the odds for SUDs (aOR, 3.21; 95% CI, 1.27-8.10).
Conclusions. The prevalence of smoking in underserved communities is nearly double the national prevalence. In addition, the study underscores important socioeconomic determinants of health in smoking cessation behavior and the marked disparities among individuals with mental health conditions and SUDs. Finally, the findings illuminate the unique need for tailored treatments supporting cancer prevention care to address challenges confronted by vulnerable populations.

Han B, Volkow ND, Blanco C, Tipperman D, Einstein EB, Compton WM.
Trends in Prevalence of Cigarette Smoking among US Adults with Major Depression or Substance Use Disorders, 2006-2019.
JAMA. 2022;327(16):1566-1576. doi:10.1001/jama.2022.4790

Importance. Tobacco use is highly concentrated in persons with mental illness.
Objectives. To assess trends in past-month prevalence of cigarette smoking among adults with vs without past-year depression, substance use disorders (SUDs), or both, using nationally representative data.
Design, setting, and participants. Exploratory, serial, cross-sectional study based on data from 558 960 individuals aged 18 years or older who participated in the 2006-2019 US National Surveys on Drug Use and Health.
Exposure. Past-year major depressive episode (MDE) and SUD using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria.
Main outcomes and measures. Past-month self-reported cigarette use, adjusted for sociodemographic characteristics.
Results. Of the sampled 558 960 adults, 41.4% (unweighted) were aged 18 to 25 years, 29.8% (unweighted) were aged 26 to 49 years, and 53.4% (unweighted) were women. From 2006 to 2019, the past-month self-reported cigarette smoking prevalence declined significantly among adults with MDE from 37.3% to 24.2% for an average annual percent change of -3.2 (95% CI, -3.5 to -2.8; P < .001), adults with SUD from 46.5% to 35.8% for an average annual percent change of -1.7 (95% CI, -2.8 to -0.6; P = .002), and adults with co-occurring MDE and SUD from 50.7% to 37.0% for an annual average annual percent change of -2.1 (95% CI, -3.1 to -1.2; P < .001). The prevalence declined significantly for each examined age, sex, and racial and ethnic subgroup with MDE and with SUD (all P < .05), except for no significant changes in American Indian or Alaska Native adults with MDE (P = .98) or with SUD (P = .46). Differences in prevalence of cigarette smoking between adults with vs without MDE declined significantly for adults overall from 11.5% to 6.6%, for an average annual percent change of -3.4 (95% CI, -4.1 to -2.7; P < .001); significant average annual percent change declines were also seen for men (-5.1 [95% CI, -7.2 to -2.9]; P < .001); for women (-2.7 [95% CI, -3.9 to -1.5]; P < .001); for those aged 18 through 25 years (-5.2 [95% CI, -7.6 to -2.8]; P < .001); for those aged 50 years or older (-4.7 [95% CI, -8.0 to -1.2]; P = .01); for Hispanic individuals (-4.4 [95% CI, -8.0 to -0.5]; P = .03), and for White individuals (-3.6 [95% CI, -4.5 to -2.7]; P < .001). For American Indian or Alaska Native adults, prevalence did not significantly differ between those with vs without MDE during 2006-2012 but was significantly higher for those with MDE during 2013-2019 (difference, 11.3%; 95% CI, 0.9 to 21.7; P = .04). Differences among those with vs without SUD declined for women for an average annual percent change of -1.8 (95% CI, -2.8 to -0.9; P = .001).
Conclusions and relevance. In this exploratory, serial, cross-sectional study, there were significant reductions in the prevalence of self-reported cigarette smoking among US adults with major depressive episode, substance use disorder, or both, between 2006 and 2019. However, continued efforts are needed to reduce the prevalence further.

Patten CA, Hiratsuka VY, Nash SH, et al.
Smoking Patterns among Urban Alaska Native and American Indian Adults: The Alaska EARTH 10-year Follow-up Study.
Nicotine Tob Res. 2022;24(6):840-846. doi:10.1093/ntr/ntab245

Introduction. Data on cigarette smoking prevalence among Alaska Native and American Indian (ANAI) people are limited to cross-sectional studies or specific subpopulations. Using data from the Alaska Education and Research toward Health (EARTH) Study 10-year follow-up, this study assessed patterns of smoking from baseline and factors associated with current use.
Aims and methods. EARTH Study urban south central ANAI participants (N = 376; 73% women) provided questionnaire data on smoking at baseline and 10-year follow-up. Multivariable-adjusted logistic regression assessed whether gender, cultural factors (Tribal identity, language spoken in the home), depressive symptoms (PHQ-9), baseline smoking status, and baseline cigarettes per day (CPD) were associated with current smoking at follow-up.
Results. Current smoking was 27% and 23% at baseline and follow-up, respectively. Of baseline smokers, 60% reported smoking at follow-up (77% men, 52% women). From multivariable-adjusted analyses, the odds of current smoking at follow-up were lower among women than men, those who never or formerly smoked versus currently smoked at baseline, and smoking <10 CPD compared with ≥10 CPD at baseline. PHQ-9 score or cultural variables were not associated with smoking at follow-up. Smoking fewer baseline CPD was associated with former smoking status (ie, quitting) at follow-up among women, but not men.
Conclusions. Our project is among the first to longitudinally explore smoking within an ANAI cohort. While we observed persistent smoking during a 10-year period, there were important differences by gender and CPD in quitting. These differences may be important to enhance the reach and efficacy of cessation interventions for ANAI people.
Implications. This study contributes novel longitudinal information on cigarette smoking prevalence during a 10-year period among Alaska Native and American Indian (ANAI) people. Prior data on smoking prevalence among ANAI people are limited to cross-sectional studies or specific subpopulations. Our project is among the first to longitudinally explore smoking prevalence within an ANAI cohort. We observed persistent smoking during a 10-year period. The study also contributes information on differences by gender and cigarettes smoked per day in quitting. These findings have implications for enhancing the reach and efficacy of cessation interventions for ANAI people.

Bedi MK, Bedi DK, Ledgerwood DM.
Gender Differences in Reasons for Using E-cigarettes: A Systematic Review.
[published online ahead of print, 2022 Apr 19]. Nicotine Tob Res. 2022;ntac108. doi:10.1093/ntr/ntac108

Introduction. Differential reasons for e-cigarette use for men and women have seldom been examined, and there is no systematic overview of this research literature. The aim for this review is to conduct a systematic review of the literature to identify gender differences in the reasons for e-cigarette use.
Methods. Systematic searches covered in three databases found 866 unique articles: Web of Science, Pubmed and PsycInfo. Twenty six studies met the inclusion criteria and were reviewed. Reasons for e-cigarette use were sorted into 17 distinct categories.
Results and conclusions. Fifteen studies identified statistically significant differences in reasons between men and women. Frequently assessed reasons for e-cigarette use across studies included Health/Smoking Cessation, Experimentation/Curiosity, Enjoyment/Pleasure, Use in Specific Locations, Acceptable to Others, and Cost. Of those that identified statistically significant differences in reasons between men and women, the findings varied considerably, and some reasons for e-cigarette use were found to be significant in only one or two studies. Most of the reasons identified were only measured in a small number of studies, complicating our ability to make intervention recommendations based on gender. Additionally, we limited our literature search to peer-reviewed studies. Of the reason categories that did find significant differences between gender, such as reasons related to Health/Smoking Cessation, the outcomes were not consistent across studies. Future studies are needed to identify potentially important differences in the reasons for e-cigarette use among men and women.
Implication. This systematic review aims to uncover gender differences in e-cigarette use to understand important differences in motivation for use that may help us better understand strategies for prevention and treatment of tobacco use disorder. This review is the first on this topic and could provide further insight on patterns of e-cigarette use across gender.

Boynton MH, Sanzo N, Brothers W, et al.
Perceived Effectiveness of Objective Elements of Vaping Prevention Messages among Adolescents.
Tobacco Control Published Online First: 09 May 2022. doi: 10.1136/tobaccocontrol-2021-057151
 
Introduction. In recent years, vaping prevention campaigns have proliferated in response to a surge of e-cigarette use among adolescents in the USA. To date, the research literature has provided minimal guidance as to what vaping prevention message elements have the greatest potential for discouraging vaping, are ineffective or have unintended negative effects. The purpose of the current study was to identify and test a large set of vaping prevention ads used by federal, state, local and non-governmental agencies, examining how objectively coded message elements of vaping prevention messages might affect youth.
Methods. A convenience sample of adolescents (N=1501) completed an online survey with each participant rating seven randomly selected vaping prevention ads from a pool of 220 ads on perceived message effectiveness (PME) and vaping appeal. Ads were coded on 37 objective elements in three message categories: themes, imagery and other features. Analyses examined how objective elements predicted PME.
Results. Addiction, chemicals, negative health symptoms and effects, and cigarette comparison themes were associated with higher PME, as were graphic images and warning symbols. Industry targeting, environmental impact, flavour themes, images of food and people’s faces were associated with lower PME, as were hashtags, statistics and first-person language or the word ‘teen’. Most elements were not associated with appeal, but ads with a flavour theme were associated with increased vaping appeal.
Conclusion. Promising vaping prevention messages focus on the adverse consequences of vaping, use negative imagery and avoid speaking for teens using their vernacular or perspective.

Technology

Chalela P, McAlister AL, Akopian D, et al.
Facebook Chat Application to Prompt and Assist Smoking Cessation among Spanish-speaking Young Adults in South Texas.
Health Promot Pract. 2022;23(3):378-381. doi:10.1177/15248399211026263

Given how smart phones, internet services, and social media have shown great potential for assisting smoking cessation, we constructed a Facebook chat application based on our previous work with SMS texting services. This report summarizes findings from 2,364 Spanish-speaking young adults recruited through Facebook advertising in South Texas during the 2020 New Year holiday season. Among these service users, 926 (39%) were ready to make a quit attempt, and 26 (3.1%) of those users reported that they were tobacco free 1 month later. There were no responses to a chat question survey 72 days after the dates selected for quitting. Although more research with longer follow up is needed, these findings show that social media chat applications may be helpful for at least prompting quit attempts and short-term cessation among young adult Spanish-speaking smokers. There is no evidence of an impact on long-term cessation, and more research is clearly needed.

Tobacco Use

Zavala-Arciniega L, Hirschtick JL, Meza R, Fleischer NL.
Flavoring Patterns of Exclusive and Dual-use of Cigarettes and E-cigarettes among US Adults: Results from the TUS-CPS 2018-2019.
[published online ahead of print, 2022 May 2]. Am J Health Promot. 2022;8901171221097682. doi:10.1177/08901171221097682

Purpose. To describe patterns of menthol/non-menthol cigarettes with flavored e-cigarettes (tobacco, menthol, sweet/spicy, and other flavorings) use.
Design. We used cross-sectional data from the 2018-2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS).
Setting. United States.
Subjects. Adults over 18 years old.
Sample. A nationally representative sample (n = 135 329).
Measures. We generated a 15-category variable of all combinations of cigarette and e-cigarette flavoring use.
Analysis. We estimated population prevalence (PP) for the 15-category flavored cigarette and e-cigarette use variable and proportion of flavored cigarette and e-cigarette use among adults who used cigarettes or e-cigarettes (PAU) by age, sex, race/ethnicity, and income.
Results. Exclusive menthol cigarette use was higher among NH Black (PP = 8.79%, PAU = 68.96%) and low-income (PP = 4.86%, PAU = 29.09%) compared to NH White (PP = 2.63%, PAU = 18.83%) and high-income participants (PP = 1.25%, PAU = 19.02%). Exclusive sweet/spicy e-cigarette use (PP = 1.32%, PAU = 10.22%) and exclusive menthol e-cigarette use (PP = .95%, PAU = 7.40%) was higher in younger (18-34) vs older (35+) adults (PP = .34% and PAU = 2.76%, and PP = .14%, PAU = 1.11%, respectively). Older dual users tended to combine the same flavor in both products (eg, menthol cigarettes + menthol e-cigarettes), while younger adults were more likely to combine menthol and non-menthol cigarettes with sweet/spicy e-cigarettes.
Conclusion. Findings suggest that a menthol cigarette ban might be most effective in conjunction with sweet/spicy e-cigarette flavor restrictions, given these flavors are attractive for younger adults.

Le TTT, Jaffri MA.
The Association Between Smoking Behaviors and Prices and Taxes per Cigarette Pack in the United States from 2000 Through 2019.
BMC Public Health. 2022;22(1):856. Published 2022 Apr 28. doi:10.1186/s12889-022-13242-5

Objective. The conclusions on how tax and price increases affect smoking behaviors are mixed. This work is devoted to re-evaluating the relationship between cigarette prices and taxes and smoking behaviors.
Methods. Using 2000-2019 Behavioral Risk Factor Surveillance System data, we employed linear mixed-effect models to re-examine the impact of cigarette prices and taxes on smoking prevalence and the proportion of current smokers having tried to quit smoking in the past 12 months. All the analyses were conducted for the general population, then by age group, gender, race/ethnicity, and income level.
Results. The results indicate that higher cigarette prices and taxes were associated with a decrease in smoking prevalence and an increased likelihood of quitting smoking. Cigarette tax and price increases produced the most powerful impact on the smoking prevalence of 18- to 24-year-olds. The estimates also show that males tended to be more price-sensitive than females. Raising cigarette prices and taxes was estimated to be more effective in reducing the smoking prevalence among non-Hispanic Blacks and Hispanics when compared to non-Hispanic whites. Cigarette price and tax changes were likely to have a smaller effect on individuals with annual income under $25,000 relative to individuals with higher income levels.
Conclusions. Increases in cigarette prices and taxes are significantly associated with a reduction in smoking prevalence and an increased likelihood of quitting smoking among adults across different demographic and socioeconomic groups. However, as cigarette price and tax changes disproportionately affect low-income individuals, raising cigarette prices and taxes may deepen income disparities.

COVID-19

Gaggero A.
The Consequences of the COVID-19 Pandemic on Smoking Behaviour: Evidence from the English Longitudinal Study of Ageing.
[published online ahead of print, 2022 Apr 13]. Nicotine Tob Res. 2022;ntac097. doi:10.1093/ntr/ntac097

Introduction. Smoking is a risk factor for progression of COVID-19, with smokers having higher odds of COVID-19 progression than never-smokers. This study presents novel findings on the effect of the COVID-19 pandemic on smoking behaviour in older adults.
Methods. Panel data were obtained from the English Longitudinal Study of Ageing (N= 60160, 12% smokers, 55% women, 62% married, mean age = 67 years, 23% employed). Fixed effect regression models were used to estimate the extent to which the COVID-19 pandemic affected smoking behaviour. A separate model was estimated for men, women, employed, and retired.
Results. The findings suggest a significant and positive effect of the COVID-19 pandemic on smoking behaviour (β= 0.024; p<0.001). The estimated effects were stronger for men and for the sample of individuals reporting being employed.
Conclusions. In this study, I provide robust evidence of the effect of the COVID-19 pandemic on smoking behaviour using the English Longitudinal Study of Ageing. This large and representative dataset is uniquely suited for the analysis. I find evidence that the proportion of smokers has increased significantly as a result of the COVID-19 pandemic.
Implications. In the UK, the proportion of smokers increased significantly as a consequence of the COVID-19 pandemic. These findings suggest that smoking behaviour may have been used as a mechanism to cope with depression, stress, and anxiety due to the COVID-19 outbreak. To the extent to which smoking behaviour has been used as a coping mechanism to deal with job-related issues, targeted policy action to provide financial stability to those in worse economic situations may be have beneficial effects on smoking behaviour.

Grummon AH, Hall MG, Mitchell CG, et al.
Reactions to Messages About Smoking, Vaping and COVID-19: Two National Experiments.
Tob Control. 2022;31(3):402-410. doi:10.1136/tobaccocontrol-2020-055956

Introduction. The pace and scale of the COVID-19 pandemic, coupled with ongoing efforts by health agencies to communicate harms, have created a pressing need for data to inform messaging about smoking, vaping, and COVID-19. We examined reactions to COVID-19 and traditional health harms messages discouraging smoking and vaping.
Methods. Participants were a national convenience sample of 810 US adults recruited online in May 2020. All participated in a smoking message experiment and a vaping message experiment, presented in a random order. In each experiment, participants viewed one message formatted as a Twitter post. The experiments adopted a 3 (traditional health harms of smoking or vaping: three harms, one harm, absent) × 2 (COVID-19 harms: one harm, absent) between-subjects design. Outcomes included perceived message effectiveness (primary) and constructs from the Tobacco Warnings Model (secondary: attention, negative affect, cognitive elaboration, social interactions).
Results. Smoking messages with traditional or COVID-19 harms elicited higher perceived effectiveness for discouraging smoking than control messages without these harms (all p <0.001). However, including both traditional and COVID-19 harms in smoking messages had no benefit beyond including either alone. Smoking messages affected Tobacco Warnings Model constructs and did not elicit more reactance than control messages. Smoking messages also elicited higher perceived effectiveness for discouraging vaping. Including traditional harms in messages about vaping elicited higher perceived effectiveness for discouraging vaping (p <0.05), but including COVID-19 harms did not.
Conclusions. Messages linking smoking with COVID-19 may hold promise for discouraging smoking and may have the added benefit of also discouraging vaping.