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Asare S. Association of cigarette smoking with changes in macroeconomic conditions. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101397. [PMID: 38703460 DOI: 10.1016/j.ehb.2024.101397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
This study uses data from the 1987-2022 Behavioral Risk Factor Surveillance System and state-level employment rates from the US Bureau of Labor Statistics to estimate the association between macroeconomic conditions and cigarette smoking. Our finding suggests a positive association, which constantly declined with time after the 2001 recession. We find that a one percentage point increase in the employment rate is associated with a 1.4% higher likelihood of smoking cigarettes in the overall sample but declined to 0.4% among cohorts surveyed from 2011 to 2022. We also find strong positive and heterogeneous associations among sociodemographic groups, except among Blacks and persons aged 65 years and older, among whom there is no association; however, the positive associations consistently decreased among these sociodemographic groups. Consequently, the strong positive association disappeared in several sociodemographic groups in cohorts surveyed over the last decade.
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Affiliation(s)
- Samuel Asare
- Tobacco Control Research, Surveillance and Health Equity Science, American Cancer Society, United States of America.
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Rothenberg WA, Skinner AT, Lansford JE, Bacchini D, Bornstein MH, Chang L, Deater-Deckard K, Giunta LD, Dodge KA, Gurdal S, Junla D, Liu Q, Long Q, Oburu P, Pastorelli C, Sorbring E, Steinberg L, Tirado LMU, Yotanyamaneewong S, Alampay LP, Al-Hassan SM. How adolescents' lives were disrupted over the course of the COVID-19 pandemic: A longitudinal investigation in 12 cultural groups in 9 nations from March 2020 to July 2022. Dev Psychopathol 2024:1-17. [PMID: 38273765 PMCID: PMC11272905 DOI: 10.1017/s0954579423001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
It is unclear how much adolescents' lives were disrupted throughout the COVID-19 pandemic or what risk factors predicted such disruption. To answer these questions, 1,080 adolescents in 9 nations were surveyed 5 times from March 2020 to July 2022. Rates of adolescent COVID-19 life disruption were stable and high. Adolescents who, compared to their peers, lived in nations with higher national COVID-19 death rates, lived in nations with less stringent COVID-19 mitigation strategies, had less confidence in their government's response to COVID-19, complied at higher rates with COVID-19 control measures, experienced the death of someone they knew due to COVID-19, or experienced more internalizing, externalizing, and smoking problems reported more life disruption due to COVID-19 during part or all of the pandemic. Additionally, when, compared to their typical levels of functioning, adolescents experienced spikes in national death rates, experienced less stringent COVID-19 mitigation measures, experienced less confidence in government response to the COVID-19 pandemic, complied at higher rates with COVID-19 control measures, experienced more internalizing problems, or smoked more at various periods during the pandemic, they also experienced more COVID-19 life disruption. Collectively, these findings provide new insights that policymakers can use to prevent the disruption of adolescents' lives in future pandemics.
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Affiliation(s)
- W. Andrew Rothenberg
- Duke University, Durham, NC, USA
- University of Miami Miller, School of Medicine, Miami, FL, USA
| | | | | | | | - Marc H. Bornstein
- NICHD, Bethesda, MD, USA
- UNICEF, New York, NY, USA
- Institute for Fiscal Studies, London, UK
| | | | - Kirby Deater-Deckard
- University of Massachusetts Amherst, Amherst, MA, USA
- Helsinki Collegium for Advanced Studies, Helsinki, Finland
| | | | | | | | | | - Qin Liu
- Chongqing Medical University, Chongqing, China
| | - Qian Long
- Duke Kunshan University, Kunshan, China
| | | | | | | | - Laurence Steinberg
- Temple University, Philadelphia, PA, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | | | - Suha M. Al-Hassan
- Abu Dhabi Early Childhood Authority, Abu Dhabi, United Arab Emirates
- Hashemite University, Zarqa, Jordan
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Gaffney A, Himmelstein DU, Woolhandler S. Population-level trends in asthma and chronic obstructive pulmonary disease emergency department visits and hospitalizations before and during the coronavirus disease 2019 pandemic in the United States. Ann Allergy Asthma Immunol 2023; 131:737-744.e8. [PMID: 37619778 DOI: 10.1016/j.anai.2023.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Previous studies have identified reductions in exacerbations of chronic lung disease in many locales after onset of the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE To evaluate the population-level impacts of COVID-19 on asthma and chronic obstructive pulmonary disease (COPD) exacerbations-with a focus on disadvantaged communities-in the United States. METHODS We analyzed 2016 to 2020 county-level data on asthma and COPD acute care use, with myocardial infarction hospitalizations as a comparator condition. We linked this with county-level lower respiratory disease mortality data. We calculated rates of emergency department (ED) visits, hospitalizations, and deaths and evaluated changes using linear regressions adjusted for year and county-fixed effects. For a supplementary analysis, we calculated ED visit rates nationwide for asthma, COPD, or any diagnosis using the 2016 to 2020 National Hospital Ambulatory Medical Care Survey. RESULTS Our county-level data included 685 counties in 13 states. Rates of each outcome fell in 2020. In adjusted analyses, we found large reductions in asthma and COPD ED visit rates (eg, a 21.5 per 10,000-person reduction in COPD ED visits; 95% confidence interval, -23.8 to -19.1), with smaller reductions in hospitalizations and chronic lower respiratory mortality. Disadvantaged communities had mostly higher baseline rates of respiratory morbidity and larger absolute reductions in some outcomes. Among 90,808 ED visits in the National Hospital Ambulatory Medical Care Survey, asthma ED visits/y fell 33% during the pandemic and COPD visits by 51%; overall ED visits fell by only 7%. CONCLUSION Onset of the COVID-19 pandemic coincided with reductions in acute care utilization for asthma and COPD. Understanding the mechanism of this reduction might inform future efforts to prevent exacerbations.
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Affiliation(s)
- Adam Gaffney
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - David U Himmelstein
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Hunter College, City University of New York, New York, New York; Public Citizen Health Research Group, Washington, District of Columbia
| | - Steffie Woolhandler
- Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Hunter College, City University of New York, New York, New York; Public Citizen Health Research Group, Washington, District of Columbia
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Wadsworth E, Goodman S, Hammond D. Self-reported Impact of the COVID-19 Pandemic on Cannabis Use in Canada and the United States. J Psychoactive Drugs 2023; 55:483-492. [PMID: 35981105 DOI: 10.1080/02791072.2022.2110023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/06/2022] [Accepted: 06/03/2022] [Indexed: 10/15/2022]
Abstract
The current study examined the self-reported impact of the COVID-19 pandemic on cannabis consumption and behaviors among past 12-month cannabis consumers in Canada and the U.S. across different cannabis laws. Cross-sectional survey data were collected in 2020 from respondents recruited through online commercial panels, aged 16-65, who consumed cannabis in the past 12 months (n = 13,689). Weighted multinomial logistic regression models examined differences between jurisdictions for five outcomes: 1) cannabis consumption; 2) use of product types; 3) use of sources to obtain cannabis; 4) legality of source used; and 5) access to cannabis. Approximately one third of cannabis consumers reported changes to their consumption during the pandemic. Edibles (23% - 31%) and dried flower (21% - 30%) were the two most common products that respondents reported they were "more likely" to use during the pandemic. Most consumers reported "no difference" to changes in sourcing cannabis. Compared to consumers in U.S. recreational states, consumers in U.S. medical (AOR = 1.27, 95% CI: 1.07, 1.50) and illegal states (AOR = 1.22, CI: 1.00,1.48) had higher odds of reporting it was "harder" to access cannabis, and consumers in Canada had lower odds (AOR = 0.73, CI: 0.63,0.84). Future research should examine whether these changes remain after public health restrictions due to the pandemic are removed.
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Affiliation(s)
- Elle Wadsworth
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Canadian Centre on Substance Use and Addiction, Ottawa, ON, Canada
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Gehlert S, Rees VW, Choi K, Jackson PD, Sheehan BE, Grucza RA, Paulson AC, Plunk AD. COVID-19 Stay-At-Home Orders and Secondhand Smoke in Public Housing. Am J Prev Med 2023; 65:512-516. [PMID: 36871639 PMCID: PMC9984233 DOI: 10.1016/j.amepre.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
INTRODUCTION This study aimed to better understand the inequitable impact of the pandemic by examining the associations between stay-at-home orders and indoor smoking in public housing, measured by ambient particulate matter at the 2.5-micron threshold, a marker for secondhand smoke. METHODS Particulate matter at the 2.5-micron threshold was measured in 6 public-housing buildings in Norfolk, VA from 2018 to 2022. Multilevel regression was used to compare the 7-week period of the Virginia stay-at-home order in 2020 with that period in other years. RESULTS Indoor particulate matter at the 2.5-micron threshold was 10.29 μg/m3 higher in 2020 (95% CI=8.51, 12.07) than in the same period in 2019, a 72% increase. Although particulate matter at the 2.5-micron threshold improved in 2021 and 2022, it remained elevated relative to the level in 2019. CONCLUSIONS Stay-at-home orders likely led to increased indoor secondhand smoke in public housing. In light of evidence linking air pollutants, including secondhand smoke, with COVID-19, these results also provide further evidence of the disproportionate impact of the pandemic on socioeconomically disadvantaged communities. This consequence of the pandemic response is unlikely to be isolated and calls for a critical examination of the COVID-19 experience to avoid similar policy failures in future public health crises.
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Affiliation(s)
- Sarah Gehlert
- Brown School, Washington University in St. Louis, St. Louis, Missouri; Institute for Addiction Science, University of Southern California, Los Angeles, California
| | - Vaughan W Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachussetts
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Peter D Jackson
- Division of Pulmonary Critical Care and Global Health, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia; Global Health, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia
| | - Brynn E Sheehan
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, Virginia; Healthcare Analytics and Delivery Science Institute, Eastern Virginia Medical School, Norfolk, Virginia
| | - Richard A Grucza
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri; Department of Health and Clinical Outcomes Research, School of Medicine, Saint Louis University, St. Louis, Missouri
| | - Amy C Paulson
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia
| | - Andrew D Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia.
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Sung J, Shrestha SS, Kim Y, Emery S, Wang X. Changes in Sales of Tobacco and Nicotine Replacement Therapy Products Before and During the COVID-19 Pandemic. Prev Chronic Dis 2023; 20:E71. [PMID: 37590902 PMCID: PMC10457104 DOI: 10.5888/pcd20.220406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic and its associated social distancing policies such as lockdowns and quarantine influenced people's lives and health behaviors. We comprehensively assessed national trends in sales of cigarettes, cigars, e-cigarettes, and over-the-counter nicotine replacement therapy (NRT) products before and during the pandemic, allowing for cross-product comparisons. Stockpiling behavior was also assessed. METHODS We used US national tobacco and over-the-counter NRT retail store scanner data (excluding internet, specialty/vape store, and prescription sales) collected at 4-week intervals by NielsenIQ from December 2018 to June 2021. We applied an interrupted time-series model to assess differences in tobacco product and NRT unit sales before and during the pandemic. We defined the prepandemic period as December 16, 2018, through April 4, 2020, pandemic as starting on April 5, 2020, through June 26, 2021, and the stockpiling period as one 4-week period before the pandemic started. RESULTS Four-week cigarette, e-cigarette, and cigar unit sales on average increased by 11.5% (P = .006), 37.1% (P < .001), and 26.1% (P < .001) respectively, while 4-week NRT unit sales decreased on average by 13.1% (P < .001), during the pandemic compared with the prepandemic period. Stockpiling was associated with increases in sales of all tobacco products and NRT products. CONCLUSION Unit sales of assessed tobacco products increased while NRT unit sales decreased during the COVID-19 pandemic, compared with the prepandemic period. These changes may suggest an increase in the intensity of tobacco product use or stockpiling of tobacco products among people who use tobacco.
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Affiliation(s)
- Jaesang Sung
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sundar S Shrestha
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-7, Atlanta, GA 30341
| | - Yoonsang Kim
- NORC at the University of Chicago, Chicago, Illinois
| | - Sherry Emery
- NORC at the University of Chicago, Chicago, Illinois
| | - Xu Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Laddu DR, Biggs E, Kaar J, Khadanga S, Alman R, Arena R. The impact of the COVID-19 pandemic on cardiovascular health behaviors and risk factors: A new troubling normal that may be here to stay. Prog Cardiovasc Dis 2023; 76:38-43. [PMID: 36481209 PMCID: PMC9722238 DOI: 10.1016/j.pcad.2022.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
In March 2020, the Coronavirus disease 2019 (COVID-19) outbreak was officially declared a global pandemic, leading to closure of public facilities, enforced social distancing and stay-at-home mandates to limit exposures and reduce transmission rates. While the severity of this "lockdown" period varied by country, the disruptions of the pandemic on multiple facets of life (e.g., daily activities, education, the workplace) as well as the social, economic, and healthcare systems impacts were unprecedented. These disruptions and impacts are having a profound negative effect on multiple facets of behavioral health and psychosocial wellbeing that are inextricably linked to cardiometabolic health and associated with adverse outcomes of COVID-19. For example, adoption of various cardiometabolic risk behavior behaviors observed during the pandemic contributed to irretractable trends in weight gain and poor mental health, raising concerns on the possible long-term consequences of the pandemic on cardiometabolic disease risk, and vulnerabilities to future viral pandemics. The purpose of this review is to summarize the direct and indirect effects of the pandemic on cardiometabolic health risk behaviors, particularly related to poor diet quality, physical inactivity and sedentary behaviors, smoking, sleep patterns and mental health. Additional insights into how the pandemic has amplified cardiovascular risk behaviors, particularly in our most vulnerable populations, and the potential implications for the future if these modifiable risk behaviors do not become better controlled, are described.
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Affiliation(s)
- Deepika R Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America.
| | - Elisabeth Biggs
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Jill Kaar
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
| | - Sherrie Khadanga
- Department of Medicine, Division of Cardiology, Larner College of Medicine, University of Vermont, Burlington, VT, United States of America
| | - Rocio Alman
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, United States of America
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8
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Whitsel LP, Ajenikoko F, Chase PJ, Johnson J, McSwain B, Phelps M, Radcliffe R, Faghy MA. Public policy for healthy living: How COVID-19 has changed the landscape. Prog Cardiovasc Dis 2023; 76:49-56. [PMID: 36690285 PMCID: PMC9852261 DOI: 10.1016/j.pcad.2023.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic had a transformational impact on public policy as governments played a leading role, working alongside and coordinating with business/industry, healthcare, public health, education, transportation, researchers, non-governmental organizations, philanthropy, and media/communications. This paper summarizes the impact of the pandemic on different areas of public policy affecting healthy living and cardiovascular health including prevention (i.e., nutrition, physical activity, air quality, tobacco use), risk factors for chronic disease (hypertension, diabetes, obesity, substance abuse), access to health care, care delivery and payment reform, telehealth and digital health, research, and employment policy. The paper underscores where public policy is evolving and where there are needs for future evidence base to inform policy development, and the intersections between the public and private sectors across the policy continuum. There is a continued need for global multi-sector coordination to optimize population health.
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Affiliation(s)
- Laurie P Whitsel
- American Heart Association, Washington, DC 20036, United States of America.
| | - Funke Ajenikoko
- American Heart Association, Washington, DC 20036, United States of America
| | - Paul J Chase
- American Heart Association, Washington, DC 20036, United States of America
| | - Janay Johnson
- American Heart Association, Washington, DC 20036, United States of America
| | - Brooke McSwain
- American Heart Association, Washington, DC 20036, United States of America
| | - Melanie Phelps
- American Heart Association, Washington, DC 20036, United States of America
| | - Reyna Radcliffe
- American Heart Association, Washington, DC 20036, United States of America
| | - Mark A Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Deby, United Kingdom
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Abstract
This cohort study estimates state-level changes in cigarette sales in the US during the COVID-19 pandemic.
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Affiliation(s)
- Samuel Asare
- Tobacco Control Research, Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Zheng Xue
- Tobacco Control Research, Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Anuja Majmundar
- Tobacco Control Research, Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Priti Bandi
- Risk Factors & Screening Surveillance Research, Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Nigar Nargis
- Tobacco Control Research, Surveillance & Health Equity Science, American Cancer Society, Kennesaw, Georgia
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Sustained decline in tobacco purchasing in Denmark during the COVID-19 pandemic. COMMUNICATIONS MEDICINE 2022; 2:96. [PMID: 35923348 PMCID: PMC9344799 DOI: 10.1038/s43856-022-00160-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 07/13/2022] [Indexed: 11/08/2022] Open
Abstract
Abstract
Background
An estimated 8 million people die every year due to tobacco use. The COVID-19 pandemic has increased the health consequences of smoking, which is a leading risk factor for more severe COVID-19 symptoms, hospitalization, and death. The pandemic has also led to reductions in physical activity, increases in stress and declines in mental well-being, all factors commonly associated with triggering higher tobacco use.
Methods
Using a longitudinal data set of purchasing behavior from 2019–2020 among a national sample of the Danish population (n = 4042), we estimate changes in tobacco use during the COVID-19 pandemic. Our analysis compares tobacco purchases prior to the pandemic to purchases during the pandemic, at the individual level. We also examine effects within subgroups based on smoking behavior in 2019 prior to the pandemic. We estimate effects for smokers and non-smokers and, within smokers, for occasional smokers and regular smokers.
Results
We find large, sustained decreases in tobacco purchases during COVID-19. We estimate that weekly tobacco purchase rates decline by 24% and average quantities decline by 12% during the period spanning the onset of the pandemic in March 2020 through the end of the year. The declines are driven by regular smokers with little change in behavior among nonsmokers and increases in purchases among occasional smokers. Among regular smokers, purchase rates decline by about 30%, tobacco purchases decline by about 20% and quitting rates increase by about 10 percentage points.
Conclusions
Our results suggest that the COVID-19 pandemic could lead to sustained reductions in smoking.
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Agaku IT, Nkosi L, Erim D. Estimating the Impact of COVID-19 on Changes in Volume Sales of Cigars, Smokeless Tobacco Products, Pipe, and Roll-your-own Tobacco in the United States. Nicotine Tob Res 2022; 25:318-324. [PMID: 35931420 PMCID: PMC9384638 DOI: 10.1093/ntr/ntac191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 06/29/2022] [Accepted: 08/03/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION We examined the potential impact of COVID-19 on trends in volume sales of non-cigarette combustible and smokeless tobacco products in the United States. AIMS AND METHODS We analyzed monthly national sales for cigars, smokeless tobacco, pipe, and roll-your-own tobacco during June 2019-June 2021. Data were from the U.S Department of the Treasury. Interrupted time-series were used to measure associations of the COVID-19 "shock" (taken as June 2020 or 6 months after the first diagnosis of COVID-19 in the United States) and volume sales. Negative binomial regression was used to evaluate associations between volume sales and changes in community mobility. RESULTS Within interrupted time-series analysis, the shock of the COVID-19 pandemic was associated with an initial increase in the number of little cigars sold by 11.43 million sticks (p < .01), with no significant sustained change in trend. The COVID-19 shock was also associated with an initial increase in large cigar volume sales by 59.02 million sticks, followed by a subsequent decrease by 32.57 million sticks per month (p = .005). Every 10% reduction in mobility to retail stores was significantly associated with reduced volume sales of little cigars (IRR = 0.84, 95% CI, 0.71 to 0.98) and large cigars (IRR = 0.92, 95% CI, 0.88 to 0.96). Other findings were statistically nonsignificant. CONCLUSIONS COVID-19 was associated with increased volume sales for cigars and there was a significant association between reduced mobility to points of sale and reduced cigar volume sales. Intensified efforts are needed to prioritize evidence-based tobacco prevention and control efforts amidst the pandemic.
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Affiliation(s)
- Israel T Agaku
- Corresponding Author: Israel Agaku, PhD, Harvard School of Dental Medicine, Boston, MA Tel: +1 (404) 580-3276;
| | - Lungile Nkosi
- Sefako Makgatho Health Sciences University (SMU), Pretoria, South Africa
| | - Daniel Erim
- Lineberger Comprehensive Cancer Center, University of North Carolina, USA
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Bandi P, Asare S, Majmundar A, Xue Z, Han X, Westmaas JL, Nargis N, Jemal A. Changes in Smoking Cessation-Related Behaviors Among US Adults During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2225149. [PMID: 35913738 PMCID: PMC9344362 DOI: 10.1001/jamanetworkopen.2022.25149] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Smoking cessation is an urgent public health priority given that smoking is associated with increased risk of severe COVID-19 outcomes and other diseases. It is unknown how smoking cessation changed nationally during the COVID-19 pandemic. OBJECTIVE To investigate changes in smoking cessation-related behaviors in the US during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted using 2011 to 2020 data on 788 008 individuals who had smoked in the past year from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. Representative retail scanner sales data between January 2017 and July 2021 for 1004 unique nicotine replacement therapy (NRT) universal product codes in 31 US states from NielsenIQ were also used. EXPOSURES Calendar year and 4-week sales periods. MAIN OUTCOMES AND MEASURES Changes in annual self-reported prevalence of past-year quit attempts and recent successful cessation before (ie, 2011-2019) and during (ie, 2020) the COVID-19 pandemic and changes in sales volumes in millions of pieces of nicotine gum, lozenge, and patch brands before (1271 four-week sales periods between January 2017 and February 2020) and during (558 four-week sales periods between March 2020 and July 2021) the COVID-19 pandemic were calculated. RESULTS The 2011 to 2020 pooled BRFSS sample (response rate range, 45.2%-49.9%) included 788 008 respondents (243 061 individuals ages 25-44 years [weighted percentage, 42.5%]; 374 519 men [weighted percentage, 55.7%]). For the first time since 2011, annual past-year quit attempt prevalence decreased between 2019 and 2020, from 65.2% (95% CI, 64.5% to 65.9%) to 63.2% (95% CI, 62.3% to 64.0%), with the largest relative decreases among individuals ages 45 to 64 years (61.4% [95% CI, 60.3% to 62.5%] vs 57.7% [95% CI, 56.3% to 59.2%]), those with 2 or more comorbidities (67.1% [95% CI, 66.0% to 68.2%] to 63.0% [95% CI, 61.6% to 64.4%]), and Black individuals (72.5% [95% CI, 70.3 to 74.6] vs 68.4% [95% CI, 65.3% to 71.3%]). Recent successful cessation remained unchanged during 2019 to 2020. Observed mean (SD) 4-week NRT sales volume in the prepandemic period was 105.6 (66.2) million gum pieces, 51.9 (31.6) million lozenges, and 2.0 (1.1) million patches. Compared with expected sales, observed sales during the COVID-19 pandemic were lower by 13.0% (95% CI, -13.7% to -12.3%) for lozenges, 6.4% (95% CI, -7.3% to -5.5%) for patches, and 1.2% (95% CI, -1.7% to -0.7%) for gum. CONCLUSIONS AND RELEVANCE This study found that serious smoking cessation activity among US adults decreased immediately and remained depressed for more than a year during the COVID-19 pandemic. These findings suggest that smokers experiencing disproportionately negative outcomes during the pandemic should be reengaged and assisted in quit attempts.
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Affiliation(s)
- Priti Bandi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Samuel Asare
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Anuja Majmundar
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zheng Xue
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - J. Lee Westmaas
- Population Science, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Gaffney A, Himmelstein DU, Woolhandler S. Reply: Trends in Smoking Prevalence and the Continuing Imperative of Tobacco Control. Ann Am Thorac Soc 2022; 19:1441-1442. [PMID: 35533311 PMCID: PMC9353966 DOI: 10.1513/annalsats.202204-354le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Adam Gaffney
- Cambridge Health AllianceCambridge, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - David U. Himmelstein
- Cambridge Health AllianceCambridge, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
- City University of New YorkNew York, New York
| | - Steffie Woolhandler
- Cambridge Health AllianceCambridge, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
- City University of New YorkNew York, New York
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14
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COVID-19 and Cardiometabolic Health: Lessons Gleaned from the Pandemic and Insights for the Next Wave. Curr Atheroscler Rep 2022; 24:607-617. [PMID: 35773565 PMCID: PMC9247906 DOI: 10.1007/s11883-022-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review
To review the current evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiometabolic health, with a focus on strategies to help mitigate adverse effects on population health. Recent Findings Individuals with cardiometabolic disease are particularly vulnerable to worse outcomes with COVID-19 infection. In addition, the pandemic itself has had significant deleterious impact on the cardiometabolic health of the population, including declines in physical activity, increases in smoking and alcohol use, worsening blood pressure and glycemic control, and detrimental effects on mental health. Targeted interventions at the patient and community level will be needed to mitigate the long-term consequences of the COVID-19 pandemic on population cardiometabolic health. Summary The COVID-19 pandemic has worsened cardiometabolic health, but there are several opportunities and enhanced tools available to counteract these changes.
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Agaku IT, Nkosi L, Agaku QD, Gwar J, Tsafa T. A Rapid Evaluation of the US Federal Tobacco 21 (T21) Law and Lessons From Statewide T21 Policies: Findings From Population-Level Surveys. Prev Chronic Dis 2022; 19:E29. [PMID: 35653765 PMCID: PMC9165472 DOI: 10.5888/pcd19.210430] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND On December 20, 2019, the minimum age for purchasing tobacco in the US was raised nationally to 21 years. We evaluated this law (Tobacco 21 [T21]) 1 year after implementation. We also compared states with versus without T21 policies during 2019 to explore potential equity impacts of T21 policies. METHODS We examined shifts in tobacco access among 6th through 12th graders using the National Youth Tobacco Survey. To explore equity of state T21 policies among youths and young adults, the associations with tobacco use were explored separately for race and ethnicity by using data from the 2019 Behavioral Risk Factor Surveillance System (for persons aged 18 to 20 years) and the 2019 Youth Risk Behavior Survey (for high school students). RESULTS The overall percentage of 6th to 12th graders perceiving that it was easy to buy tobacco products from a store decreased from 2019 (67.2%) to 2020 (58.9%). However, only 17.0% of students who attempted buying cigarettes in 2020 were unsuccessful because of their age. In the 2019 BRFSS, those aged 18 to 20 years living in a state with T21 policies had a lower likelihood of being a current cigarette smoker (adjusted prevalence ratio [APR], 0.58) or smoking cigarettes daily (APR, 0.41). Similar significant associations were seen when analyses were restricted to only non-Hispanic White participants but not for participants who were non-Hispanic Black, non-Hispanic Asian, Hispanic, or of other races or ethnicities. Consistent findings were seen among high school students. CONCLUSION Greater compliance with the federal T21 law is needed as most youth who attempted buying cigarettes in 2020 were successful. Comparative analysis of states with versus states without statewide T21 policies in 2019 suggest the policies were differentially more protective of non-Hispanic White participants than other participants. Equitable and intensified enforcement of T21 policies can benefit public health.
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Affiliation(s)
- Israel T Agaku
- Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115.
| | - Lungile Nkosi
- Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | | | - Joy Gwar
- Federal Medical Center, Makurdi, Benue, Nigeria
| | - Tina Tsafa
- Federal Medical Center, Makurdi, Benue, Nigeria
- Benue State University, Makurdi, Benue, Nigeria
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Westmaas JL, Masters M, Bandi P, Majmundar A, Asare S, Diver WR. COVID-19 and Tweets About Quitting Cigarette Smoking: Topic Model Analysis of Twitter Posts 2018-2020. JMIR INFODEMIOLOGY 2022; 2:e36215. [PMID: 35611092 PMCID: PMC9118581 DOI: 10.2196/36215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023]
Abstract
Background The risk of infection and severity of illness by SARS-CoV-2 infection is elevated for people who smoke cigarettes and may motivate quitting. Organic public conversations on Twitter about quitting smoking could provide insight into quitting motivations or behaviors associated with the pandemic. Objective This study explored key topics of conversation about quitting cigarette smoking and examined their trajectory during 2018-2020. Methods Topic model analysis with latent Dirichlet allocation (LDA) identified themes in US tweets with the term “quit smoking.” The model was trained on posts from 2018 and was then applied to tweets posted in 2019 and 2020. Analysis of variance and follow-up pairwise tests were used to compare the daily frequency of tweets within and across years by quarter. Results The mean numbers of daily tweets on quitting smoking in 2018, 2019, and 2020 were 133 (SD 36.2), 145 (SD 69.4), and 127 (SD 32.6), respectively. Six topics were extracted: (1) need to quit, (2) personal experiences, (3) electronic cigarettes (e-cigarettes), (4) advice/success, (5) quitting as a component of general health behavior change, and (6) clinics/services. Overall, the pandemic was not associated with changes in posts about quitting; instead, New Year’s resolutions and the 2019 e-cigarette or vaping use–associated lung injury (EVALI) epidemic were more plausible explanations for observed changes within and across years. Fewer second-quarter posts in 2020 for the topic e-cigarettes may reflect lower pandemic-related quitting interest, whereas fourth-quarter increases in 2020 for other topics pointed to a late-year upswing. Conclusions Twitter posts suggest that the pandemic did not generate greater interest in quitting smoking, but possibly a decrease in motivation when the rate of infections was increasing in the second quarter of 2020. Public health authorities may wish to craft messages for specific Twitter audiences (eg, using hashtags) to motivate quitting during pandemics.
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Affiliation(s)
- J Lee Westmaas
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Matthew Masters
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Priti Bandi
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Anuja Majmundar
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - Samuel Asare
- Population Science Department American Cancer Society Kennesaw, GA United States
| | - W Ryan Diver
- Population Science Department American Cancer Society Kennesaw, GA United States
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Mills J. Varenicline (Chantix): The Smoking Cessation Medication Prescribers May Be Avoiding. Issues Ment Health Nurs 2022; 43:489-494. [PMID: 35412411 DOI: 10.1080/01612840.2022.2061806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jeremy Mills
- Peninsula, A Division of Parkwest Medical Center, Knoxville, Tennessee, USA
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