Tattan-Birch, H; Perski, O; Jackson, S; Shahab, L; West, R; Brown, J; (2020) COVID-19, smoking, vaping and quitting: A representative population survey in England. Addiction 10.1111/add.15251. (In press).

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Abstract

AIMS: To estimate 1) associations between self-reported COVID-19, hand washing, smoking status, e-cigarette use, and nicotine replacement therapy (NRT) use and 2) the extent to which COVID-19 has prompted smoking and vaping quit attempts, and more smoking inside the home. DESIGN: Cross-sectional household surveys. SETTING AND PARTICIPANTS: A representative sample of the population in England from April-May 2020. The sample included 3,179 adults aged ≥18 years. MEASUREMENTS: Participants who reported they definitely or thought they had coronavirus were classified as having self-reported COVID-19. Participants were asked how often they wash their hands after returning home, before preparing foods, before eating or before touching their face. They were also asked whether, due to COVID-19, they had i) attempted to quit smoking, ii) attempted to quit vaping, and iii) changed the amount they smoke inside the home. FINDINGS: Odds of self-reported COVID-19 were significantly greater among current smokers (20.9%, adjusted odds ratio [ORadj ]=1.34, 95% confidence interval [CI]=1.04-1.73) and long-term (>1-year) ex-smokers (16.1%, ORadj =1.33, 95%CI=1.05-1.68) compared with never smokers (14.5%). Recent (<1-year) ex-smokers had non-significantly greater odds of self-reported COVID-19 (22.2%, ORadj =1.50, 95%CI=0.85-2.53, Bayes factor=0.55-1.17). Bayes factors indicated there was sufficient evidence to rule out large differences in self-reported COVID-19 by NRT use and medium differences by e-cigarette use. With the exception of hand washing before face touching, engagement in hand washing behaviours was high (>85%) regardless of nicotine use. A minority (12.2%) of quit attempts in the past 3 months were reportedly triggered by COVID-19, and approximately one-in-ten current e-cigarette users reported attempting to quit vaping because of COVID-19. CONCLUSIONS: In England, current smokers and long-term ex-smokers appear to have higher odds of self-reported COVID-19 compared with never smokers in adjusted analyses, but there were no large differences between people who used nicotine replacement therapy or e-cigarettes. Engagement in hand washing appears to be high regardless of nicotine or tobacco use. A minority of past-year smokers and current e-cigarette users, respectively, report attempting to quit smoking/vaping due to COVID-19.

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