Department of Health Sciences, University of York, York, UK.
The Initiative, Orange Grove Farm, Banigala, Islamabad, Pakistan.
Nicotine Tob Res. 2021 Mar 19;23(4):765-769. doi: 10.1093/ntr/ntaa207.
We investigated the influence of COVID-19 on smoking patterns in Pakistan.
In a longitudinal survey, we asked cigarette smokers in Pakistan about their smoking behaviors before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health, and well-being. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis.
We recruited 6014 smokers between September 2019 and February 2020; of these, 2087 (2062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated; while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020).
There have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. Although many people stopped, reduced, or tried quitting smoking, some increased smoking and some relapsed after quitting.
We observed significant and complex changes in people's smoking patterns, which are likely to be attributable to the COVID-19 pandemic and replicated in similar events in the future. Assessing these changes is essential for most low- and middle-income countries like Pakistan, where the vast majority of tobacco users live, but cessation support is still rudimentary. If provided routinely, smoking cessation interventions can potentially support millions of highly motivated individuals in quitting successfully both in general and in global events like COVID-19, in particular.
本研究旨在调查 COVID-19 对巴基斯坦吸烟模式的影响。
采用纵向调查，我们询问了巴基斯坦的吸烟者在 COVID-19 之前和之后的吸烟行为。在 COVID-19 之前，通过两阶段随机概率抽样招募吸烟者。自 COVID-19 以来，我们通过电话进行了后续的三个波次调查，询问了社会决定因素、心理健康和幸福感方面的附加问题。基于前两个波次，我们估计了停止、减少、维持或增加吸烟的吸烟者比例。我们还探讨了与吸烟模式变化相关的任何因素。对于 COVID-19 后不久就戒烟的人，我们估计了在随后的波次中复吸的比例。我们根据完整病例分析估计了所有比例。
我们于 2019 年 9 月至 2020 年 2 月间招募了 6014 名吸烟者；其中，2087 名（2062 名报告了吸烟结果）在 COVID-19 后于 2020 年 5 月接受了随访。自 COVID-19 以来，14%（290/2062）的吸烟者报告戒烟。在继续吸烟的人中：68%（1210/1772）减少了吸烟量，14%（239/1772）维持了吸烟量，18%（323/1772）增加了吸烟量；37%（351/938）报告至少有一次戒烟尝试；41%（669/1619）戒烟动机更强；而 21%（333/1619）戒烟动机更弱。吸烟模式的变化因尼古丁依赖、戒烟动机和 COVID-19 后的财务稳定性而异。在 COVID-19 后不久报告戒烟的人中，39%（81/206）在随后的几个月（2020 年 6 月至 7 月）复吸。
自 COVID-19 以来，巴基斯坦的吸烟模式发生了显著的双向变化。尽管许多人停止、减少或尝试戒烟，但也有一些人增加了吸烟量，一些人戒烟后又复吸。
我们观察到人们的吸烟模式发生了显著而复杂的变化，这可能归因于 COVID-19 大流行，并在未来的类似事件中得到复制。评估这些变化对于像巴基斯坦这样的大多数低收入和中等收入国家至关重要，因为绝大多数烟草使用者都生活在这些国家，但戒烟支持仍然很基础。如果常规提供，戒烟干预措施可能会支持数以百万计的高度戒烟动机的个人成功戒烟，无论是在一般情况下，还是在 COVID-19 等全球事件中。
