Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA.
Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA.
Int J Drug Policy. 2021 Aug;94:103175. doi: 10.1016/j.drugpo.2021.103175. Epub 2021 Mar 1.
The COVID-19 pandemic and associated public health prevention measures (e.g., "stay at home" orders) may impact tobacco supply and demand among consumers. This qualitative study identified multi-level drivers of shifts in inhaled tobacco product use and access patterns during the initial COVID-19 "lockdown" period in the United States.
Between April and May 2020, we conducted semi-structured telephone interviews (n = 44) with adults who use cigarettes and/or electronic nicotine delivery systems (ENDS). Transcripts were thematically analyzed using a socioecological framework.
Nearly all participants reported changes in their product use during lockdown, though patterns varied. Increased use was most common and was predominantly driven by individual-level factors: pandemic-related anxiety, boredom, and irregular routines. Decreased use was common among social users who cited fewer interpersonal interactions and fear of sharing products. At the community level, retail access impacted cigarette and ENDS use differently. While cigarettes were universally accessible, ENDS access was more limited, driving some to purchase products online. Delayed deliveries led some ENDS users to compensate with readily-available cigarettes.
To mitigate ways that the COVID-19 pandemic may exacerbate an existing public health crisis, multi-level policy strategies, such as expanded virtual cessation services and implementation and enforcement of smoke-free home rules, can better support population health during this critical period. Policies that facilitate access to lower risk products can help minimize harm among those who cannot or do not want to quit smoking.
COVID-19 大流行及相关公共卫生预防措施（例如“居家令”）可能会影响消费者对烟草的供应和需求。本定性研究确定了在美国 COVID-19“封锁”初期，影响吸入式烟草制品使用和获取模式转变的多层次驱动因素。
2020 年 4 月至 5 月期间，我们对使用香烟和/或电子尼古丁输送系统（ENDS）的成年人进行了半结构式电话访谈（n=44）。使用社会生态学框架对转录本进行主题分析。
几乎所有参与者都报告在封锁期间改变了他们的产品使用情况，尽管模式有所不同。增加使用最为常见，主要由个人层面的因素驱动：与大流行相关的焦虑、无聊和不规则的日常生活。社交用户的使用减少较为常见，他们提到人际互动减少和担心共享产品。在社区层面，零售渠道对香烟和 ENDS 的使用产生了不同的影响。虽然香烟普遍可获得，但 ENDS 的获取则更为有限，导致一些人在网上购买产品。延迟交货导致一些 ENDS 用户用随手可得的香烟来弥补。
为了减轻 COVID-19 大流行可能加剧现有公共卫生危机的方式，可以采用多层次的政策策略，例如扩大虚拟戒烟服务以及实施和执行无烟家庭规定，以便在这一关键时期更好地支持人口健康。促进获得低风险产品的政策可以帮助减少那些无法或不想戒烟的人的伤害。
