Sarich Peter, Cabasag Citadel J, Liebermann Erica, Vaneckova Pavla, Carle Chelsea, Hughes Suzanne, Egger Sam, O'Connell Dianne L, Weber Marianne F, da Costa Allini Mafra, Caruana Michael, Bray Freddie, Canfell Karen, Ginsburg Ophira, Steinberg Julia, Soerjomataram Isabelle
The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia.
Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
EClinicalMedicine. 2022 May;47:101375. doi: 10.1016/j.eclinm.2022.101375. Epub 2022 Apr 12.
Globally, tobacco smoking remains the largest preventable cause of premature death. The COVID-19 pandemic has forced nations to take unprecedented measures, including 'lockdowns' that might impact tobacco smoking behaviour. We performed a systematic review and meta-analyses to assess smoking behaviour changes during the early pre-vaccination phases of the COVID-19 pandemic in 2020.
We searched Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN databases (January-November 2020) for published and pre-print articles that reported specific smoking behaviour changes or intentions after the onset of the COVID-19 pandemic. We used random-effects models to pool prevalence ratios comparing the prevalence of smoking during and before the pandemic, and the prevalence of smoking behaviour changes during the pandemic. The PROSPERO registration number for this systematic review was CRD42020206383.
31 studies were included in meta-analyses, with smoking data for 269,164 participants across 24 countries. The proportion of people smoking during the pandemic was lower than that before, with a pooled prevalence ratio of 0·87 (95%CI:0·79-0·97). Among people who smoke, 21% (95%CI:14-30%) smoked less, 27% (95%CI:22-32%) smoked more, 50% (95%CI:41%-58%) had unchanged smoking and 4% (95%CI:1-9%) reported quitting smoking. Among people who did not smoke, 2% (95%CI:1-3%) started smoking during the pandemic. Heterogeneity was high in all meta-analyses and so the pooled estimates should be interpreted with caution ( >91% and -heterogeneity<0·001). Almost all studies were at high risk of bias due to use of non-representative samples, non-response bias, and utilisation of non-validated questions.
Smoking behaviour changes during the first phases of the COVID-19 pandemic in 2020 were highly mixed. Meta-analyses indicated that there was a relative reduction in overall smoking prevalence during the pandemic, while similar proportions of people who smoke smoked more or smoked less, although heterogeneity was high. Implementation of evidence-based tobacco control policies and programs, including tobacco cessation services, have an important role in ensuring that the COVID-19 pandemic does not exacerbate the smoking pandemic and associated adverse health outcomes.
No specific funding was received for this study.
在全球范围内，吸烟仍然是可预防的过早死亡的最大原因。新冠疫情迫使各国采取前所未有的措施，包括可能影响吸烟行为的“封锁”措施。我们进行了一项系统评价和荟萃分析，以评估2020年新冠疫情疫苗接种前早期阶段的吸烟行为变化。
我们检索了Medline/Embase/PsycINFO/BioRxiv/MedRxiv/SSRN数据库（2020年1月至11月），以查找报告新冠疫情爆发后特定吸烟行为变化或意图的已发表和预印文章。我们使用随机效应模型汇总患病率比值，以比较疫情期间和疫情前的吸烟患病率，以及疫情期间吸烟行为变化的患病率。该系统评价的PROSPERO注册号为CRD42020206383。
31项研究纳入荟萃分析，涉及24个国家的269,164名参与者的吸烟数据。疫情期间吸烟的人群比例低于疫情前，汇总患病率比值为0.87（95%置信区间：0.79-0.97）。在吸烟者中，21%（95%置信区间：14%-30%）吸烟减少，27%（95%置信区间：22%-32%）吸烟增加，50%（95%置信区间：41%-58%）吸烟量不变，4%（95%置信区间：1%-9%）报告戒烟。在不吸烟者中，2%（95%置信区间：1%-3%）在疫情期间开始吸烟。所有荟萃分析中的异质性都很高，因此对汇总估计值的解释应谨慎（异质性>91%且I²<0.001）。几乎所有研究都因使用非代表性样本、无应答偏倚和使用未经验证的问题而存在高偏倚风险。
2020年新冠疫情第一阶段的吸烟行为变化非常复杂。荟萃分析表明，疫情期间总体吸烟患病率相对降低，虽然吸烟者中吸烟增加或减少的比例相似，但异质性很高。实施包括戒烟服务在内的循证烟草控制政策和项目，对于确保新冠疫情不会加剧吸烟流行及相关不良健康后果具有重要作用。
本研究未获得特定资金。
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