School of Public Health, University of Hong Kong, Hong Kong SAR, China.
School of Nursing, University of Hong Kong, Hong Kong SAR, China.
Nicotine Tob Res. 2023 Jan 5;25(2):309-317. doi: 10.1093/ntr/ntac147.
Changes in tobacco use and related personal and environmental factors amid the coronavirus disease 2019 (COVID-19) pandemic can be captured by qualitative studies, but they are few in non-Western populations.
We assessed the perceived links between tobacco use and COVID-19, and changes in the use of cigarettes, electronic cigarettes (ECs), and heated tobacco products (HTPs) in the early phase of the pandemic in Hong Kong, where lockdown was not implemented. Semi-structured telephone interviews were conducted from January to June 2021 in 95 participants (36 EC users, 28 HTP users, and 32 exclusive cigarette users). Transcriptions were coded using deductive and inductive approaches, and factors for changes were nested in the social-ecological model.
Two-thirds of participants perceived their infection susceptibility was the same as never tobacco users, and 44.2% perceived more severe COVID-19 disease if infected. Amid the pandemic, tobacco use decreased overall but increased indoors for all three products. Increased tobacco use was mostly attributed to increased emotional distress, while decreases were attributed to various personal (health concerns) and environmental factors (e.g., COVID-19 regulations). Perceived convenience and lower costs were reasons for increased EC use. Limited access to HTPs was compensated by cigarette use.
Many participants were unaware of the potential harm of tobacco use on COVID-19. Overall tobacco use decreased due to COVID-19 regulations, which may not be sustainable post-pandemic. Indoor consumption increased, supporting a comprehensive smoke-free policy that covers private indoor areas. Better cessation services targeting EC, HTP, and cigarette use are needed.
Smokers need better awareness of the risk of tobacco use on COVID-19. Smoking cessation services can be improved by offering brief advice, strengthening advocacy against secondhand smoke, and covering EC and HTP use, highlighting their potential harms to users and others, and their risk of addiction and relapse to cigarette use.
在 2019 年冠状病毒病（COVID-19）大流行期间，通过定性研究可以捕捉到烟草使用和相关个人及环境因素的变化，但在非西方人群中此类研究很少。
我们评估了在香港（未实施封锁）COVID-19 大流行早期，人们对烟草使用与 COVID-19 之间的关联以及香烟、电子烟（EC）和加热烟草产品（HTP）使用变化的看法。2021 年 1 月至 6 月，我们对 95 名参与者（36 名 EC 用户、28 名 HTP 用户和 32 名只吸烟的用户）进行了半结构式电话访谈。使用演绎和归纳方法对转录本进行编码，并将变化因素嵌套在社会生态模型中。
三分之二的参与者认为他们的感染易感性与从不吸烟的人相同，如果感染，44.2%的人认为 COVID-19 疾病会更严重。在大流行期间，三种产品的总吸烟量都有所下降，但室内吸烟量有所增加。吸烟量增加主要归因于情绪困扰增加，而吸烟量减少则归因于个人（健康问题）和环境因素（如 COVID-19 规定）。EC 使用量增加的原因是便利性和成本降低。HTP 供应有限，用香烟来弥补。
许多参与者没有意识到烟草使用对 COVID-19 的潜在危害。由于 COVID-19 法规的实施，总体吸烟量有所下降，这在大流行后可能不会持续。室内消费增加，支持全面的无烟政策，涵盖私人室内区域。需要针对 EC、HTP 和香烟使用提供更好的戒烟服务。
吸烟者需要更好地了解烟草使用对 COVID-19 的风险。通过提供简短的建议、加强反对二手烟的宣传以及涵盖 EC 和 HTP 使用，可以改进戒烟服务，突出其对使用者和他人的潜在危害，以及使用者对它们的成瘾和复吸风险。
