Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.
Population Science, American Cancer Society, Atlanta, Georgia.
JAMA Netw Open. 2022 Aug 1;5(8):e2225149. doi: 10.1001/jamanetworkopen.2022.25149.
Smoking cessation is an urgent public health priority given that smoking is associated with increased risk of severe COVID-19 outcomes and other diseases. It is unknown how smoking cessation changed nationally during the COVID-19 pandemic.
To investigate changes in smoking cessation-related behaviors in the US during the COVID-19 pandemic.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study was conducted using 2011 to 2020 data on 788 008 individuals who had smoked in the past year from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. Representative retail scanner sales data between January 2017 and July 2021 for 1004 unique nicotine replacement therapy (NRT) universal product codes in 31 US states from NielsenIQ were also used.
Calendar year and 4-week sales periods.
Changes in annual self-reported prevalence of past-year quit attempts and recent successful cessation before (ie, 2011-2019) and during (ie, 2020) the COVID-19 pandemic and changes in sales volumes in millions of pieces of nicotine gum, lozenge, and patch brands before (1271 four-week sales periods between January 2017 and February 2020) and during (558 four-week sales periods between March 2020 and July 2021) the COVID-19 pandemic were calculated.
The 2011 to 2020 pooled BRFSS sample (response rate range, 45.2%-49.9%) included 788 008 respondents (243 061 individuals ages 25-44 years [weighted percentage, 42.5%]; 374 519 men [weighted percentage, 55.7%]). For the first time since 2011, annual past-year quit attempt prevalence decreased between 2019 and 2020, from 65.2% (95% CI, 64.5% to 65.9%) to 63.2% (95% CI, 62.3% to 64.0%), with the largest relative decreases among individuals ages 45 to 64 years (61.4% [95% CI, 60.3% to 62.5%] vs 57.7% [95% CI, 56.3% to 59.2%]), those with 2 or more comorbidities (67.1% [95% CI, 66.0% to 68.2%] to 63.0% [95% CI, 61.6% to 64.4%]), and Black individuals (72.5% [95% CI, 70.3 to 74.6] vs 68.4% [95% CI, 65.3% to 71.3%]). Recent successful cessation remained unchanged during 2019 to 2020. Observed mean (SD) 4-week NRT sales volume in the prepandemic period was 105.6 (66.2) million gum pieces, 51.9 (31.6) million lozenges, and 2.0 (1.1) million patches. Compared with expected sales, observed sales during the COVID-19 pandemic were lower by 13.0% (95% CI, -13.7% to -12.3%) for lozenges, 6.4% (95% CI, -7.3% to -5.5%) for patches, and 1.2% (95% CI, -1.7% to -0.7%) for gum.
This study found that serious smoking cessation activity among US adults decreased immediately and remained depressed for more than a year during the COVID-19 pandemic. These findings suggest that smokers experiencing disproportionately negative outcomes during the pandemic should be reengaged and assisted in quit attempts.
鉴于吸烟与严重 COVID-19 结果和其他疾病风险增加有关，戒烟是一项紧迫的公共卫生重点。目前尚不清楚在 COVID-19 大流行期间，全国范围内的戒烟行为发生了怎样的变化。
调查 COVID-19 大流行期间美国与戒烟相关行为的变化。
设计、地点和参与者：这项横断面研究使用了来自全国代表性行为风险因素监测系统（BRFSS）调查的过去一年中吸烟的 788008 名个体的数据，这些个体在 2011 年至 2020 年期间每年自我报告过去一年戒烟尝试的流行率和最近成功戒烟的情况。还使用了尼尔森 IQ 公司在 31 个州的 1004 种独特尼古丁替代疗法（NRT）通用产品代码的代表性零售扫描销售数据，2017 年 1 月至 2021 年 7 月期间，每个月有 4 周的销售期。
日历年度和 4 周销售期。
计算了在 COVID-19 大流行之前（即 2011-2019 年）和期间（即 2020 年）每年自我报告过去一年戒烟尝试的流行率和最近成功戒烟的变化，以及在 COVID-19 大流行之前（2017 年 1 月至 2020 年 2 月期间有 1271 个四周销售期）和期间（2020 年 3 月至 2021 年 7 月期间有 558 个四周销售期）尼古丁口香糖、含片和贴片品牌的销售量变化。
2011 年至 2020 年 BRFSS 汇总样本（应答率范围为 45.2%-49.9%）包括 788008 名受访者（243061 名年龄在 25-44 岁的个体[加权百分比，42.5%]；374519 名男性[加权百分比，55.7%]）。自 2011 年以来，每年过去一年戒烟尝试的流行率首次在 2019 年至 2020 年期间下降，从 65.2%（95%CI，64.5%-65.9%）降至 63.2%（95%CI，62.3%-64.0%），降幅最大的是 45 岁至 64 岁的个体（61.4%[95%CI，60.3%-62.5%]与 57.7%[95%CI，56.3%-59.2%]）、有 2 种或多种合并症的个体（67.1%[95%CI，66.0%-68.2%]与 63.0%[95%CI，61.6%-64.4%]）和黑人个体（72.5%[95%CI，70.3%至 74.6%]与 68.4%[95%CI，65.3%至 71.3%]）。最近成功戒烟在 2019 年至 2020 年期间保持不变。在大流行前期间，观察到的平均（SD）4 周 NRT 销售量为 1.056 亿片口香糖、5190 万片含片和 200 万贴剂。与预期销售额相比，COVID-19 大流行期间的观察销售额下降了 13.0%（95%CI，-13.7%至-12.3%），下降幅度最大的是含片（6.4%[95%CI，-7.3%至-5.5%]），其次是贴片（1.2%[95%CI，-1.7%至-0.7%]）和口香糖（1.2%[95%CI，-1.7%至-0.7%]）。
本研究发现，美国成年人的严重戒烟活动立即减少，并在 COVID-19 大流行期间持续低迷超过一年。这些发现表明，在大流行期间经历不成比例的负面结果的吸烟者应该重新参与并协助他们尝试戒烟。
