Department of Health Promotion, National Institute of Public Health, Wako, Japan.
Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan.
Tob Control. 2024 Apr 19;33(3):287-294. doi: 10.1136/tc-2022-057353.
Smoking behaviour may have changed due to the COVID-19 pandemic, the April 2020 revised smoke-free policy and the high prevalence of heated tobacco product (HTP) use in Japan (10.9% in 2020). This study examined the association between these three events and smoking behaviour changes using 6-month follow-up data from before and during the pandemic.
Using longitudinal data from an internet survey conducted in February 2020 (baseline) and follow-up in August to September 2020, prevalence ratios (PR) and 95% confidence intervals (95% CIs) for smoking behaviour changes (increase and quit) were calculated using multivariable Poisson regression with adjustments for potential covariates including three event-related five factors: fear of COVID-19, living in a COVID-19 endemic area, workplace smoking rules, self-imposed smoking rules at home and type of tobacco use (cigarette only/HTP only/dual use). A smoker who reported an increase in smoking intensity in the last month was defined as an increase. A smoker who had stopped both cigarettes and HTPs at follow-up was defined as a quit.
We analysed 1810 tobacco users (1448 males (80%); mean age 50.8 years±13.2 SD). At baseline, 930 participants used cigarettes only, 293 HTPs only and 587 both. While 214 (11.8%) users increased smoking intensity, 259 (14.3%) quit both tobacco products. Those who feared COVID-19 were less likely to quit (PR=0.77, 95% CI 0.68 to 0.95), while living in a COVID-19 endemic area was not associated with either smoking behaviour change. Workplace smoking rules were not associated with either smoking behaviour change, but those with no home smoking ban were less likely to quit. Compared with cigarette-only users, HTP-only users were more likely to quit (PR=1.57, 95% CI 1.17 to 2.11), while dual users were more likely to increase smoking intensity (PR=1.35, 95% CI 1.01 to 1.79).
During the pandemic, dual cigarette and HTP use increased smoking intensity, whereas HTP-only use was associated with quitting but fear of COVID-19 and not having a home smoking ban made it harder to quit.
由于 COVID-19 大流行、2020 年 4 月修订的禁烟政策以及日本加热烟草制品（HTP）使用率高（2020 年为 10.9%），吸烟行为可能发生了变化。本研究使用大流行前后的 6 个月随访数据，探讨了这三个事件与吸烟行为变化之间的关系。
使用 2020 年 2 月（基线）进行的互联网调查的纵向数据以及 2020 年 8 月至 9 月的随访数据，使用多变量泊松回归计算吸烟行为变化（增加和戒烟）的患病率比（PR）和 95%置信区间（95%CI），调整了三个与事件相关的五个因素的潜在混杂因素：对 COVID-19 的恐惧、生活在 COVID-19 流行地区、工作场所吸烟规则、在家中自行制定的吸烟规则和烟草使用类型（仅香烟/仅 HTP/双重使用）。在上个月增加吸烟强度的吸烟者被定义为增加。在随访时已停止使用香烟和 HTP 的吸烟者被定义为戒烟。
我们分析了 1810 名烟草使用者（1448 名男性（80%）；平均年龄 50.8 岁±13.2 岁标准差）。基线时，930 名参与者仅使用香烟，293 名仅使用 HTP，587 名同时使用两者。虽然有 214 名（11.8%）使用者增加了吸烟强度，但有 259 名（14.3%）同时戒烟了两种烟草产品。对 COVID-19 感到恐惧的人戒烟的可能性较小（PR=0.77，95%CI 0.68 至 0.95），而生活在 COVID-19 流行地区与任何一种吸烟行为变化均无关。工作场所吸烟规则与任何一种吸烟行为变化均无关，但没有在家中禁烟规定的人戒烟的可能性较小。与仅使用香烟的使用者相比，仅使用 HTP 的使用者更有可能戒烟（PR=1.57，95%CI 1.17 至 2.11），而双重使用者更有可能增加吸烟强度（PR=1.35，95%CI 1.01 至 1.79）。
在大流行期间，双重使用香烟和 HTP 增加了吸烟强度，而仅使用 HTP 与戒烟有关，但对 COVID-19 的恐惧和没有在家中禁烟规定使戒烟变得更加困难。
