Smoking and COVID-19: A Literature Review of Cohort Studies in Non-Chinese Population Settings

Reactions to Pictorial and Text Cigarette Pack Warning Labels among Chinese Smokers

Objectives. This study aims at examining the impact of graphic pictorial warning labels on inten-tion to quit smoking and perceived harms among Chinese working-age adults (n = 661). Methods. A randomized controlled trial is utilized as the research design by comparing three scenarios: Group 1 as baseline (n = 193) and presented with real market tobacco products with text-only la-bels, Group 2 as price group and with hypothetical scenarios of manipulated prices, and Group 3 as the imaging group and with hypothetical scenarios of graphic pictorial cigarette warning la-bels. Both bivariate and multivariate analyses are utilized to determine the effectiveness of warn-ing labels. Results. Graphic pictorial cigarette warning labels are associated with stronger inten-tion to quit smoking and greater perceived harms. Smokers have a greater number of attempts if they are less nicotine dependent and express greater smoking risk perceptions. Conclusions. This study adds to the evidence that graphic pictorial warning labels are more effective than text-only labels in increasing intention to quit smoking. As China strives to achieve a reduction in smoking to meet the goal of the Healthy China 2030 initiative, this work strengthens the evidence base for policy makers, practitioners, and researchers to design low-cost warning labels on cigarette packs to promote tobacco control.

COVID-19 patients with documented alcohol use disorder or alcohol-related complications are more likely to be hospitalized and have higher all-cause mortality

BACKGROUND

Coronavirus Disease 2019 (COVID-19) has affected every country globally, with hundreds of millions of people infected with the SARS-CoV-2 virus and over 6 million deaths to date. It is unknown how alcohol use disorder (AUD) affects the severity and mortality of COVID-19. AUD is known to increase the severity and mortality of bacterial pneumonia and the risk of developing acute respiratory distress syndrome. Our objective is to determine whether individuals with AUD have increased severity and mortality from COVID-19.

METHODS

We utilized a retrospective cohort study of inpatients and outpatients from 44 centers participating in the National COVID Cohort Collaborative. All were adult COVID-19 patients with and without documented AUDs.

RESULTS

We identified 25,583 COVID-19 patients with an AUD and 1,309,445 without. In unadjusted comparisons, those with AUD had higher odds of hospitalization (odds ratio [OR] 2.00, 95% confidence interval [CI] 1.94 to 2.06, p < 0.001). After adjustment for age, sex, race/ethnicity, smoking, body mass index, and comorbidities, individuals with an AUD still had higher odds of requiring hospitalization (adjusted OR [aOR] 1.51, CI 1.46 to 1.56, p < 0.001). In unadjusted comparisons, individuals with AUD had higher odds of all-cause mortality (OR 2.18, CI 2.05 to 2.31, p < 0.001). After adjustment as above, individuals with an AUD still had higher odds of all-cause mortality (aOR 1.55, CI 1.46 to 1.65, p < 0.001).

CONCLUSION

This work suggests that AUD can increase the severity and mortality of COVID-19 infection. This reinforces the need for clinicians to obtain an accurate alcohol history from patients hospitalized with COVID-19. For this study, our results are limited by an inability to quantify the daily drinking habits of the participants. Studies are needed to determine the mechanisms by which AUD increases the severity and mortality of COVID-19.

Smoking enhances suicide risk-a significant role in the COVID-19 pandemic?

The COVID-19 outbreak has severely affected the whole world. Considerable evidence suggests that tobacco smoking is associated with increased severity of COVID-19 and death in COVID-19 patients. Tobacco smoking cessation is necessary to decrease COVID-19-related hospitalizations and deaths. In this commentary, I suggest that tobacco smoking cessation is also needed to reduce suicidal behavior during and after the COVID-19 pandemic. Significant evidence suggests that the COVID-19 pandemic leads to increased tobacco consumption as smokers use more tobacco to cope with pandemic-related stress, anxiety, depression and loneliness. Multiple studies have demonstrated that tobacco smoking is associated with suicidal ideation, suicide attempts, suicide death and a contributing factor in the pathophysiology of suicide. Smoking may increase the probability of development of post-COVID syndrome because it increases severity of COVID-19. Suicide risk may be increased in individuals with post-COVID syndrome. Smoking prevention and cessation should be a target of suicide prevention interventions during and after the COVID-19 pandemic. The COVID-19 pandemic enhances the need to act to integrate tobacco smoking cessation in the health care as a standard of patient care.

Addictions en temps de pandémie

L’Organisation mondiale de la santé a déclaré la maladie causée par le coronavirus 2 comme pandémie en mars 2020. Via les différentes mesures prises, un phénomène stressant psychosocial induit par cette épidémie a, dès lors, émergé en raison des difficultés financières, de l’isolement social et du caractère incertain du futur. L’ensemble des études nationales et internationales a mis en évidence une augmentation des usages de tabac, d’alcool et de substances illicites. Outre les comportements de consommation excessive, voire les décompensations addictives liées aux substances, il faut également prendre en considération l’usage excessif de la pornographie, des jeux de hasard et d’argent, des jeux vidéo essentiellement via Internet et l’exercice physique. La COVID-19 peut être à l’origine d’un certain nombre de conséquences et de complications chez les personnes souffrant de troubles liés à l’usage de substances licites ou illicites, population particulièrement vulnérable. Dans cette revue de la littérature narrative, nous analyserons les données concernant les comportements de consommation excessive et les addictions aux substances psychoactives licites et illicites et à certains types de comportements de la vie quotidienne. Nous avons, pour ce faire, utilisé les combinaisons de mots-clés pour sélectionner les articles scientifiques de langue anglaise et française publiés entre 2019 et 2021 en consultant les bases de données Medline, Embase, PsycInfo, Google Scholar.