Attitudes towards smoking and COVID-19, and changes in smoking behaviors before and after the outbreak of COVID-19: A nationwide cross-sectional survey study in China

Six addiction components of problematic social media use in relation to depression, anxiety, and stress symptoms: a latent profile analysis and network analysis

BACKGROUNDS

Components of addiction (salience, tolerance, mood modification, relapse, withdrawal, and conflict) is the most cited theoretical framework for problematic social media use (PSMU). However, studies criticized its ability to distinguish problematic users from engaged users. We aimed to assess the association of the six criteria with depression, anxiety, and stress at a symptom level.

METHODS

Ten thousand six hundred sixty-eight participants were recruited. Bergen Social Media Addiction Scale (BSMAS) was used to detect six addiction components in PSMU. We applied the depression-anxiety-stress scale to assess mental distress. Latent profile analysis (LPA) was conducted based on BSMAS items. Network analysis (NA) was performed to determine the symptom-symptom interaction of PSMU and mental distress.

RESULTS

(1) Social media users were divided into five subgroups including occasional users (10.6%, n = 1127), regular users (31.0%, n = 3309), high engagement low risk users (10.4%, n = 1115), at-risk users (38.1%, n = 4070), and problematic users (9.8%, n = 1047); (2) PSMU and mental distress varied markedly across subgroups. Problematic users had the most severe PSMU, depression, anxiety, and stress symptoms. High engagement users scored high on tolerance and salience criteria of PSMU but displayed little mental distress; (3) NA showed conflict and mood modification was the bridge symptoms across the network, while salience and tolerance exhibited weak association with mental distress.

CONCLUSIONS

Salience and tolerance might not distinguish engaged users from problematic users. New frameworks and assessment tools focusing on the negative consequences of social media usage are needed.

Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era

Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.

Changes in cigarette consumption and intention to quit in response to the COVID-19 pandemic in China

INTRODUCTION

Significant changes occurred in the way people socialize and interact with each other since China reported its first COVID-19 cases. However, little is known about how smoking behaviors may have changed due to the COVID-19 pandemic in China. The aim of this study was to assess changes in smoking behavior and intention to quit during the early stage of the COVID-19 pandemic in China and to investigate the associated factors.

METHODS

An online cross-sectional survey was conducted among Chinese adult smokers. Participants were recruited through snowball sampling from 19 March to 2 April 2020.

RESULTS

A total of 1388 smokers participated in this study. Of those, 1014 (73.0%) reported not changing their cigarette consumption, 104 (7.5%) reported smoking more and 268 (19.3%) reported smoking less due to the pandemic. Average daily cigarette consumption among all participants decreased from 15.0 (IQR: 10.0-20.0) to 13.0 (IQR: 8.0-20.0) (W=6.919, p<0.001). For intention to quit, 270 (19.5%) respondents reported becoming more willing to quit, and 91 (6.6%) reported becoming less willing to quit. Multivariate analyses showed that tobacco addiction, overall knowledge about the relationship between smoking and COVID-19, level of attention devoted to COVID-19, anxiety, living alone, and number of smokers in the family were significantly correlated with cigarette consumption and intention to quit, and living alone was the strongest factor associated with increased cigarette consumption (AOR=5.29; 95% CI: 1.51-18.56).

CONCLUSIONS

The COVID-19 pandemic led to a slight decrease in cigarette consumption and an increase in quitting intention among Chinese smokers. During the early stages of the pandemic, it was important to focus on the anxiety of smokers, dispel smokers' misunderstandings of smoking and COVID-19 and create a supporting environment in the family to help smokers quit.

Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study

The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in California in April 2021 were held to discuss tobacco and cannabis use patterns, adverse events, and the effect of COVID-19 on tobacco and cannabis product use. Factors affecting changes in use were largely similar between tobacco products and cannabis products. Drivers of increased cannabis use distinct from tobacco or nicotine product use included feeling greater freedom to disengage and perceptions of less harm. Increases in product use were a result of changing social environment, coping with emotional and psychological distress, and product related factors. Decreases in product use were a result of social isolation, COVID-19-related health concerns, disruptions in daily patterns of living, and reduced access. Improved understanding of how the pandemic has affected tobacco and cannabis use can inform tailored interventions to both support those who have decreases or quit and assist those who have increased use during the pandemic to reduce or cease their consumption.

COVID-19 and hookah smoking cessation among women in Southern Iran: A cross-sectional study

Hookah smoking does not only transmit COVID-19 but also intensifies the symptoms of the disease. Thus, the present research aimed to explore the association between COVID-19 and hookah cessation among female smokers. The institutional-based cross-sectional study was conducted nine months after the onset of the COVID-19 pandemic. Face-to-face interviews were held between November 2020 and January 2021 to explore the pattern of hookah smoking among 561 female hookah smokers in Bandar Abbas in the south of Iran. The daily, weekly and monthly rates of hookah smoking showed a statistically significant decrease in the during COVID-19 era (p < .001). Thirteen percent of women managed to cease hookah smoking successfully during the pandemic. The odds ratio of hookah cessation was higher in single women (95% CI 1.09-5.23) as well as women with a high socioeconomic status (SES) (95% CI 4.28-24.01). It was also higher among women who initiated hookah smoking at an older age (95% CI 29-68) and among those with no hookah smoking family member (95% CI 301- 943). Fear of COVID-19 infection was the leading factor involved in hookah cessation or reduction. Entertainment was the leading barrier to successful hookah cessation behavior. It is believed that COVID-19 has directly and indirectly contributed to the reduced or ceased hookah smoking behavior. One of the reasons for the reduction of hookah smoking was the fear of aggravated symptoms and reasons for cessation included closure of coffee shops and removal of all hookahs from the city.