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Nakkash R, Tleis M, Khalil J, Romani M, Salloum RG. A qualitative study on tobacco use during the COVID-19 pandemic in Lebanon: Waterpipe and cigarette smokers' views, risk perceptions, and behaviors. Tob Prev Cessat 2024; 10:TPC-10-27. [PMID: 38938265 PMCID: PMC11209738 DOI: 10.18332/tpc/189770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/26/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic. METHODS We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically. RESULTS The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking. CONCLUSIONS Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19.
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Affiliation(s)
- Rima Nakkash
- Global and Community Health Department, College of Public Health, George Mason University, Fairfax, Virginia, United States
| | - Malak Tleis
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Joanna Khalil
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Maya Romani
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, United States
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Wang H, Feng Z, Zheng Z, Yang J. Chinese undergraduates' mental health help-seeking behavior: the health belief model. Front Psychol 2024; 15:1377669. [PMID: 38817829 PMCID: PMC11137748 DOI: 10.3389/fpsyg.2024.1377669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/03/2024] [Indexed: 06/01/2024] Open
Abstract
The detection rate of mental health problems among undergraduates has recently risen significantly. However, undergraduates underutilize mental health services; approximately a third only of undergraduates in need of treatment use school counseling resources. Based on a social psychological theoretical framework, the health belief model, factors of undergraduates' willingness to seek help when dealing with psychological problems were investigated. A cross-sectional online questionnaire and a snowball sampling method with 446 undergraduates investigated perceived susceptibility, perceived severity, perceived behavioral benefits, perceived barriers, self-efficacy, and cues to action to understand how students' mental health-seeking behaviors are affected. We found that perceived susceptibility (p < 0.01), perceived severity (p < 0.01), perceived benefits (p < 0.01), perceived barriers (p < 0.01), self-efficacy (p < 0.01), and cues to action (p < 0.01) significantly correlated with behavioral intention. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help. In addition, we used a bias-corrected Bootstrap approach to test the significance of the mediating effect, the mediation effect of cues to action between undergraduates' perceived susceptibility and mental health help-seeking behavior was utterly significant [mediation effect value of 0.077, with an SE value of 0.027 and a 95% CI (0.028, 0.133)]. It demonstrated that those who perceived themselves to be at high risk of developing a mental illness and who had received encouragement or counseling to seek mental health help were more likely to be motivated to seek mental health help. Multiple regression analyses indicated that self-efficacy (Z = 5.425, p < 0.01) and cues to action (Z = 6.673, p < 0.01) independently influenced behavioral intentions. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help.
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Affiliation(s)
| | - Zhuowen Feng
- College of Literature and News Communication, Guangdong Ocean University, Zhanjiang, Guangdong, China
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Andersen AJ, Wallez S, Melchior M, Mary-Krause M. Our perception may not be reality: A longitudinal study of the relationship between perceived and actual change in smoking behavior. PLoS One 2024; 19:e0301515. [PMID: 38557563 PMCID: PMC10984459 DOI: 10.1371/journal.pone.0301515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Results of the impact of lockdowns and stay-at-home orders during the COVID-19 pandemic on changes in cigarette smoking are mixed. Previous studies examining smoking changes during the early stages of the pandemic in 2020 have mainly focused on smoker's perception of changes in cigarette consumption. Such measure has not been widely used in other contexts, and therefore we aim to compare the discrepancy between smokers' perceived changes in cigarette smoking and the actual change in the number of cigarettes smoked, using repeated measurements. METHODS We included 134 smokers from the French TEMPO cohort with repeated measurements of their perceived changes in smoking habits during the first phase of the COVID-19 pandemic and the number of cigarettes smoked repeatedly from March to May 2020. We used generalized estimation equations (GEE) to examine the association between changes in the number of cigarettes smoked and the odds of mismatched answers. RESULTS The results suggest that at each study wave, 27-45% of participants provided mismatching answers between their perceived change in smoking habits and the actual change in the number of cigarettes smoked daily, measured repeatedly. Results from GEE analysis demonstrated that a mismatching assessment of smoking behavior was elevated among those who had an increase (OR = 2.52 [1.37;4.65]) or a decrease (OR = 5.73 [3.27;10.03]) in number of cigarettes smoked. DISCUSSION Our findings highlight the possibility of obtaining different results depending on how changes in tobacco smoking are measured. This highlights the risk of underestimating the actual changes in cigarette smoking during the COVID-19 pandemic, but also more generally when validating public health interventions or smoking cessation programs. Therefore, objective measures such as the actual consumption of psychoactive substances should be utilized, preferably on a longitudinal basis, to mitigate recall bias.
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Affiliation(s)
- Astrid Juhl Andersen
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Solène Wallez
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Maria Melchior
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
| | - Murielle Mary-Krause
- INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Equipe de Recherche en Epidémiologie Sociale, ERES, Sorbonne Université, Paris, France
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Halliday DM, Epperson AE, Gonzalez M, Song AV. Perceptions of COVID-related risks among people who smoke: A mediation model. Prev Med Rep 2023; 33:102205. [PMID: 37193534 PMCID: PMC10106784 DOI: 10.1016/j.pmedr.2023.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
The COVID-19 pandemic provides both reasons to quit smoking as well as stress that may promote increased cigarette consumption. Perceptions of COVID-19 risk related to smoking may motivate cessation among smokers. At the same time, other evidence shows that affective perceptions (i.e., worry) could lead to increased smoking as a coping mechanism. Using a sample drawn from a rural region of California (N = 295), we examined the relationship between perceptions about health risks for smokers during the pandemic and both reported increases in smoking frequency and intentions to quit smoking. We also examined whether worry about health risks mediated these relationships. High perceived risk was associated both with reported increases in smoking frequency as well as greater intentions to quit smoking. Worry partially mediated both these relationships, with worry accounting for 29.11% of the variance in the relationship between high risk perceptions and increased smoking as well as 20.17% of the relationship between risk perceptions and intentions to quit smoking. These findings suggest that while smokers' awareness about their increased risk of COVID-19 can motivate intent to quit smoking in the future, smokers may require greater support to act on these intentions.
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Affiliation(s)
- Deanna M. Halliday
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Anna E. Epperson
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Mariaelena Gonzalez
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
- Department of Public Health, University of California, Merced, United States
| | - Anna V. Song
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
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Wharton MK, Islam S, Abadi MH, Pokhrel P, Lipperman-Kreda S. COVID-19 Restrictions and Adolescent Cigarette and E-cigarette Use in California. Am J Prev Med 2023; 64:385-392. [PMID: 36347663 PMCID: PMC9636984 DOI: 10.1016/j.amepre.2022.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Shelter-in-place orders altered facilitators and barriers to tobacco use (e.g., outlet closures, restricted social gatherings). This study examined whether the duration of time in shelter in place and compliance with different shelter-in-place orders influenced adolescent cigarette and E-cigarette use and how the use may differ by demographic characteristics. METHODS Shelter-in-place policy data obtained from government websites were merged with cross-sectional 2020 survey data on adolescents in California. Treatment variables included the proportion of time in shelter in place and self-reported compliance with shelter-in-place orders (for essential businesses and retail spaces and social and outdoor contexts). Multilevel logit models for dichotomous past 6-month cigarette and E-cigarette use and multilevel negative binomial regression models for past 6-month frequency of use were used. Moderation analyses were conducted on demographic measures. The sample included 1,196 adolescents (mean age=15.8 years, age range=13-19 years, 49.2% female, 50.0% White). Analyses were conducted in 2022. RESULTS No associations were found between the proportion of time in shelter in place and outcomes. Shelter-in-place compliance with essential business and retail space orders was associated with lower odds of using cigarettes and E-cigarettes in the past 6 months. Compliance with social and outdoor context-related orders were associated with lower odds of using E-cigarettes and fewer days using cigarettes and E-cigarettes. Being aged ≥18 years moderated the associations between essential business/retail space and social/outdoor context-related shelter-in-place compliance orders and past 6-month frequency of cigarette smoking. CONCLUSIONS Findings support tailored interventions for less compliant and older adolescents for future pandemic mitigation measures.
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Affiliation(s)
- M Kristina Wharton
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California; School of Public Health, University of California, Berkeley, Berkeley, California.
| | - Sabrina Islam
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California; School of Public Health, University of California, Berkeley, Berkeley, California
| | - Melissa H Abadi
- Pacific Institute for Research and Evaluation, Louisville, Kentucky
| | - Pallav Pokhrel
- University of Hawai'i Cancer Center, University of Hawai'i, Honolulu, Hawaii
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
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Reed BW, Brody AL, Sanavi AY, Doran N. Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1153. [PMID: 36673907 PMCID: PMC9859008 DOI: 10.3390/ijerph20021153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
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.
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Affiliation(s)
- Brandon W. Reed
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Arthur L. Brody
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Andre Y. Sanavi
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Neal Doran
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
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Bahri N, Mardani F, Sharifi N, Dashti S. Predicting factors for breast cancer screening in Middle Eastern women based on health belief model: a systematic review. J Egypt Natl Canc Inst 2022; 34:50. [DOI: 10.1186/s43046-022-00150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/14/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Background
Breast cancer screening can reduce mortality and improve the quality of life in affected women. The present study aimed to determine the predictive factors of breast cancer screening in Iranian women based on the health belief model (HBM).
Methods
This review was conducted by searching electronic databases of Google Scholar; electronic databases, including Scopus, PubMed/MEDLINE, Cochrane Library, Web of Science, ProQuest, Embase, and Google scholar Magiran; and SID with the English keywords of “breast cancer,” “mammography,” “health belief model,” and “breast self-exam” and the equivalent Persian keywords. The results were evaluated based on the health belief model (HBM) constructs. Articles were evaluated for quality and the findings were extracted and reviewed.
Results
A total of 8 relevant articles were selected for review. Women’s awareness of breast cancer screening methods was moderate in two studies and poor in two other studies. Among the constructs of HBM, knowledge, perceived susceptibility, perceived severity, perceived benefits, and action plan were poor in the majority of the studies, while perceived barriers, cues to action, and self-efficacy were mainly good.
Conclusion
Considering the observed weakness of many HBM constructs, it is recommended that special attention be given to all HBM constructs in implementing HBM-based education programs.
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Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study. Addict Behav Rep 2022; 16:100470. [PMCID: PMC9661417 DOI: 10.1016/j.abrep.2022.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Akbayram HT, Dogru S. Smoking and smoking addiction in future physicians during the COVID-19 pandemic; an example of a medical school in Turkey. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2124547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Hatice Tuba Akbayram
- Department of Family Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkiye
| | - Sibel Dogru
- Department of Pulmonary Disease, Gaziantep University Faculty of Medicine, Gaziantep, Turkiye
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Benowitz NL, Goniewicz ML, Halpern-Felsher B, Krishnan-Sarin S, Ling PM, O'Connor RJ, Pentz MA, Robertson RM, Bhatnagar A. Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research. THE LANCET. RESPIRATORY MEDICINE 2022; 10:900-915. [PMID: 35985357 PMCID: PMC9381032 DOI: 10.1016/s2213-2600(22)00182-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 01/27/2022] [Accepted: 05/03/2022] [Indexed: 01/11/2023]
Abstract
Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings of peer-reviewed, published studies relating tobacco product use to SARS-CoV-2 infection and COVID-19 outcomes, with most studies focusing on cigarette smoking in adults. Findings pertaining to the effects of tobacco product use on the incidence of SARS-CoV-2 infection are inconsistent. However, evidence supports a role for cigarette smoking in increasing the risk of poor COVID-19 outcomes, including hospital admission, progression in disease severity, and COVID-19-related mortality. We discuss the potential effects of tobacco use behaviour on SARS-CoV-2 transmission and infection, and highlight the pathophysiological changes associated with cigarette smoking that could promote SARS-CoV-2 infection and increased disease severity. We consider the biological mechanisms by which nicotine and other tobacco product constituents might affect immune and inflammatory responses to SARS-CoV-2 infection. Finally, we identify current knowledge gaps and suggest priorities for research to address acute and post-acute health outcomes of COVID-19 during and after the pandemic.
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Affiliation(s)
- Neal L Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | | | - Pamela M Ling
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Rose Marie Robertson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aruni Bhatnagar
- Department of Medicine, University of Louisville, Louisville, KY, USA.
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Liu H, Lai G, Shi G, Zhong X. The Influencing Factors of HIV-Preventive Behavior Based on Health Belief Model among HIV-Negative MSMs in Western China: A Structural Equation Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10185. [PMID: 36011822 PMCID: PMC9407807 DOI: 10.3390/ijerph191610185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/07/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Men who have sex with other men (MSMs) are at high risk of being infected by the human immunodeficiency virus (HIV) in western China. Pre-exposure prophylaxis (PrEP) is an efficient way to prevent HIV transmission. However, adherence is the most vital determinant factor affecting PrEP effectiveness. We conducted a study based on the Health Belief Model to explore factors that predict adherence to PrEP among a cohort of 689 MSMs in western China. (2) Methods: We assessed perceived susceptibility, severity, benefits, barriers, self-efficacy, cues to action, and HIV-preventive behavior through a cross-sectional survey. (3) Results: PrEP self-efficacy was directly associated with PrEP behaviors (β = 0.221, p < 0.001), cues to action were directly associated with PrEP behaviors (β = 0.112, p < 0.001), perceived benefits were directly associated with PrEP behaviors (β = 0.101, p < 0.001), and perceived susceptibility was directly associated with PrEP behaviors (β = 0.117, p = 0.043). (4) Conclusion: Medication self-efficacy, perceived susceptibility, and cue to action structures are predictors of the MSMs’ HIV-preventive behavior in western China. These results will provide theoretical plans for promoting PrEP adherence in MSMs.
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Anyanwu P, Moriarty Y, McCutchan G, Grozeva D, Goddard M, Whitelock V, Cannings-John R, Quinn-Scoggins H, Hughes J, Gjini A, Hepburn J, Osborne K, Robling M, Townson J, Waller J, Whitaker KL, Brown J, Brain K, Moore G. Health behaviour change among UK adults during the pandemic: findings from the COVID-19 cancer attitudes and behaviours study. BMC Public Health 2022; 22:1437. [PMID: 35902822 PMCID: PMC9332100 DOI: 10.1186/s12889-022-13870-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 related lockdowns may have affected engagement in health behaviours among the UK adult population. This prospective observational study assessed socio-demographic patterning in attempts to change and maintain a range of health behaviours and changes between two time points during the pandemic. METHODS Adults aged 18 years and over (n = 4,978) were recruited using Dynata (an online market research platform) and the HealthWise Wales platform, supplemented through social media advertising. Online surveys were conducted in August/September 2020 when lockdown restrictions eased in the UK following the first major UK lockdown (survey phase 1) and in February/March 2021 during a further national lockdown (survey phase 2). Measures derived from the Cancer Awareness Measure included self-reported attempts to reduce alcohol consumption, increase fruit/vegetable consumption, increase physical activity, lose weight and reduce/stop smoking. Multivariable logistic regressions were used to assess individual health behaviour change attempts over time, adjusted for age, sex, ethnicity, employment and education. RESULTS Around half of participants in survey phase 1 reported trying to increase physical activity (n = 2607, 52.4%), increase fruit/vegetables (n = 2445, 49.1%) and lose weight (n = 2413, 48.5%), with 19.0% (n = 948) trying to reduce alcohol consumption among people who drink. Among the 738 participants who smoked, 51.5% (n = 380) were trying to reduce and 27.4% (n = 202) to stop smoking completely. Most behaviour change attempts were more common among women, younger adults and minority ethnic group participants. Efforts to reduce smoking (aOR: 0.98, 95% CI: 0.82-1.17) and stop smoking (aOR: 0.98, 95% CI: 0.80-1.20) did not differ significantly in phase 2 compared to phase 1. Similarly, changes over time in attempts to improve other health behaviours were not statistically significant: physical activity (aOR: 1.07; 95% CI: 0.99-1.16); weight loss (aOR: 0.95; 95% CI: 0.90-1.00); fruit/vegetable intake (aOR: 0.98, 95% CI: 0.91-1.06) and alcohol use (aOR: 1.32, 95% CI: 0.92-1.91). CONCLUSION A substantial proportion of participants reported attempts to change health behaviours in the initial survey phase. However, the lack of change observed over time indicated that overall motivation to engage in healthy behaviours was sustained among the UK adult population, from a period shortly after the first lockdown toward the end of the second prolonged lockdown.
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Affiliation(s)
- Philip Anyanwu
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK.
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
| | | | - Grace McCutchan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Mark Goddard
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Harriet Quinn-Scoggins
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Ardiana Gjini
- Public Health Wales, Cardiff, UK
- Cardiff University, Cardiff, UK
| | - Julie Hepburn
- Public Involvement Community, Health and Care Research Wales Support Centre, Cardiff, UK
| | | | - Michael Robling
- Centre for Trials Research, Cardiff University, Cardiff, UK
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Julia Townson
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Kate Brain
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Graham Moore
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), School of Social Sciences, Cardiff University, Cardiff, UK
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Phetphum C, Prajongjeep A, Keeratisiroj O, Thawatchaijareonying K. Communication intervention to improve perceived threat of smoking-related COVID-19 and intentions to quit smoking during the COVID-19 pandemic in Thailand. Tob Induc Dis 2022; 20:66. [PMID: 35949929 PMCID: PMC9310059 DOI: 10.18332/tid/150363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smokers are more likely to be at risk of developing severe COVID-19. This study aimed to develop and evaluate the effect of a communication intervention for enhancing perceived threat of coronavirus 19 (COVID-19) infection associated with smoking and examine intentions to quit smoking among smokers during the COVID-19 pandemic in Thailand. METHODS This study was of experimental design. The sample was 427 eligible smokers who were living in Kosumphi Nakhon district. They were either assigned to the intervention group (233) or control group (194). The intervention group received the communication intervention, developed based on the Health Belief Model (HBM), including education online, motivation via social networks, and communication through local mass media. The difference in mean scores between the two groups was examined using an independent t-test. Regression models were fitted to explore the factors associated with the improvement score of intention to quit smoking. RESULTS The participants in the intervention group who received the communication intervention had a significantly higher mean score of perceived threats of smoking-induced COVID-19 (effect size=0.518, p<0.001) and had a significantly higher mean score of intentions to quit smoking (effect size=0.717, p<0.001) than in the control group. However, the number of e-cigarettes smoked per day between-groups was not significantly different (p=0.532). In the regression analysis, factors that significantly associated with the improvement score of intentions to quit smoking, included female gender (p=0.002), addicted to nicotine score (p<0.001), intervention group (p=0.010), and the improvement score of perceived threats (p=0.026). CONCLUSIONS This community-based communication intervention could enhance the perceived threats of smoking-induced COVID-19 and increased the intentions to quit smoking among the smokers. However, further research to track the success rate of smoking cessation is still needed.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health Phitsanulok, Phitsanulok, Thailand
| | - Orawan Keeratisiroj
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Fucito LM, Bold KW, Cannon S, Serrantino A, Marrero R, O’Malley SS. Cigarette Smoking in Response to COVID-19: Examining Co-Morbid Medical Conditions and Risk Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8239. [PMID: 35886090 PMCID: PMC9317071 DOI: 10.3390/ijerph19148239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
Abstract
During the initial wave of the Coronavirus Disease 2019 (COVID-19) pandemic in the U.S., information was mixed about the relative COVID-19 risks and potential benefits associated with cigarette smoking. Therefore, we sought to understand individual differences in the impact of COVID-19 on cigarette smoking in a sample of adults who reported recent use, with a particular focus on chronic medical conditions likely associated with increased COVID-19 risk. Participants completed an online survey of smoking behavior, demographic variables, medical history, and COVID-19 risk perceptions between July and August 2020 (N = 286). We examined whether medical conditions, COVID-19 risk perceptions and/or demographic characteristics were related to smoking changes in response to the pandemic (i.e., no change, decrease, increase) using multinomial logistical regression. Younger age, higher COVID-19 risk perceptions and Black versus White race were associated with greater odds of decreased smoking compared to no smoking change. Moreover, having at least one chronic medical condition was associated with greater odds of increased smoking relative to no change. The results have important implications for tobacco cessation treatment and preventive healthcare during the ongoing COVID-19 pandemic and other public health threats.
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Affiliation(s)
- Lisa M. Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
- Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA
- Smilow Cancer Hospital at Yale-New Haven, New Haven, CT 06519, USA
| | - Krysten W. Bold
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
- Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Sydney Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
| | - Alison Serrantino
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
| | - Rebecca Marrero
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
| | - Stephanie S. O’Malley
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA; (K.W.B.); (S.C.); (A.S.); (R.M.); (S.S.O.)
- Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA
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Shircliff K, Liu M, Prestigiacomo C, Fry M, Ladd K, Gilbert MK, Rattermann MJ, Cyders MA. Mixed methods prospective findings of the initial effects of the U.S. COVID-19 pandemic on individuals in recovery from substance use disorder. PLoS One 2022; 17:e0270582. [PMID: 35776699 PMCID: PMC9249176 DOI: 10.1371/journal.pone.0270582] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
The beginning of the U.S. COVID-19 pandemic interrupted integral services and supports for those in recovery from substance use disorders. The current study used qualitative and quantitative data to identify 1) pandemic-related barriers/stressors, 2) coping strategies employed, and 3) how the stressors and strategies predicted subsequent substance use frequency. Participants were 48 adults (40.5% female; 90.2% White) between 26 and 60 years old (M = 42.66, SD = 8.44) who were part of a larger, multi-year longitudinal study of individuals in recovery from substance use disorders. Individuals completed two interviews, one during the six weeks of initial stay-at-home orders in the state in which data were collected and the second within six to twelve months of their initial interview. Common barriers to recovery included cancelled support meetings, changes in job format (i.e., being fired or furloughed), and lack of social support. Common coping strategies included self-care, leisure activities/hobbies, taking caution against exposure, and strengthening personal relationships. The relationship between cravings at baseline and substance use at follow up was stronger for those who experienced worsening of their mental health (B = 21.80, p < .01) than for those who did not (B = 5.45, p = 0.09), and for those who were taking caution against exposure (B = 24.57, p < .01) than for those who were not (B = 1.87, p = 0.53). Those who engaged in self-care (B = 0.00, p>.99) had lower rates of substance use at follow-up than those who did not employ self-care as a coping mechanism (B = 16.10, p < .01). These findings inform research priorities regarding prospective effects of the pandemic on treatment endeavors, particularly emphasizing treating mental health and encouraging self-care strategies.
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Affiliation(s)
- Katherine Shircliff
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Melissa Liu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Christiana Prestigiacomo
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
| | - Melissa Fry
- Department of Sociology, Indiana University Southeast, Indianapolis, Indiana, United States of America
| | - Kevin Ladd
- Department of Psychology, Indiana University South Bend, Indianapolis, Indiana, United States of America
| | | | - Mary Jo Rattermann
- Research & Evaluation Resources LLC, Indianapolis, Indiana, United States of America
- Community Fairbanks Recovery Center, Indianapolis, Indiana, United States of America
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States of America
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Wang X, Ma Z, Wang C. A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105979. [PMID: 35627516 PMCID: PMC9141667 DOI: 10.3390/ijerph19105979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China;
| | - Zaifei Ma
- School of Statistics, Renmin University of China, Beijing 100872, China;
| | - Chunan Wang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beihang Hangzhou Innovation Institute Yuhang, Hangzhou 310023, China
- MoE Key Laboratory of Complex System Analysis and Management Decision, Beijing 100191, China
- Correspondence:
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Bennett B, Romm KF, Berg CJ. Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors. Tob Prev Cessat 2022; 8:18. [PMID: 35601562 PMCID: PMC9074834 DOI: 10.18332/tpc/148245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION COVID-19 impacted cigarette and e-cigarette use behaviors among some individuals. This study examined COVID-19 factors and prior substance use as predictors of cigarette and e-cigarette cessation and initiation among US young adults from before to during the COVID-19 pandemic. METHODS We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas. We examined COVID-19 news exposure, perceived smoking and e-cigarette use risk, and prior substance use, as predictors of cigarette and e-cigarette cessation and initiation, respectively. RESULTS Of W3 cigarette users (n=516), 37.8% (n=195) quit cigarettes at W5; predictors of cessation included younger age, fewer days of W3 past-month cigarette use, and no W3 e-cigarette use. Of W3 e-cigarette users (n=687), 38.7% (n=266) quit e-cigarettes at W5; predictors included greater COVID-19 news exposure, fewer days of W3 past-month e-cigarette use, and no W3 cigarette use. Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. CONCLUSIONS These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions.
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Affiliation(s)
- Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Katelyn F. Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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Willingness of the Jordanian Population to Receive a COVID-19 Booster Dose: A Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10030410. [PMID: 35335042 PMCID: PMC8950968 DOI: 10.3390/vaccines10030410] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 (COVID-19) vaccines are critical for containing serious infections. However, as COVID-19 evolves toward more transmissible varieties and serum antibody levels in vaccinated persons steadily decline over time, the likelihood of breakthrough infections increases. This is a cross-sectional study based on an online questionnaire for Jordanian adults (n = 915) to determine how individuals who have finished the current vaccination regimen feel about a prospective COVID-19 booster shot and what factors might influence their decision. Almost half of the participants (44.6%) intended to get the booster dose of the COVID-19 vaccine. The most frequently mentioned reasons for participants’ reluctance to get the COVID-19 vaccine booster dose were “The benefits of booster dose have not been scientifically proven” (39.8%), followed by “I took the last dose a short time ago, and there will be no need to take the booster dose for at least a year” (24.6%). In turn, “I was infected with COVID-19; thus, I do not require the booster dose” was the least reported reason (13.1%). These findings highlight the considerable hesitancy toward COVID-19 booster immunization among Jordanians, as well as the variables associated with vaccine hesitancy and the most frequently mentioned reasons for hesitancy, which will aid in creating excellent campaigns regarding booster doses.
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Zhang H, Zhuang M, Cao Y, Pan J, Zhang X, Zhang J, Zhang H. Social Distancing in Tourism Destination Management during the COVID-19 Pandemic in China: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111223. [PMID: 34769741 PMCID: PMC8583034 DOI: 10.3390/ijerph182111223] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 01/02/2023]
Abstract
While protective measures in response to infectious diseases may reduce the freedom of tourists (regarding their behaviors), few studies have documented the effects of destination protective measures on the self-protective behaviors of tourists. By applying the protection motivation theory, this study examines the effects of perceived destination protective supports on the social distancing intentions of tourists during the COVID-19 pandemic. The results reveal significant relationships among perceived destination support, coping appraisal, threat appraisal, and the social distancing intentions of tourists. Moreover, two cognitive appraisals—toward the pandemic—partially mediate the relationship between perceived destination support and social distancing intention, and this mediational process is ‘intervened’ with by social norms. This has implications on whether tourist destinations apply more rigorous social distancing polices during the COVID-19 pandemic, to enhance the coping confidence behaviors of tourists, without causing anxiety and fear, and to achieve the goal of enhancing tourists’ intentions to protect themselves.
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High Perceived Susceptibility to and Severity of COVID-19 in Smokers Are Associated with Quitting-Related Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010894. [PMID: 34682641 PMCID: PMC8535969 DOI: 10.3390/ijerph182010894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/19/2022]
Abstract
A growing body of evidence shows smoking is a risk factor for coronavirus disease (COVID-19). We examined the associations of quitting-related behaviors with perceived susceptibility to and severity of COVID-19 in smokers. We conducted a telephone survey of 659 community-based adult smokers (81.7% male) in Hong Kong, where there was no lockdown. Exposure variables were perceptions that smoking can increase the risk of contracting COVID-19 (perceived susceptibility) and its severity if infected (perceived severity). Outcome variables were quit attempts, smoking reduction since the outbreak of the pandemic, and intention to quit within 30 days. Covariates included sex, age, education, heaviness of smoking, psychological distress, and perceived danger of COVID-19. High perceived susceptibility and severity were reported by 23.9% and 41.7% of participants, respectively. High perceived susceptibility was associated with quit attempts (prevalence ratio (PR) 2.22, 95% CI 1.41–3.49), smoking reduction (PR 1.75, 95% CI 1.21–2.51), and intention to quit (PR 2.31, 95% CI 1.40–3.84). Perceived severity of COVID-19 was associated with quit attempts (PR 1.64, 95% CI 1.01–2.67) but not with smoking reduction or intention to quit. To conclude, the perceived susceptibility to and severity of COVID-19 in smokers were associated with quitting-related behaviors in current smokers, which may have important implications for smoking cessation amid the pandemic.
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