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Multi-level drivers of tobacco use and purchasing behaviors during COVID-19 "lockdown": A qualitative study in the United States.

Authors
  • Giovenco, Daniel P1
  • Spillane, Torra E2
  • Maggi, Rachel M1
  • Lee, Esther Y1
  • Philbin, Morgan M1
  • 1 Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA.
  • 2 Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722W 168th St, New York, NY 10032, USA. Electronic address: [email protected]
Type
Published Article
Journal
The International journal on drug policy
Publication Date
Aug 01, 2021
Volume
94
Pages
103175–103175
Identifiers
DOI: 10.1016/j.drugpo.2021.103175
PMID: 33662811
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The COVID-19 pandemic and associated public health prevention measures (e.g., "stay at home" orders) may impact tobacco supply and demand among consumers. This qualitative study identified multi-level drivers of shifts in inhaled tobacco product use and access patterns during the initial COVID-19 "lockdown" period in the United States. Between April and May 2020, we conducted semi-structured telephone interviews (n = 44) with adults who use cigarettes and/or electronic nicotine delivery systems (ENDS). Transcripts were thematically analyzed using a socioecological framework. Nearly all participants reported changes in their product use during lockdown, though patterns varied. Increased use was most common and was predominantly driven by individual-level factors: pandemic-related anxiety, boredom, and irregular routines. Decreased use was common among social users who cited fewer interpersonal interactions and fear of sharing products. At the community level, retail access impacted cigarette and ENDS use differently. While cigarettes were universally accessible, ENDS access was more limited, driving some to purchase products online. Delayed deliveries led some ENDS users to compensate with readily-available cigarettes. To mitigate ways that the COVID-19 pandemic may exacerbate an existing public health crisis, multi-level policy strategies, such as expanded virtual cessation services and implementation and enforcement of smoke-free home rules, can better support population health during this critical period. Policies that facilitate access to lower risk products can help minimize harm among those who cannot or do not want to quit smoking. Copyright © 2021. Published by Elsevier B.V.

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