How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?

ABSTRACT Background Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID‐19 pandemic impacted smoking behaviors. Methods Following a preregistered plan, we accessed population‐based data from the Beh...

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Main Author: Jason Semprini
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Lifestyle Medicine
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Online Access:https://doi.org/10.1002/lim2.70005
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author Jason Semprini
author_facet Jason Semprini
author_sort Jason Semprini
collection DOAJ
description ABSTRACT Background Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID‐19 pandemic impacted smoking behaviors. Methods Following a preregistered plan, we accessed population‐based data from the Behavioral Risk Factor Surveillance System (2010–2023) to analyze three primary outcomes: (1) currently smoking, (2) number of cigarettes per day, and (3) quit smoking in the past year. Two‐way fixed effect linear regression models accounted for state‐level factors and temporal trends. Splitting each survey into an early and late wave, we identified the effect of exposure to the COVID‐19 pandemic by comparing changes in an unexposed reference group (interviewed January 1–March 20, early wave) with the changes in an exposed group (interviewed January 1–March 31, late wave). Results The sample included 1,449,112 responses, among which 12.8% were in the late wave. Baseline smoking prevalence was 15.9% in the late wave, with an average of 12.5 cigarettes smoked per day among smokers. 8.6% of the late‐wave respondents attempted to quit smoking in the past year. Overall, we found a negative 1.7% point association between the pandemic and smoking prevalence. However, among smokers, we found that the pandemic was associated with 5.1 more cigarettes smoked per day. The pandemic was also associated with a 6.3% point decline in the probability of attempting to quit smoking in the past year. While these results did not vary significantly over time, we did observe heterogeneous associations between the pandemic and smoking outcomes by socioeconomic subgroups. Conclusions Smoking prevalence continues to decline in the United States, and the pandemic appeared to have been associated with lower smoking rates. However, our results suggest that the pandemic was also associated with greater intensity and fewer quit attempts among smokers warranting greater attention from policymakers and researchers.
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spelling doaj-art-58fb3793660f4e45b037b97833fb10882025-01-27T06:15:57ZengWileyLifestyle Medicine2688-37402025-01-0161n/an/a10.1002/lim2.70005How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?Jason Semprini0Department of Public Health Des Moines University College of Health Sciences Des Moines USAABSTRACT Background Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID‐19 pandemic impacted smoking behaviors. Methods Following a preregistered plan, we accessed population‐based data from the Behavioral Risk Factor Surveillance System (2010–2023) to analyze three primary outcomes: (1) currently smoking, (2) number of cigarettes per day, and (3) quit smoking in the past year. Two‐way fixed effect linear regression models accounted for state‐level factors and temporal trends. Splitting each survey into an early and late wave, we identified the effect of exposure to the COVID‐19 pandemic by comparing changes in an unexposed reference group (interviewed January 1–March 20, early wave) with the changes in an exposed group (interviewed January 1–March 31, late wave). Results The sample included 1,449,112 responses, among which 12.8% were in the late wave. Baseline smoking prevalence was 15.9% in the late wave, with an average of 12.5 cigarettes smoked per day among smokers. 8.6% of the late‐wave respondents attempted to quit smoking in the past year. Overall, we found a negative 1.7% point association between the pandemic and smoking prevalence. However, among smokers, we found that the pandemic was associated with 5.1 more cigarettes smoked per day. The pandemic was also associated with a 6.3% point decline in the probability of attempting to quit smoking in the past year. While these results did not vary significantly over time, we did observe heterogeneous associations between the pandemic and smoking outcomes by socioeconomic subgroups. Conclusions Smoking prevalence continues to decline in the United States, and the pandemic appeared to have been associated with lower smoking rates. However, our results suggest that the pandemic was also associated with greater intensity and fewer quit attempts among smokers warranting greater attention from policymakers and researchers.https://doi.org/10.1002/lim2.70005behavior changeepidemiologynicotine replacementpublic healthsubstance abuse
spellingShingle Jason Semprini
How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
Lifestyle Medicine
behavior change
epidemiology
nicotine replacement
public health
substance abuse
title How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
title_full How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
title_fullStr How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
title_full_unstemmed How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
title_short How Did the COVID‐19 Pandemic Change Cigarette Smoking Behavior?
title_sort how did the covid 19 pandemic change cigarette smoking behavior
topic behavior change
epidemiology
nicotine replacement
public health
substance abuse
url https://doi.org/10.1002/lim2.70005
work_keys_str_mv AT jasonsemprini howdidthecovid19pandemicchangecigarettesmokingbehavior