People may have smoked less during the pandemic

Regular smokers in Denmark bought fewer cigarettes during the initial phase of the COVID-19 pandemic than before, according to a study published earlier this month in Communication medicine.

Dr. Sally Sadoff

“We see this as a potential bright spot for the pandemic,” said Sally Sadoff, PhD, an economist at the University of California, San Diego, who led the study. Falling pandemic-era smoking among the most frequent smokers should lead to long-term health improvements, she said.

Sadoff said researchers and clinicians are concerned that the added stress of living through a pandemic could cause an increase in smoking. This happened for social smokers. But for regular smokers, who face greater health risks from COVID-19 and in general, the opposite was true.

Other countries have seen an increase in smoking during the pandemic, so the new findings are encouraging, said Hilary Tindle, MD, MPH, founding director of the Vanderbilt Center for Tobacco, Addiction and Lifestyle at Vanderbilt University Medical Center, Nashville , Tennessee.

“Everybody was in the opposite direction, so that’s great,” said Tindle, who wasn’t involved in the final work. She co-authored a 2021 study that showed some smokers in the United States smoked more during the pandemic even though they were aware of the risks of COVID-19 for smokers.

Tracking with an app

Sadoff and his colleagues analyzed data on cigarette purchases by more than 4,000 Danes in 2019 (before the pandemic) and 2020 (during the pandemic). The data comes from smartphone apps that anonymously track purchases in Danish grocery stores. The data allowed researchers to explore changes in individual shopping habits. They were unable to identify by name who purchased cigarettes.

If a shopper bought an average of at least one cigarette a day in 2019, the researchers considered that person a regular smoker. Anyone with a lower average was an occasional smoker and anyone who did not buy cigarettes at all was a non-smoker. By these standards, before the pandemic, 76% of the sample were non-smokers, 16% were occasional smokers and 8% were regular smokers, according to the researchers.

Sadoff and his colleagues estimate that in 2020―the first year of the pandemic―regular smokers purchased cigarettes 30% less often than in 2019 and purchased 20% fewer cigarettes each time they added cigarettes to their diet. their grocery cart. Occasional smokers, on the other hand, bought cigarettes at the same rate as before and tended to buy slightly more cigarettes after the start of the pandemic. People who were non-smokers before the pandemic stayed that way.

“Our story demonstrates the importance of shopping data that tracks people at the individual level before and during the pandemic,” Sadoff said, noting that other studies of smoking behavior during the pandemic rely on self-reports, which may be less reliable.

The Danish study has limitations. It only tracked cigarette purchases at grocery stores, not convenience stores, so some purchases were likely missed. On the other hand, Sadoff said, cartons of cigarettes purchased at a grocery store are for household use rather than individual use, which may overestimate the number of cigarettes people buy for themselves.

The researchers also compared how often regular smokers quit completely in 2019 and 2020 by identifying people who bought cigarettes in the first 10 weeks of either year but didn’t. never bought again during the rest of the year. Some people continued to buy after this 10th week but eventually stopped; by mid-2020, 10% more regular smokers had quit than before the pandemic.

“The sustained decline in purchases and abandonments suggests that these behaviors may persist over the long term, which could lead to long-term improvements in health,” Sadoff said.

Sadoff and his colleagues were unable to study how many people may have switched from traditional cigarettes to alternatives, such as e-cigarettes, because their dataset does not include this information. Tindle noted that while it’s always best not to smoke at all, switching to e-cigarettes could still be beneficial.

“We know that any non-combustible tobacco is better than combustible tobacco,” Tindle said. “So that would potentially be useful for public health.”

Sadoff and Tindle have disclosed no relevant financial relationship.

Common Med. Published online August 2, 2022. Full text

Marcus A. Banks, MA, is a New York-based journalist who covers health news with a focus on new cancer research. His work appears in Medscape, Cancer Today, The Scientist, Gastroenterology & Endoscopy News, Slate, TCTMD and Spectrum.

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