The impact of COVID-19 on smoking patterns in Pakistan: findings from a longitudinal survey of smokers

Kamran Siddiqi; Faraz Siddiqui; Amina Khan; Saeed Ansari; Mona Kanaan; Mariam Ahmad Khokhar; Ziauddin Islam; Masuma Pervin Mishu; Linda Bauld

doi:10.1093/ntr/ntaa207

The impact of COVID-19 on smoking patterns in Pakistan: findings from a longitudinal survey of smokers

Kamran Siddiqi, Faraz Siddiqui, Amina Khan, Saeed Ansari, Mona Kanaan, Mariam Ahmad Khokhar, Ziauddin Islam, Masuma Pervin Mishu, Linda Bauld

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction We investigated the influence of COVID-19 on smoking patterns in Pakistan. Methods In a longitudnal survey, we asked cigarette smokers in Pakistan about their smoking behaviours before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health and wellbeing. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis.
Results
We recruited 6,014 smokers between September 2019 and February 2020; of these, 2,087 (2,062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2,062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020).
Conclusions
There have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. While many people stopped, reduced, or tried quitting smoking, some increased smoking, and some relapsed after quitting.

Original language	English
Journal	Nicotine & tobacco research
Early online date	8 Oct 2020
DOIs	https://doi.org/10.1093/ntr/ntaa207
Publication status	E-pub ahead of print - 8 Oct 2020

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This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

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10.1093/ntr/ntaa207

C19 and smoking behaviour.R1 (1)
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Cite this

@article{04a1c6365f2e41d283ca15d6514ccbe8,

title = "The impact of COVID-19 on smoking patterns in Pakistan: findings from a longitudinal survey of smokers",

abstract = "Introduction We investigated the influence of COVID-19 on smoking patterns in Pakistan. Methods In a longitudnal survey, we asked cigarette smokers in Pakistan about their smoking behaviours before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health and wellbeing. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis.ResultsWe recruited 6,014 smokers between September 2019 and February 2020; of these, 2,087 (2,062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2,062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020).ConclusionsThere have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. While many people stopped, reduced, or tried quitting smoking, some increased smoking, and some relapsed after quitting. ",

author = "Kamran Siddiqi and Faraz Siddiqui and Amina Khan and Saeed Ansari and Mona Kanaan and Khokhar, {Mariam Ahmad} and Ziauddin Islam and Mishu, {Masuma Pervin} and Linda Bauld",

note = "This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details. ",

year = "2020",

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doi = "10.1093/ntr/ntaa207",

language = "English",

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TY - JOUR

T1 - The impact of COVID-19 on smoking patterns in Pakistan

T2 - findings from a longitudinal survey of smokers

AU - Siddiqi, Kamran

AU - Siddiqui, Faraz

AU - Khan, Amina

AU - Ansari, Saeed

AU - Kanaan, Mona

AU - Khokhar, Mariam Ahmad

AU - Islam, Ziauddin

AU - Mishu, Masuma Pervin

AU - Bauld, Linda

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2020/10/8

Y1 - 2020/10/8

N2 - Introduction We investigated the influence of COVID-19 on smoking patterns in Pakistan. Methods In a longitudnal survey, we asked cigarette smokers in Pakistan about their smoking behaviours before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health and wellbeing. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis.ResultsWe recruited 6,014 smokers between September 2019 and February 2020; of these, 2,087 (2,062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2,062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020).ConclusionsThere have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. While many people stopped, reduced, or tried quitting smoking, some increased smoking, and some relapsed after quitting.

AB - Introduction We investigated the influence of COVID-19 on smoking patterns in Pakistan. Methods In a longitudnal survey, we asked cigarette smokers in Pakistan about their smoking behaviours before and since COVID-19. Smokers were recruited before COVID-19 using two-stage random probability sampling. Since COVID-19, three subsequent waves were conducted over the telephone, asking additional questions on social determinants, mental health and wellbeing. Based on the first two waves, we estimated the proportion of smokers who stopped, decreased, maintained, or increased smoking. We also explored any factors associated with the change in smoking patterns. In those who stopped smoking soon after COVID-19, we estimated the proportion relapsed in subsequent waves. We estimated all proportions based on complete-case analysis.ResultsWe recruited 6,014 smokers between September 2019 and February 2020; of these, 2,087 (2,062 reported smoking outcomes) were followed up in May 2020 after COVID-19. Since COVID-19, 14% (290/2,062) smokers reported quitting. Among those who continued smoking: 68% (1210/1772) reduced, 14% (239/1772) maintained, and 18% (323/1772) increased cigarette consumption; 37% (351/938) reported at least one quit attempt; 41% (669/1619) were more motivated while 21% (333/1619) were less motivated to quit. Changes in smoking patterns varied with nicotine dependence, motivation to quit, and financial stability since COVID-19. Among those reporting quitting soon after COVID-19, 39% (81/206) relapsed in the subsequent months (June-July 2020).ConclusionsThere have been significant bidirectional changes in smoking patterns since COVID-19 in Pakistan. While many people stopped, reduced, or tried quitting smoking, some increased smoking, and some relapsed after quitting.

U2 - 10.1093/ntr/ntaa207

DO - 10.1093/ntr/ntaa207

M3 - Article

SN - 1462-2203

JO - Nicotine & tobacco research

JF - Nicotine & tobacco research

ER -