| Summary: | Introduction
The perceived health risks of tobacco products may change during the
ongoing COVID-19 pandemic. This study aimed to examine the perceived risks
of tobacco use on COVID-19 infection and severity, and possible COVID-related
changes in perceptions of tobacco use and overall health.
Methods
We conducted an online survey of adults in the United States in June 2020
(n=2097). The survey covered cigarettes, cigars, e-cigarettes, and hookah. We
also assessed changes in the use of any of the four tobacco products. Multivariate
logistic regression models were used to estimate the odds of agreeing with the
perceived risks for each risk and each product, with the adjustment of demographic
and COVID-19 related variables.
Results
For all four tobacco products, the perceived risks to general health were
slightly higher during the pandemic than before the pandemic (77% vs 79.5%
for cigarettes) and the perceived risk of COVID-19 severity was larger than the
perceived risk of COVID-19 infection (73.3% vs 56.2% for cigarettes). All risk
measures varied with tobacco products consistently, with the risks highest for
cigarettes, then cigars, followed by e-cigarettes and hookah. Females and people
with higher income or education were more likely to endorse the risks of tobacco
use than their counterparts. People who perceived higher risks of using cigarettes
(OR=1.65; 95% CI: 1.20–2.27) and cigars (OR=1.63; 95% CI: 1.17–2.27) to
COVID-19 severity were more likely to have decreased or quit their use.
Conclusions
Tobacco/nicotine use was perceived to increase the risk of COVID-19
severity and the perceived risk of tobacco/nicotine use to general health was high
during the pandemic, particularly for cigarettes. The change of perceived risks
appeared to be prompting harm-reducing changes in tobacco product use.
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