There was a decrease in serious smoking cessation activity among U.S. adults during the COVID-19 pandemic, according to a study in JAMA Network Open. This decreased activity remained depressed for more than a year, indicating a need for health care workers to reengage smokers and assist them in quit attempts.
The study was conducted using 2011-2020 data on 788,008 individuals from the Behavioral Risk Factor Surveillance System survey who had smoked in the past year. Self-reported quit attempt were reported by current smokers who reported that they stopped smoking for more than 1 days during the past 12 months.
For the first time since 2011, the annual past-year quit attempt prevalence decreased from 2019 to 2020 from 65.2% to 63.2%. The researchers noted that the largest relative decreases were among people aged 45 to 64 (61.4% to 57.7%), those with two or more comorbidities (67.1% vs. 63.0%), and Black individuals (72.5% vs. 68.4%).
“These findings suggest an immediate decrease in serious quitting activity among US smokers after the COVID-19 pandemic onset, a decrease that persisted throughout 2020,” the researchers wrote.
The researchers also looked at changes in sales volumes of nicotine gum, lozenge, and patch brands before and during the pandemic. The observed mean four-week nicotine replacement therapy (NRT) sales volume pre-pandemic was 105.6 million gum pieces, 51.9 million lozenges, and 2.0 million patches. Compared with what was expected, the observed sales during the pandemic were lower by 13.0% for lozenges, 6.4% for patches, and 1.2% for gum. The deficit in lozenges sales persisted the longest.
“NRT sales results suggest a continuation of this trend in 2021 quarter 1 but potentially a return to expected levels in 2021 quarter 2 based on NRT gum and patch sales,” the researchers wrote. “These findings are consistent with a report of a sustained decrease in cessation assistance calls to state quit lines from 2020 quarter 2 to 2021 quarter 1, followed by an increase in 2021 quarter 2.”
The researchers noted several limitations to the study, including the fact that NRT sales data is only a proxy for consumption, and the data did not include all states, online sales, or sales in health care settings.
They suggest that decreases in quit attempts may be due to COVID-19 related stress coping or health care disruptions that reduced access to cessation treatments.
Based on these results, there is an “urgent need to reengage smokers in evidence-based quitting strategies, especially among individuals experiencing disproportionately negative outcomes during the pandemic.”