How has COVID-19 lockdown impacted smoking? A thematic analysis of written accounts from UK smokers

Objective. This study was designed to investigate UK smokers' accounts of impacts of COVID-19 on their smoking, to develop implications for supporting smoking cessation. Design. One hundred and thirty-two smokers aged 19-52 years (mean age 25 years), recruited through an advert distributed through social media and a dedicated Twitter page, completed an anonymous online questionnaire. Main Outcome Measures. Smokers produced written accounts of how COVID-19 had impacted their smoking. Responses were of unlimited length and completed online 22(nd) May-22(nd) June 2020 during UK COVID-19 lockdown. Results. Inductive thematic analysis generated three themes: i) increased smoking as a coping mechanism to deal with anxiety, boredom, stress, and anger in COVID-19 lockdown; ii) lockdown as enabling quitting through lifting social barriers and enabling a focus on health benefits; and iii) no change, avoiding Government/media COVID-19 information due to disbelief, lack of trust, and perceptions of bias. Conclusions. Results demonstrate a need for credible public health messaging on COVID-19 risk aimed at smokers. Implications for supporting smoking cessation are discussed, including maintaining quitting in those social smokers who quit during lockdown, and support on stress-management and emotion regulation in those who use smoking as a way to cope with stress, anger, and boredom.

Automated summary

This study investigated the impacts of COVID-19 on smoking among UK smokers and found that smoking was used as a coping mechanism for anxiety, boredom, stress, and anger during the lockdown. However, the lockdown also provided an opportunity for some smokers to quit, as it removed social barriers and allowed them to focus on the health benefits. Additionally, some smokers did not change their smoking behavior due to distrust in government and media COVID-19 information.