ArticleThe International journal on drug policy2021
Multi-level drivers of tobacco use and purchasing behaviors during COVID-19 "lockdown": A qualitative study in the United States.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Impact of COVID-19 lockdown on smoking and vaping: systematic review and meta-analysis.Public health · 2023Pooled it
- Multilevel geographic determinants of smoking and smokeless tobacco use among young men in India: evidence for targeted addiction prevention policies.Addictive behaviors reports · 2026Article
- Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland.Tobacco control · 2025Article
- Depression and anxiety mediate the relationship between COVID-19 stay-at-home orders and tobacco and marijuana use.PloS one · 2025Article
- Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians.Human resources for health · 2024Article
- Associations of U.S. state-level COVID-19 policies intensity with cannabis sharing behaviors in 2020.Harm reduction journal · 2024Article
- Noncigarette Tobacco Product Use Among Smoking-Susceptible and Nonsusceptible Adolescent Never Smokers, 2009-2021.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Article
- Our perception may not be reality: A longitudinal study of the relationship between perceived and actual change in smoking behavior.PloS one · 2024Article
- Association of tobacco purchasing behaviors with tobacco use by user groups during the COVID-19 pandemic: A mixed methods analysis.PloS one · 2024Article
- A qualitative study on tobacco use during the COVID-19 pandemic in Lebanon: Waterpipe and cigarette smokers' views, risk perceptions, and behaviors.Tobacco prevention & cessation · 2024Article
- Changes in prevalence and sociodemographic correlates of tobacco and nicotine use in Finland during the COVID-19 pandemic.European journal of public health · 2023Article
- A qualitative study on the influence of COVID-19 on smoking behaviors through changing social and physical contexts.Health education research · 2023Article
- Differences in demographics and behaviors across two web-based survey platforms: Observations from a study of risk perceptions of heated tobacco products (HTPs).Preventive medicine reports · 2023Article
- Smokeless Tobacco Use and Cessation Attempts during COVID-19 Lockdown: A Qualitative Study.Asian Pacific journal of cancer prevention : APJCP · 2023Article
- Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities.International journal of environmental research and public health · 2023Review
- Substance Use From Social Distancing and Isolation by US Nativity During the Time of COVID-19: Cross-sectional Study.JMIR public health and surveillance · 2023Article
- The Impact of the Covid-19 Pandemic on Smoking Among Vulnerable Populations.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- "I'm Bored and I'm Stressed": A Qualitative Study of Exclusive Smokers, ENDS Users, and Transitioning Smokers or ENDS Users in the Time of COVID-19.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- Alcohol, nicotine, and COVID-19: A retrospective study of health outcomes in central Pennsylvania.Brain research bulletin · 2023Article
- Exposure to IQOS ads and reduced exposure claims, and association with perceived risk from COVID-19 on IQOS purchase and use intentions: results from a web-based survey.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe COVID-19 pandemic and associated public health prevention measures (e.g., "stay at home" orders) may impact tobacco supply and demand among consumers. This qualitative study identified multi-level drivers of shifts in inhaled tobacco product use and access patterns during the initial COVID-19 "lockdown" period in the United States.
methodsBetween April and May 2020, we conducted semi-structured telephone interviews (n = 44) with adults who use cigarettes and/or electronic nicotine delivery systems (ENDS). Transcripts were thematically analyzed using a socioecological framework.
resultsNearly all participants reported changes in their product use during lockdown, though patterns varied. Increased use was most common and was predominantly driven by individual-level factors: pandemic-related anxiety, boredom, and irregular routines. Decreased use was common among social users who cited fewer interpersonal interactions and fear of sharing products. At the community level, retail access impacted cigarette and ENDS use differently. While cigarettes were universally accessible, ENDS access was more limited, driving some to purchase products online. Delayed deliveries led some ENDS users to compensate with readily-available cigarettes.
conclusionTo mitigate ways that the COVID-19 pandemic may exacerbate an existing public health crisis, multi-level policy strategies, such as expanded virtual cessation services and implementation and enforcement of smoke-free home rules, can better support population health during this critical period. Policies that facilitate access to lower risk products can help minimize harm among those who cannot or do not want to quit smoking.
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