A new study led by researchers at the American Cancer Society (ACS), shows serious smoking cessation activity declined among adults in the United States immediately after the onset of the COVID-19 pandemic and persisted for more than a year. Declines in attempts to quit smoking were largest among persons experiencing disproportionately negative outcomes during COVID-19, including Black people, people with comorbidities, middle-aged people, and people with lower educational attainment. The data were published by Fedewa et al in JAMA Network Open.
“Smoking cessation is an urgent public health priority given that smoking is associated with an increased risk of severe COVID-19 outcomes and at least 12 cancers,“ said Priti Bandi, PhD, Principal Scientist, Risk Factors and Screening Surveillance Research at the ACS and lead author of the study. “It is essential to reengage persons who smoke in serious attempts to quit smoking, considering a typical smoker tries to quit on average six times before being successful.”
Study Details
Researchers conducted this cross-sectional study using 2011 to 2020 data on close to 800,000 individuals who had smoked in the past year from the nationally representative Behavioral Risk Factor Surveillance System survey. Representative retail scanner sales data between January 2017 and July 2021 for 1,004 unique nicotine replacement therapy universal produce codes in 31 U.S. states from NielsenIQ, a global information services company, were also used.
The results showed the annual prevalence of past-year quit attempts among U.S. smokers decreased for the first time since 2011, from 65.2% in 2019 to 63.2% in 2020. Declines began in the first quarter of 2020 and quit attempt prevalence remained depressed throughout the year. The report also showed relative decreases between 2019 and 2020 were the largest among persons known to have experienced disproportionately negative outcomes during the COVID-19 pandemic, including middle-aged persons, those with two or more comorbidities, Black persons, and less-educated persons.
According to the authors, observed sales of nicotine replacement therapy products from representative retail scanner data in 31 states declined by between 1% and 13% compared to expected sales. Declines began immediately after the pandemic onset (April 2020) and persisted through the first quarter of 2021.
Implications
“These results remind us how critical it is for clinicians and health-care systems to support persons who smoke with evidence-based quitting strategies,” said William L. Dahut, MD, Chief Scientific Officer at the ACS. “Such efforts must be particularly targeted to persons disproportionately impacted by the COVID-19 pandemic, including Black persons, middle-aged persons, those with comorbidities, and [persons with less education].”
“Tobacco is the number one, preventable cause of cancer and is responsible for up to one-third of all cancer deaths,” said Lisa Lacasse, President of the ACS Cancer Action Network, ACS’s advocacy affiliate. “We know quitting tobacco isn’t easy, so we must do everything in our power to ensure individuals trying to quit have access to the cessation services they need. By ensuring Medicaid programs cover all FDA-approved cessation treatments and services in every state and that state tobacco prevention and cessation programs are adequately funded, we can help more people quit and help reduce cancer disparities driven by this deadly product.”
