A team of scientists from the United Kingdom has conducted a cross-sectional survey in England to investigate the association between smoking habits and psychological distress during the coronavirus disease 2019 (COVID-19) pandemic.
Prevalence of psychological distress among past−year smokers. Image Credit: https://www.medrxiv.org/content/10.1101/2020.12.07.20245514v1.full.pdf
The findings reveal that compared to the pre-COVID-19 era, a deterioration in mental health has occurred among smokers during the COVID-19 pandemic. The study is currently available on the MedRxiv* preprint server.
There is a growing pool of evidence suggesting that smoking may increase the risk of severe COVID-19, a newly-emerged disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Epidemiological studies have indicated that the prevalence of smoking is higher among individuals with mental health conditions, such as anxiety, depression, and other serious mental illnesses. Moreover, people with mental health conditions are more susceptible to be dependent smokers who face major difficulty in quitting smoking and maintaining non-smoking behavior after quitting.
In England, the prevalence of smoking in the general population was 16% during 2014 – 2015. During the same period, about 28%, 34%, and 40% of people with anxiety/depression, chronic mental illness, and serious mental illness, respectively, were found to be smokers.
Studies conducted during the COVID-19 pandemic have indicated that the restrictions imposed during lockdown have caused a decline in the mental health condition of the general UK population, especially women and young adults. Moreover, it has been found that a significant proportion of smokers have tried to quit smoking during this period.
In the current study, scientists aimed to evaluate the prevalence of mental illness among smokers during the COVID-19 pandemic, as well as to determine whether the prevalence differs from the pre-pandemic period.
Current study design
The Smoking Toolkit Study is a cross-sectional survey conducted monthly on the general adult population in England. The data collected by the survey from April to July in 2016, 2017, and 2020 were used in the current study.
The information about mental health, smoking status, smoking addiction, smoking quitting behavior, and sociodemographic characteristics were collected from a total of 2972 smokers.
Smoking status and mental distress
The study findings revealed that compared to previous years (2016/2017), the prevalence of moderate to severe mental distress was higher among past-year smokers and current smokers during the pandemic period.
Moreover, elderly people were less likely to report distress symptoms than younger people (age range: 16 – 24 years).
Smoking status, socio-demographic characteristics, and mental distress
Compared to previous years, the prevalence of moderate distress was higher during the pandemic among young and middle-aged people, women, socioeconomically deprived people, and people with low smoking addiction.
In contrast, a higher prevalence of severe distress was observed during the pandemic among elderly people, women, and people with low smoking addiction.
The study findings reveal a clear induction in mental distress among smokers during the COVID-19 pandemic. The scientists believe that a deterioration in work and social life due to lockdown-related restrictions in England may be responsible for poor mental health, especially among smokers.
Although, in general, elderly people reported lower distress incidence than younger people, the socioeconomic analysis reveals that elderly people are more susceptible to severe distress than young and middle-aged people.
Moreover, women, socioeconomically deprived people, and people with and without children at home are found to have a higher risk of developing mental distress. These findings indicate that the incidence of mental distress is not equally distributed across society.
Overall, the study findings highlight the need for developing effective smoking cessation support systems for people with mental illness, or for those who are at higher risk of developing mental illness.
Mental health professionals should pay more attention to the smoking behaviors of their patients during the pandemic and should provide the patients with information about smoking cessation services.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.