COVID‐19, smoking, vaping and quitting: a representative population survey in England

AIMS: To estimate (1) associations between self‐reported COVID‐19, hand‐washing, smoking status, e‐cigarette use and nicotine replacement therapy (NRT) use and (2) the extent to which COVID‐19 has prompted smoking and vaping quit attempts and more smoking inside the home. DESIGN: Cross‐sectional household surveys. SETTING AND PARTICIPANTS: A representative sample of the population in England from April to May 2020. The sample included 3179 adults aged ≥ 18 years. MEASUREMENTS: Participants who reported that they definitely or thought they had coronavirus were classified as having self‐reported COVID‐19. Participants were asked how often they wash their hands after returning home, before preparing foods, before eating or before touching their face. They were also asked whether, due to COVID‐19, they had (i) attempted to quit smoking, (ii) attempted to quit vaping and (iii) changed the amount they smoke inside the home. FINDINGS: Odds of self‐reported COVID‐19 were significantly greater among current smokers [20.9%, adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI) = 1.04–1.73] and long‐term (> 1‐year) ex‐smokers (16.1%, aOR = 1.33, 95% CI = 1.05–1.68) compared with never smokers (14.5%). Recent (< 1‐year) ex‐smokers had non‐significantly greater odds of self‐reported COVID‐19 (22.2%, aOR = 1.50, 95% CI = 0.85–2.53). Bayes factors indicated there was sufficient evidence to rule out large differences in self‐reported COVID‐19 by NRT use and medium differences by e‐cigarette use. With the exception of hand‐washing before face‐touching, engagement in hand‐washing behaviours was high (> 85%), regardless of nicotine use. A minority (12.2%) of quit attempts in the past 3 months were reportedly triggered by COVID‐19, and approximately one in 10 current e‐cigarette users reported attempting to quit vaping because of COVID‐19. CONCLUSIONS: In England, current smokers and long‐term ex‐smokers appear to have higher odds of self‐reported COVID‐19 compared with never smokers in adjusted analyses, but there were no large differences between people who used nicotine replacement therapy or e‐cigarettes. Engagement in hand‐washing appears to be high, regardless of nicotine or tobacco use. A minority of past‐year smokers and current e‐cigarette users, respectively, report attempting to quit smoking/vaping due to COVID‐19.