In recent months, the countries of the whole  world have been overwhelmed, with more or less force, by the health emergency COVID-19. In addition to the direct repercussions, in terms of the spread of the infection and deaths, the repercussions of the lockdown and social isolation measures adopted by many Countries to limit the spread of the virus are important. Several studies report that the increase in stress levels and concerns have led to an increase in the consumption of tobacco and related products. Let’s see the details.

Most States have adopted more or less stringent containment measures to limit the spread of COVID-19.
Among the Countries where these measures were most drastic, Italy, the UK, the United States and South Africa were selected by the Foundation for a Smoke-Free World (FSFW) for a study on the state of tobacco use during the lockdown.
6800 regular smokers between 18 (21 for the USA) and 65 years old were interviewed online.

In the four States analyzed, the lockdown was applied with particularly stringent measures, and had a significant impact on the habits of the population: in fact, during the period of isolation only movements out of necessity were allowed (to go to grocery store or to pharmacy); travel for work was severely limited (with the activation of smart working or job reduction policies), as well as outdoor sports and walks.
Many commercial activities made long periods of closure: tobacco sales have been restricted in India and South Africa, and only in Italy the vaping stores remained open.
The lockdown lasted about 2 months, varying in individual states.

It is clear that such a serious health situation and such invasive restrictions on mobility have led to a strong increase in anxiety and concern among the population. Just under 40% of the interviewees said that his mental state was negatively influenced by social distancing; the percentage rises to over 60% for respondents who had a positive family member at COVID-19.

The main concerns are about the possibility of getting sick (for about 80% of the interviewees), the difficulty in managing stress and anxiety (for about 65%) and the risk of losing your job (for about 60%).

For about 30% of respondents, lockdown measures led to an increase in the use of nicotine and tobacco products; the lowest percentage (25%) is observed in South Africa, while the highest percentage (40%) in the United States.
The type of product whose use has increased the most are products for the reduction of tobacco damage, including the electronic cigarette: during the lockdown, in fact, the percentage of respondents who say they consume this type of product increases by 3-5 percentage points.

These data are consistent with those of a study conducted in Italy by the Istituto Superiore di Sanità (ISS): with the lockdown, the percentage of habitual users of electronic cigarettes grew from 8.1% to 9.1% of the population between 18 and 79 years. This increase corresponds to 436,000 people.
In addition, 40% of regular users have increased the number of daily puffs, and about 50% of occasional users have increased the frequency of use.

This may also be linked to the widespread perception that vaping does not represent a risk factor for COVID-19: the FSFW report shows that over 65% of Italian respondents do not believe that vaping can increase the risk for COVID-19.

In Italy, 53% of FSFW respondents do not even perceive smoking as a risk factor for COVID-19.
Among respondents from other states, only in the UK is believed that smoking is a greater risk factor for COVID-19 than vaping (about 66% versus about 51%).
By contrast, over half of respondents from the USA, India and South Africa identify, with a small percentage point gap, both smoking and vaping as risk factors.
In India and South Africa, this assessment appears to have influenced respondents’ quitting smoking: respectively 64% and 42% of respondents rated quitting smoking during the lockdown.

It is important to take these data into consideration and act accordingly: now that in several countries the health emergency is less severe, it would be advisable to educate on a broad concept of prevention, which aims not only to strengthen our body, but also not to weaken it habitually. Support for acquiring healthy lifestyle habits must be a priority.