Background

Use of novel tobacco products such as heated tobacco products and e-cigarettes has recently increased as a result of being promoted as less harmful alternatives to cigarettes. The impact of the COVID-19 pandemic on tobacco use behavior may differ depending on the type of tobacco product used.

Methods

We longitudinally investigated tobacco use status and its change over a one-year period using internet-based and self-reported questionnaires among Japanese adults. We divided participants from 2019 into the pre-pandemic group and new participants from 2020 into the pandemic group. The association between quitting all tobacco products and the COVID-19 pandemic was evaluated through logistic regression analysis of the groups separately for each tobacco use status: exclusive cigarette, dual use, and exclusive novel tobacco. We conducted sampling probability weighting for all analyses by using data from the Comprehensive Survey of Living Conditions in Japan.

Results

We examined 1,920 participants in the pre-pandemic group and 2,682 in the pandemic group after weighting. One year later, 195 (10.1%) in the pre-pandemic group and 371 (13.8%) in the pandemic group had quit all tobacco products (p<0.001). By tobacco use status, the proportion of participants quitting all tobacco products changed from 10.2% to 12.7% [odds ratio (OR)=1.24, p=0.121], from 6.3% to 15.6% (OR=2.61, p<0.001), and from 19.4% to 14.8% (OR=0.66, p=0.041) after the COVID-19 pandemic among exclusive cigarette, dual, and exclusive novel tobacco users, respectively.

Conclusions

Dual users quit all tobacco products more frequently after the COVID-19 pandemic; however, exclusive novel tobacco users quit all tobacco products less frequently.