Nicotine dependence levels in pre and during pandemic and its correlations with COVID‐19 phobia among healthy men during controlled social life: A sample of primary care population

Abstract

To the editor, Tobacco use an important cause of cardiovascular and lung diseases may exacerbate clinical manifestations of COVID19. Recent evidences indicate that, increased clinical manifestations in COVID19 patients with smoking compared to nonsmokers resulted in intensive care treatment and mechanical ventilation.13 Smoking makes individuals prone to complications of COVID19, due to decreased levels of angiotensinconverting enzyme 2, the host receptor of the virus.4 This situation draws attention to the men with two times higher smoking rates than women in Turkey.5 On the other hand, uncontrollable COVID19 cases, have led to coronaphobia, referred to wig out being infected by coronavirus.6 Coronaphobia may effect nicotine addiction levels during controlled social life in pandemic. This research letter aimed to determine nicotine dependence levels in pre and during pandemic and its correlations with COVID19 phobia among men during controlled social life. Family health centres based, prospective study was conducted in the Black Sea Region of Turkey with volunteer 472 healthy men smokers between February and October 2020. Those under smoking cessation treatment and infected with COVID19 were excluded from the study. This followup study was started in February 2020 and completed on 11 March 2020 when the first coronavirus cases were reported in Turkey. Due to the lockdowns, the second process was carried out between June and October 2020 via an online questionnaire including Fagerström Nicotine Dependence Test (FTND)7 and Coronafobia scale.8 In this study, there was a decrease in nicotine addiction levels from prepandemic to during controlled social life in pandemic (Figure 1). There was a strong correlation between FTND scores of two periods and COVID19 phobia (Table 1). This result can be explanied with the result of a USA study which reported that a quarter of smokers reduced thier tobacco products use, and more than a third increased their motivation to quit due to pandemic.9 This positive step may grow out due to ‘stay at home policy’ that smoking behaviour may be adjusted to family life and as a reaction of COVID19 phobia. On the other hand, in controlled social life, citizens are asked to adopt a cautious lifestyle. Wearing a mask, ensuring hand hygiene and obeying the social distance rule are among the rules of the strategy. This strategy parallels to smoking bans and can constrain individual and collective smoking behaviour. As a matter of fact, it was reported in a Vietnam study that fear of COVID19 was higher among smokers, especially overusers.10 COVID19 phobia may be another motivator reason for low dependence and quit smoking. Fear of getting infected with COVID19 may propel some smokers to quit. Pandemic period is an unmissable opportunity to try and quit smoking.