Did COVID stress, uncertainty stall anti-smoking push?

A year after COVID-19 upended life for mil- lions of Americans, there are troubling signs that the coronavirus may have also slowed progress against another deadly health threat: smoking.

Fewer smokers called quit-smoking hotlines last year and some smoked more, contributing to an unusual bump in cigarette sales — all in the middle of the stress, anxiety and uncertainty from the pandemic.

“It’s hard for folks to quit using tobacco in the best of times, so what happens when life is suddenly turned upside down?” said Jen Cash, who oversees Minnesota’s anti-tobacco programs.

Researchers are already concerned about COVID-19’s impact on cancer screen- ings and opioid overdoses as many Americans were cut off from routine care and examinations. But services to help smokers quit -- delivered via phone and online -would seem well-positioned to withstand the disruptions of the pandemic. The programs help with devising a plan and often provide free nicotine gums and patches.

Yet, calls to states routed through a national hotline fell 27% last year to about 500,000 — the biggest drop in a decade, according to the North American Quitline Consortium. In a recent report, the coalition of anti-smok- ing counselors cited the pan- demic and the drop in public awareness messaging.

“It’s really disturbing to see that the quit line calls have gone down so much because they’re exactly what I hoped would be going up,” said Dr. Nancy Rigotti of Harvard Medical School, who was not involved in the report.

In a separate survey of 1,000 adult smokers, Rig- otti and her colleagues found about a third reported smok- ing more during the first six months of the pandemic.

Alli Comstock of Los Angeles had been smoke-free for seven years when she lost her child care job last March because of the pandemic. Facing her first long-term stretch of unemployment, she started smoking again, out of a combination of boredom and anxiety.

“It just felt like something else to do and it made me feel calmer,” said Comstock, 32, adding that she knows cigarettes, which contain the stimulant nicotine, don’t help relieve anxiety.

Comstock eventually quit again after months of feeling like “we were in a time when it didn’t matter.”

“In November, I realized it did matter and that I was a smoker, and I didn’t want to be that,” she said.

Research has linked other traumatic events to relapses among ex-smokers, including after the 9/11 attacks.

The Centers for Disease Control and Prevention says it’s too early to gauge the pandemic’s impact on smoking rates.