COVID-19 Impact on Smokers Participating in Smoking Cessation Trials: The Experience of Nondaily Smokers Participating in a Smartphone App Study.

Objectives: To provide initial insight into how the COVID-19 pandemic could affect smoking behaviors and cessation efforts that were underway at its onset. Methods: An additional survey was added to follow-up assessments in an ongoing smoking cessation study for nondaily smokers: a measure of impact of COVID-19 and a subset of previously administered scales measuring smoking, emotional well-being, and alcohol use. Pre-post tests were conducted (84 ± 28 days apart). Results: Participants (81/100 of enrolled; 67% female, 75% white, 10% Hispanic, 37 ± 11 years old) reported experiencing changes regarding work (35% income reduction/loss; 35% remote work) and living situation (15% consolidated residences). Participants reported their motivation to quit smoking "slightly" increased after COVID-19 (p < 0.001), more so in those having achieved 30-day abstinence (p = 0.0045). Worry, fear, and a desire to support the greater good increased (ps < 0.05). Increases in motivation to quit correlated positively with prosocial and wellness changes. Data from pre- to post-COVID-19 onset showed decreases in emotional well-being (increased stress, negative affect, decreased coping, positive affect, all ps < 0.01), but not changes in smoking abstinence (p = 0.65), readiness to quit (p = 0.16), smoking frequency (p = 0.96), or cigarettes per day (p = 0.96). Heavy drinking decreased (p < 0.01). Trying e-cigarettes increased (p = 0.04). Conclusions: Nondaily smokers participating in a smoking cessation study during the COVID-19 pandemic reported worsened emotional well-being without effects on smoking outcomes and said their motivation to quit was slightly increased. Correlations of motivation to quit with prosocial and wellness changes suggest that targeting these constructs may be particularly helpful during a pandemic.