Background In response to the novel Coronavirus Disease 2019 (COVID-19) pandemic, the Department of Veterans Affairs (VA) Million Veteran Program (MVP) organized efforts to better understand the impact of COVID-19 on Veterans by developing and deploying a self-reported survey. Methods The MVP COVID-19 Survey was developed to collect COVID-19 specific elements including symptoms, diagnosis, hospitalization, behavioral and psychosocial factors and to augment existing MVP data with longitudinal collection of key domains in physical and mental health. Due to the rapidly evolving nature of the pandemic, a multipronged strategy was implemented to widely disseminate the COVID-19 Survey and capture data using both the online platform and mailings. Results We limited the findings of this paper to the initial phase of survey dissemination which began in May 2020. A total of 729,625 eligible MVP Veterans were invited to complete version 1 of the COVID-19 Survey. As of October 31, 2020, 58,159 surveys have been returned. The mean and standard deviation (SD) age of responders was 71 (11) years, 8.6% were female, 8.2% were Black, 5.6% were Hispanic, and 446 (0.8%) self-reported a COVID-19 diagnosis. Over 90% of responders reported wearing masks, practicing social distancing, and frequent hand washing. Conclusion The MVP COVID-19 Survey provides a systematic collection of data regarding COVID-19 behaviors among Veterans and represents one of the first large-scale, national surveillance efforts of COVID-19 in the Veteran population. Continued work will examine the overall response to the survey with comparison to available VA health record data.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0266381&type=printable

Million Veteran Program’s response to COVID-19: Survey development and preliminary findings

During the initial wave of the Coronavirus Disease 2019 (COVID-19) pandemic in the U.S., information was mixed about the relative COVID-19 risks and potential benefits associated with cigarette smoking. Therefore, we sought to understand individual differences in the impact of COVID-19 on cigarette smoking in a sample of adults who reported recent use, with a particular focus on chronic medical conditions likely associated with increased COVID-19 risk. Participants completed an online survey of smoking behavior, demographic variables, medical history, and COVID-19 risk perceptions between July and August 2020 (N = 286). We examined whether medical conditions, COVID-19 risk perceptions and/or demographic characteristics were related to smoking changes in response to the pandemic (i.e., no change, decrease, increase) using multinomial logistical regression. Younger age, higher COVID-19 risk perceptions and Black versus White race were associated with greater odds of decreased smoking compared to no smoking change. Moreover, having at least one chronic medical condition was associated with greater odds of increased smoking relative to no change. The results have important implications for tobacco cessation treatment and preventive healthcare during the ongoing COVID-19 pandemic and other public health threats.

/pdf/cigarette-smoking-in-response-to-covid-19-examining-co-2w8rmjup.pdf

Cigarette Smoking in Response to COVID-19: Examining Co-Morbid Medical Conditions and Risk Perceptions

Non-Pharmacologic Approaches to Tobacco Cessation

Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.

/pdf/associations-between-tobacco-use-surges-and-vaccination-1jt5ouzy.pdf

Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era

By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.

/pdf/a-longitudinal-study-on-the-addictive-behaviors-of-general-7bpgd9ux.pdf

A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China

The prevalence of tobacco use increases in times of stress; however, during the initial stage of the COVID-19 pandemic, tobacco use rates stayed the same in most populations. Previous work focused on the initial months of the pandemic, while this study examined the changes in tobacco use during a later peak period of the pandemic. We used data from 61,852 visits to the VA San Diego Healthcare System from November 2019 to February 2021, divided into pre-, early, and peak pandemic periods. Multinomial logistic regression was used to test whether the odds of being a daily or non-daily tobacco user varied over time, by demographic group, or with the presence of specific psychiatric diagnoses. Younger Veterans had a greater reduction in the prevalence of non-daily tobacco use between the early and peak periods, while older Veterans had a rise in daily use from pre- to the early pandemic, which returned to baseline during the peak. Individuals with substance use disorder and serious mental illness diagnoses were more likely to report tobacco use, but psychiatric diagnoses did not predict change over time. These findings demonstrate factors that potentially contribute to changes in tobacco use during a public health crisis and may help guide future targeted cessation efforts.

Javad J Fatollahi

Papers

Changes in Tobacco Use Patterns among Veterans in San Diego during the Recent Peak of the COVID-19 Pandemic