COVID-19 and Tobacco Cessation: Lessons from India

Background: The Government of India prohibited the sale of tobacco products during COVID-19 lockdown to prevent its spread. This study assessed the tobacco cessation behaviour and its predictors among adult tobacco users during the initial COVID-19 lockdown period in India.Methods: A cross-sectional study was conducted with 801 adult tobacco users in two urban metropolitan cities of India over two months (July-August 2020). The study assessed complete tobacco cessation during the lockdown period and quit attempts. Logistic and negative binomial regression models were used to study correlates of tobacco cessation and quit attempts respectively.Findings: Out of the total sample, 90 (11<< 3%) tobacco users reported that they had quit using tobacco after the lockdown. Overall, a median of two quit attempts (IQR 0-6) were made by the tobacco users. Participants with good knowledge on health harms of tobacco use and COVID-19 were significantly more likely to quit tobacco use [OR 2<<2 (95% CI 1<<2-4<<0)], and reported more quit attempts [IRR 5<<7 (95% CI 2<<8-11<<8)] vs. those with poor knowledge. Participants with access to tobacco products were less likely to quit tobacco use vs. those with no access [OR 0<<3 (95% CI 0<<2-0<<5)].Conclusion: Access restrictions and correct knowledge on health harms of tobacco use and COVID-19 can play an important role in creating a conducive environment for tobacco cessation among users.Funding: The study was funded from the University of Edinburgh's Scottish Funding Council GlobalChallenges Research Fund (UKRI- GCRF).Declaration of Interest: None to declare. Ethical Approval: Prior ethics approval for research involving human subjects for this study was obtained from the Centre for Chronic Disease Control’s Institutional Ethics Committee (Reference #CCDC_IEC_04_2018).