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Evaluating the Causal Effect of COVID-19 Stay-At-Home Orders on Combustible Tobacco Use

  • 0Division of Epidemiology, The Ohio State University College of Public Health, Columbus OH.
Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco +

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June 27, 2025

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June 27, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

COVID-19 Stay-at-Home orders significantly reduced smoking among individuals with mental health conditions. This vulnerable population experienced sustained declines in tobacco use, unlike the general population.

Area Of Science

  • Public Health
  • Epidemiology
  • Behavioral Science

Background

  • Individuals with mental health conditions exhibit higher smoking rates than the general population.
  • Concerns arose regarding the impact of COVID-19 lockdown policies on mental health and substance use.
  • Stay-at-Home (SAH) orders during the pandemic were analyzed as a natural experiment.

Purpose Of The Study

  • To assess the causal effect of Stay-at-Home (SAH) orders on smoking prevalence.
  • To differentiate the impact of SAH orders on individuals with and without mental health impairment (MHI).

Main Methods

  • Utilized pooled data from the Behavioral Risk Factor Surveillance System (2014-2022, N=3,414,287).
  • Employed a difference-in-differences methodology.
  • Controlled for demographic factors including age, gender, race/ethnicity, and educational attainment.

Main Results

  • SAH orders led to a decrease in smoking probability among individuals with MHI, particularly after mandates.
  • Sustained smoking declines were observed among those with MHI even after SAH orders were relaxed.
  • No significant changes in smoking were observed among individuals without MHI during SAH orders, with only minor post-order declines.

Conclusions

  • Stay-at-Home orders had a differential impact on smoking behaviors based on mental health status.
  • Sustained reductions in smoking prevalence were observed specifically among individuals with mental health conditions.
  • Findings highlight the significance of public health interventions targeting tobacco use in vulnerable populations.

Keywords:

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