Smoking and COVID-19: Smoking Behavior and Motivation to Quit

Understanding the factors that predict motivation to quit smoking and smoking behavior are necessary to facilitating successful quit behavior. The protection motivation theory (PMT) is one framework that has been used to explain the adoption of health-protective behavior, such as reducing or quitting smoking. This theory may also provide a framework for understanding health protective behaviors as a result of the recent outbreak of COVID-19, especially given that numerous studies have suggested that smoking may be associated with more severe outcomes of COVID-19. There is a need for understanding the relationship between perceived threat of COVID and the relationship with other smoking-related factors using a theoretical framework. We examined associations between perceived threat of COVID and smoking-related factors (motivation to quit, smoking difference) and possible moderators (health status, self-efficacy) of this relationship. We also examined associations between COVID impact and smoking-related factors. Participants were 113 adult cigarette smokers recruited using Amazon’s Mechanical Turk Website (Mturk). A “premium” qualification within Mturk was used, which directs surveys to workers with specific attributes, in this case those who identified themselves as smokers. Regression models were used to examine the influence of perceived threat on the main criterion variables and to test the individual effects of each of the moderators. Results indicated that the main effects of perceived threat, respiratory symptoms, chronic illness, and COVID impact significantly predicted motivation to quit smoking, whereas self-efficacy did not. Contrary to hypotheses, perceived threat, respiratory symptoms, chronic illness and self-efficacy did not predict smoking difference. It is possible that methodological and sampling differences, other constructs of the PMT, the intention-behavior gap, or the general lack of change in smoking difference may explain these unexpected findings.