Associations of the perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms: a population-based survey in Hong Kong

IntroductionBoth perceived benefits and harms of COVID-19 have been reported, but whether they affect confidence in coping with the pandemic and mental health remains uncertain.ObjectiveTo examine the association of perceived benefits and harms of COVID-19 with confidence in coping with the pandemic and mental health symptoms.MethodsA population-based survey was conducted on 7,535 Hong Kong adults from 22 February to 23 March 2021, when the 4th wave of COVID-19 was under control. Information on sociodemographic characteristics, perceived benefits (10 options) and harms (12 options) of COVID-19, confidence in coping with the pandemic (range 0–10), loneliness (range 0–4), anxiety (General Anxiety Disorders-2, range 0–6) and depression (Patient Health Questionnaire-2, range 0–6) was collected. Latent profile analysis was used to identify the combined patterns of perceived benefits and harms of COVID-19. The associations of combined patterns with confidence in coping with COVID-19, loneliness, anxiety, and depression were examined using linear regression (β coefficient) adjusting for sociodemographic characteristics.ResultsThe combined patterns of perceived benefits and harms were classified into benefit (n = 4,338, 59.3%), harm (n = 995, 14.0%), and ambivalent (n = 2,202, 26.7%) groups. Compared with the ambivalent group, the benefit group had a significantly higher level of confidence (adjusted β 0.46, 95% CI 0.33 to 0.58), and lower levels of loneliness (−0.35, −0.40 to-0.29), anxiety (−0.67, 0.76 to-0.59), and depression (−0.65, −0.73 to-0.57). The harm group had a significantly lower level of confidence (−0.35, −0.53 to-0.16), and higher levels of loneliness (0.38, 0.30 to 0.45), anxiety (0.84, 0.73 to 0.96), and depression (0.95, 0.84 to 1.07).ConclusionPerceived greater benefit from COVID-19 was associated with better mental health and stronger confidence in coping with the pandemic

Workplace cessation support is associated with more abstinence in a workplace program in Hong Kong: A mixed-methods study

Introduction We examined the association of workplace smoking cessation (SC) support from employers, in addition to SC interventions, and smoking abstinence. Methods Smoking employees (≥1 cigarette daily, aged ≥18 years) from companies of various industries joined a workplace SC program in Hong Kong. Self-reported past 7-day point prevalence abstinence was measured at follow-up at 6 months. We assessed 14 types of workplace SC support with higher scores (range: 0–14) indicating greater support. Multivariable logistic regression examined the prospective association between workplace SC support and smoking abstinence, adjusting for intention to quit, nicotine dependence, self-efficacy of quitting, and sociodemographic characteristics. Average marginal effects were calculated to test if the association between overall workplace SC support and self-reported past 7-day PPA at follow-up at 6 months was modified by subgroups. We also interviewed employers from different companies to explore their perspectives of providing workplace SC support, and the data were analyzed by thematic analysis. Results In 383 participants who received a heath talk, a self-help SC booklet, and 15 text messages, greater workplace SC support was associated with smoking abstinence (AOR=1.32; 95% CI: 1.08–1.61), including support for smoke-free environment (AOR=1.51; 95% CI: 1.08–2.11) and for SC attempts/actions (AOR=1.93; 95% CI: 1.21–3.07). The association did not differ by sex, age, intention to quit, nicotine dependence, company size or company type. Qualitative interviews found that employers provided workplace SC support to establish a good company image, cost-benefit considerations were important to the types of workplace SC support provided, and lack of SC knowledge was a barrier to providing workplace SC support. Conclusions Greater workplace SC support was associated with more abstinence in a workplace SC program

Associations of changes in smoking-related practices with quit attempt and smoking consumption during the COVID-19 pandemic: A mixed-methods study

Introduction How changes in smoking routine due to COVID-19 restrictions (e.g. refraining from smoking outdoors and stockpiling tobacco products) influence smoking behaviors remains understudied. We examined the associations of changes in smoking-related practices with quit attempts and smoking consumption in current smokers using a mixed-methods design. Methods In a community-based telephone survey conducted between the second and third wave of the COVID-19 pandemic in Hong Kong, 659 smokers (87.1% male; 45.2% aged 40–59 years) were asked about quit attempts and changes in cigarette consumption and five smoking-related practices since the COVID-19 outbreak. Logistic regression was used to calculate adjusted odds ratio (AOR), adjusting for sex, age, education level, chronic disease status, heaviness of smoking (HSI), psychological distress (PHQ-4) and perceived danger of COVID-19. A subsample of 34 smokers provided qualitative data through semi-structured interviews for thematic analyses. Results Favorable changes in smoking-related practices, including having avoided smoking on the street (prevalence: 58.9%) and reduced going out to buy cigarettes (33.5%), were associated with a quit attempt (AOR: 2.09 to 2.26; p<0.01) and smoking reduction (AOR: 1.76 to 4.97; p<0.05). Avoiding smoking with other smokers (50.5%) was associated with smoking reduction (AOR=1.76; p 0.05). Unfavorable changes, including having increased smoking at home (25.0%) and stockpiled tobacco products (19.6%), were associated with increased smoking (AOR: 2.84 to 6.20; p<0.05). Low HSI (0–2) was associated with favorable changes (p<0.01), while high HSI score (3–6) was associated with unfavorable changes (p<0.01). Qualitative interviews revealed a double-edged effect of staying at home on smoking consumption and that pandemic precautionary measures (e.g. mask-wearing) reduced outdoor smoking. Conclusions Amid the pandemic, favorable changes in smoking-related practices in smokers were mostly associated with quit attempts and smoking reduction, while unfavorable changes were associated with increased smoking. Smokers with higher nicotine dependence were more negatively impacted