Abstract
OBJECTIVE: To estimate the incidence of tobacco use during the COVID-19 pandemic among Brazilian adults and to analyze the factors associated with initiation during this period. METHODS: A cross-sectional study using data from the ConVid 2 - Pesquisa de Comportamento (ConVid 2 - Behavior Survey), conducted between July and December 2023 through virtual chain sampling. Prevalence of tobacco use before, during, and after the COVID-19 pandemic, as well as initiation during the pandemic, were assessed. Independent variables included sociodemographic characteristics, health conditions, mental health, and lifestyle factors. Prevalences and 95% confidence intervals (95%CI) were estimated, and factors associated with initiation were investigated using multivariable logistic regression. RESULTS: The prevalence of smoking was 10.35% before the pandemic, 15.88% during (with an incidence of 5.5% of new smokers), and 12.2% in the post-pandemic period. Higher odds of smoking initiation during the pandemic were observed among individuals not living with a partner (OR=1.44; 95%CI 1.06-1.95), those who self-identified as non-white (OR=2.20; 95%CI 1.17-4.13), those reporting worsening feelings of sadness (OR=1.65; 95%CI 1.11-2.44), and those reporting increased alcohol consumption (OR=6.51; 95%CI 2.89-14.61). Lower odds were found among residents of the Southeast (OR=0.33; 95%CI 0.13-0.79) and Northeast (OR=0.25; 95%CI 0.11-0.57) regions. CONCLUSION: These findings highlight the need for public policies targeting more vulnerable populations.