The Role of Tobacco Cessation and Prevention to Combat COVID-19 Morbidity and Mortality in Rural Areas

1. Project Title:

The Role of Tobacco Cessation and Prevention to Combat COVID-19 Morbidity and Mortality in Rural Areas

2. Problem Statement

a) Background

The coronavirus disease 2019 (COVID-19) outbreak has reached pandemic proportions with a large global footprint. In December 2019, COVID-19 was first reported in Wuhan, Hubei Province, China. On 28 January 2020, the National Health Commission of People’s Republic of China released national strategies for assisting prevention efforts for rural areas and the older adult population. Nevertheless, this outbreak was not contained, and as of 04 April 2020, it has spread to 181 countries resulting in about 1,160,000 cases and 62,400 deaths worldwide.

To date, a total of 290,600 cases and 7,830 deaths have been reported in the United States (U.S.), with numbers climbing disproportionately on a day-to-day basis. New epidemiologic and clinical evidence is constantly evolving related to this infection while the pandemic is hastily progressing worldwide. Rapid efforts are needed to protect vulnerable populations including those living in rural areas. For example, before this pandemic, U.S. urban hospitals were over twice as likely to have growth in number of adult intensive care unit (ICU) beds available over a one-year period when compared to rural hospitals. Thus, rural hospitals are not as likely to have the higher level of resources and medical care needed for this crisis. Preventive and resource allocation strategies (e.g., ventilator availability) are needed to reach and care for

b) What is its objective or goal?

This proposal will fill the current research-to-practice gap, by examining the role of tobacco cessation in combating COVID-19 morbidity and mortality in rural areas.

3. Project Questions

a) Hypothesis, focusing areas or problems

We hypothesized that smoking behavior may be associated with adverse progression of COVID-19. This is characterized by more severe symptoms and the need for higher level care (e.g., intensive care), which is already inadequate in rural areas.

b) What do you expect to learn?

We assume that tobacco users living in U.S. rural areas may represent an additional subgroup at risk for higher COVID-19-related morbidity. Irrespective of COVID-19, individuals living in rural areas have high rates of tobacco use and related morbidity compared to individuals living in urban or metropolitan areas due to several factors including: low income, low educational attainment, higher social acceptability to tobacco use, permissive tobacco control policies, and lack of healthcare access.

4. Approach for the Project

a) Methodology

Participants will be recruited from a sample of North West Ohio residents. Phone interviews will provide and in-depth portrait of the role of tobacco cessation and COVID morbidity and mortality.

b) Required resources/data

Data will be assessed and analyzed from the convenient sample collected.

5. Expected Outcomes

a) Answers to the Project Questions

Irrespective of COVID-19, individuals living in rural areas have high rates of tobacco use and related morbidity compared to individuals living in urban or metropolitan areas due to several factors including: low income, low educational attainment, higher social acceptability to tobacco use, permissive tobacco control policies, and lack of healthcare access.

b) What form will your final project take (e.g. paper, report, model, etc.)?

Manuscript/Paper

c) How will this project be of benefit to you considering overall educational objectives?

This project will add to my overall knowledge of the current pandemic and how underlying conditions can exacerbate the issue. It will add to my knowledge of tobacco use influence, and assist me in enhancing my research writing skills.

6. Work Plan: how will you carry out the proposed project?

a) Timetable for your work and estimate the completion date of proposed project.

b) Include the frequency with which you plan to consult with your mentor.

Weekly meeting to discuss the research progress and any issues that may arise.

7. Appendix – Bibliography and any required preliminary materials

Zhu N, Zhang D, Wang D, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.

Adhikari SP, Meng S, Wu Y, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: A scoping review. Infect Dis Poverty. 2020;9(1):29. doi: 10.1186/s40249-020-00646-x.

Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2015. MMWR. 2016;65(6):1-174.

Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020. pii: S1473-3099(20)30120-1. doi: 10.1016/S1473-3099(20)30120-1.

Wallace DJ, Seymour CW, Kahn JM. Hospital-level changes in adult ICU bed supply in the United States. Crit Care Med. 2017;45(1):e67-e76.

Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2015. MMWR. 2016;65(6):1-174.