Google Trends analysis of keywords related to smoking and smoking cessation during the COVID-19 pandemic in four European countries

Smoking is a modifiable risk factor for Coronavirus SARS-CoV-2 infection. Evidence of smoking behavior during the pandemic is ambiguous with an increase. In this context, Google Trends data monitors real-time public information-seeking behavior and is therefore useful to characterize smoking-related interest over the trajectory of the pandemic. Special attention was paid to the influence of lockdowns, vaccinations, and incidence. The weekly relative search volume was retrieved from Google Trends for England, Germany, Italy, and Spain during the period from 31-12-2017 to 18-4-2021. Data was collected for keywords concerning cessation, treatment, and consumption. Trend curves were generated, and the relative search volume of keywords before and during the pandemic was compared and short-term changes linked to lockdowns flexible scan statistics were used to identify clusters. Country-wise minor differences were observed while overarching tendencies prevailed. Overall trend curves and statistical comparison revealed a decline in interest in cessation. Also, e-cigarettes and most consumption-related keywords showed decreased relative search volume during the pandemic. Substantial clusters of increased interest were sparsely linked to lockdowns, vaccination campaigns, or incidence. Generally, fewer clusters for cessation were present during the pandemic. This study reports a substantial decline in overall relative search volume and clusters for cessation interest and underline the importance of intensifying cessation aid during times of crisis. Lockdowns, vaccination, and incidence had less impact on information-seeking behavior.