TY - JOUR T1 - Changes in the reach of a smoking cessation program in Ontario, Canada, during the COVID-19 pandemic: a cross-sectional study JF - CMAJ Open JO - CMAJ SP - E957 LP - E965 DO - 10.9778/cmajo.20210053 VL - 9 IS - 4 AU - Nadia Minian AU - Scott Veldhuizen AU - Elise Tanzini AU - Stephanie Duench AU - Wayne K. deRuiter AU - Megan Barker AU - Laurie Zawertailo AU - Osnat C. Melamed AU - Peter Selby Y1 - 2021/10/01 UR - http://www.cmajopen.ca/content/9/4/E957.abstract N2 - Background: Given the harms associated with tobacco use, continuing the provision of smoking cessation treatment during the COVID-19 pandemic is critical. The aim of this study was to examine pandemic-related changes in enrolment, total treatment use and participant characteristics in a large, publicly funded smoking cessation program in Ontario, Canada.Methods: We conducted a secondary data analysis of patients who enrolled in the program between Jan. 1, 2018, and Dec. 7, 2020. We used descriptive statistics to examine changes in treatment use. To test for differences in sociodemographic and health variables, we used segmented mixed-effects regression with a break point on Mar. 17, 2020, when Ontario declared a state of emergency. We tested 25 variables, using Holm’s correction for multiplicity.Results: We analyzed 60 373 enrolments. In the month after the break point, enrolments fell 69% and total visits fell 42% relative to previous years. After Mar. 17, 2020, those who enrolled were less likely to report employment in the previous week (absolute expected difference −12.4%, 95% confidence interval [CI] −15.0% to −9.8%); were more likely to be occasional (1.3%, 95% CI 0.6% to 1.9%) or noncurrent smokers (1.7%, 95% CI 0.8% to 2.6%); were less likely to have set a target quit date (−4.8%, 95% CI −7.0% to −2.6%); and were more likely to have a physical health (6.6%, 95% CI 4.0% to 9.2%), mental health (4.6%, 95% CI 1.9% to 7.2%) or substance use diagnosis (3.5%, 95% CI 1.3% to 5.6%).Interpretation: Sharp decreases in new enrolments and subsequent visits to smoking cessation programs were seen when pandemic restrictions were implemented in Ontario, but the characteristics of the people who accessed the programs did not change markedly. Incorporating an equity perspective is essential when new models of care for smoking cessation are developed. ER -