This thesis explores the impacts of the COVID-19 pandemic and associated factors on the smoking behaviors of Asian-American adults living in the United States. Existing literature exploring COVID-19’s impact on smoking has found multiple different outcomes, with nearly equally significant numbers of individuals reporting increases in smoking and decreases in smoking, as well as some who reported no change. These data are, however, limited in generalizability, especially in application to the demographic of Asian-Americans, for whom smoking data even pre-pandemic is already highly inconsistent and for whom there is a distinct lack of culturally tailored smoking cessation resources. This project aims to fill this literature gap using a multifaceted strategy of data generation and more comprehensible data communication methods.

A meta-analysis of existing literature was conducted using the PubMed database. New data inquiring into changes and continuity in smoking behaviors over the course of the pandemic was also generated using self-administered anonymous surveys disseminated via social media. The findings were synthesized and presented using the framework of the social-ecological model of health to convey the various levels of influence at which changes and continuity in smoking behaviors occurred. Analysis from both methods of data collection demonstrated a similar double-edged effect as other populations, but with more individuals reporting decreases in smoking than increases. Factors of influence included pandemic-related stress, perceived danger of COVID-19, lack of in-person cessation resources, fear of judgment/stigma of family and peers towards smoking, and more.

Future directions and limitations are presented at the end alongside the conclusion to better inform culturally-tailored smoking cessation interventions going forward.