Significance: The COVID-19 pandemic has profoundly altered the social and physical spaces of young adults (YA), who, absent these disruptions, experience significant development during this important life stage. This study aimed to identify how social and environmental disruptions of the pandemic influenced tobacco use and perceptions among young adults in Iowa (US) who use multiple tobacco products, which can reveal important, potentially manipulatable drivers of product use change for subsequent intervention.

Methods: We conducted 11 in-depth semi-structured telephone interviews with Iowa YA aged 18-29 who reported past 30-day use of multiple tobacco products (July-August 2021). Seven participants were female, three male, and one participant was genderqueer. In the interview, we asked participants to walk us through their tobacco product use routines, life circumstances, and emotional states between February 2020 and the interview date. We conducted qualitative template analysis to organize interview content and identify consistent patterns across participants.

Results: We identified major themes across two significant periods. The themes include major shifts in perception and use of multiple tobacco products during the first 18 months of the pandemic. Young adults reported increased use of tobacco products in response to the COVID-19 pandemic related life changes. The changing, uncertain, and unengaging lifestyle of the early pandemic led to stress, boredom, anxiety and a related increase in nicotine use. For participants, smoking was a powerful socialization tool when bars and venues reopened in Iowa (May 2020), and other nicotine product use was a coping mechanism. The effect of the pandemic was such that a smallest stressor can trigger using a nicotine product.

Discussion: This study captured the nuanced short-term changes in social and physical space leading to changed perceptions and use of tobacco products for young adults across the pandemic. Documenting changes during this key developmental period can help anticipate, interpret, and address tobacco use across this unique cohort’s life course.