{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:09:49Z","timestamp":1778198989498,"version":"3.51.4"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["RO1 DA048428"],"award-info":[{"award-number":["RO1 DA048428"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010628","name":"Center for Tobacco Products","doi-asserted-by":"publisher","award":["UO1DA045517"],"award-info":[{"award-number":["UO1DA045517"]}],"id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA053410"],"award-info":[{"award-number":["K01DA053410"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DA045081"],"award-info":[{"award-number":["K23DA045081"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The coronavirus disease (COVID-19) pandemic has spread in the US with more than 100 million human infections and a million deaths since March 2020. A population of concern are high-risk individuals such as adults who are tobacco users, since COVID-19 is a respiratory disease that affects the lungs. Although 79% of the US population \u2265 18 years of age have completed the primary COVID-19 vaccine series; it is imperative to understand the factors associated with receiving or declining the COVID-19 vaccine among high-risk populations to improve vaccination rates. Guided by the diffusion of innovations (DOI) theory, this study identified factors associated with COVID-19 vaccination and the impact on COVID-19 vaccine uptake in adults who use tobacco. We conducted a cross-sectional study using a sample of Pennsylvanian adult tobacco users by sending a unique survey link to 4,081 email addresses in April 2022. Participants were asked about tobacco use, COVID-19 vaccination status, and reasons for receiving\/declining the COVID-19 vaccine. Participants (n = 157) were 75% female, 96% White, 74% current tobacco users, and had a mean age of 50.1 (SD = 10.8) years. Nearly 78% (n = 119) received at least one dose of the COVID-19 vaccine (primary series). We categorized all vaccinated tobacco users into adopter categories of the DOI theory; innovators (10%), early adopters (14%), early majority (33%), late majority (11%), and laggards (32%). The major reason that prompted participants to get the COVID-19 vaccine was to ensure they were well protected against COVID-19 infection (77%). Additionally, the only reason for receiving the vaccine that significantly predicted early vaccine uptake (being an innovator or early adopter) was \u201cto loosen restrictions on mask mandates and social\/physical distancing\u201d (p = 0.0180). Among the 22% that did not receive a COVID-19 vaccine, the most common major reason they declined the vaccine was because they felt politics played a big role in the vaccine development process (94%). Our findings suggest that major f actors that influenced why adult tobacco users would receive or decline the COVID-19 vaccine included infection control mandates, protection from the COVID-19 infection, and politics. Investigating these factors can help public health professionals design or develop future vaccination programs for high-risk populations in order to scale up vaccination rates.<\/jats:p>","DOI":"10.1371\/journal.pone.0309780","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T18:45:11Z","timestamp":1734029111000},"page":"e0309780","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Using the diffusion of innovations theory to understand factors associated with COVID-19 vaccination among tobacco users"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5307-7771","authenticated-orcid":true,"given":"Gail Carmen","family":"D\u2019Souza","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3028-668X","authenticated-orcid":true,"given":"Jessica M.","family":"Yingst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolle M.","family":"Krebs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candace","family":"Bordner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1809-3749","authenticated-orcid":true,"given":"Sophia I.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Calo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L.","family":"Hobkirk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2296-0726","authenticated-orcid":true,"given":"Jonathan","family":"Foulds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"pone.0309780.ref001","author":"CDC","year":"2022","journal-title":"Smoking & Tobacco Use"},{"key":"pone.0309780.ref002","author":"A Wheaton","year":"2019","journal-title":"Chronic Obstructive Pulmonary Disease and Smoking Status\u2014United States, 2017."},{"issue":"9","key":"pone.0309780.ref003","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/S2213-2600(22)00182-5","article-title":"Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research","volume":"10","author":"NL Benowitz","year":"2022","journal-title":"Lancet Respir Med"},{"issue":"1","key":"pone.0309780.ref004","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1136\/thoraxjnl-2021-217080","article-title":"Smoking and COVID-19 outcomes: an observational and Mendelian randomisation study using the UK Biobank cohort.","volume":"77","author":"AK Clift","year":"2022","journal-title":"Thorax"},{"key":"pone.0309780.ref005","doi-asserted-by":"crossref","first-page":"5474397","DOI":"10.1155\/2022\/5474397","article-title":"The Impact of Tobacco Use on COVID-19 Outcomes: A Systematic Review.","volume":"2022","author":"J Baker","year":"2022","journal-title":"J Smok Cessat."},{"key":"pone.0309780.ref006","author":"FDA","year":"2020","journal-title":"FDA Briefing Document"},{"key":"pone.0309780.ref007","author":"U.S. Food & Drug Administration","year":"2021","journal-title":"FDA Approves First COVID-19 Vaccine"},{"key":"pone.0309780.ref008","article-title":"Pennsylvania moves smokers to top of coronavirus vaccine list","author":"J. 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A comprehensive analysis of U.S. tweets during the COVID-19 pandemic.","volume":"28","author":"L He","year":"2021","journal-title":"J Am Med Inform Assoc"},{"issue":"Pt B","key":"pone.0309780.ref023","doi-asserted-by":"crossref","first-page":"109144","DOI":"10.1016\/j.drugalcdep.2021.109144","article-title":"Impacts of COVID-19 on cigarette use, smoking behaviors, and tobacco purchasing behaviors","volume":"229","author":"SF Maloney","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"pone.0309780.ref024","first-page":"1","article-title":"Gender differences in the intention to get vaccinated against COVID-19: a systematic review and meta-analysis.","author":"S Zintel","year":"2022","journal-title":"Z Gesundh Wiss."},{"issue":"3","key":"pone.0309780.ref025","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1093\/eurpub\/ckad052","article-title":"Explaining the gender gap in COVID-19 vaccination attitudes","volume":"33","author":"D. 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