Modifications to consuming and smoking throughout England's first COVID-19 lockdown

The worldwide spread of the severe coronavirus 2 (SARS-CoV-2) with acute respiratory syndrome, which causes a COVID-19 infection in early 2020, prompted many nations to close their borders and introduce mandatory bans. While bans abruptly stopped daily life, researchers at University College London and the University of Sheffield found that drug search behaviors did not.

The research team previously analyzed behavioral changes in April 2020, the first month of the lockdown.

"The first Covid-19 lockdown in England in March and July 2020 was associated with an increased prevalence of smoking among younger adults and an increased prevalence of high-risk alcohol consumption in all sociodemographic groups," the study's authors write.

Although they did see an increase in drug use, it was unknown whether this was a short-term or long-term response to the pandemic.

The study "Moderators of changes in smoking, drinking and quitting in connection with the first Covid-19 lockdown in England" is available as a preprint on the medRxiv * server while the article is being peer-reviewed.

Changes in smoking and alcohol consumption are not temporary

The researchers looked at how smoking and drinking behavior changed due to bans. The researchers randomly interviewed 1,700 adults per month and asked them about their drug experience over the phone or computer. A total of 36,980 adults took part in the study.

They compared people's drug use a year before the lockdown, months before the lockdown from August 2019 to February 2020, with the first lockdown in England, which came from April to July 2020. Since the lockdown was lifted on July 4, 2020, researchers have been ruling out data for that particular month.

Comparing drug use over a similar period of time helped the researchers rule out seasonal changes as a possible explanation for behavioral changes.

They found different changes in smoking and drinking behavior during the lockdown than before the lockdown. In addition, the increased drug behavior seen in the first month of lockdown persisted throughout the four months of lockdown.

“The only exception was a change in support use, which varied and was not statistically significant. This suggests that there has been an increase in risk drinking, efforts to reduce alcohol use and smoking cessation, and that the success with the latter has not been short-lived acute responses to lockdown, ”the researchers write.

Prevalence of (a) high-risk alcohol consumption in all adults; (b) Reduction attempts by high-risk drinkers; and (c) use of evidence-based support and (d) use of remote alcohol reduction support by high risk drinkers who attempted alcohol reduction in England from August 2019 to July 2020. The line break in March 2020 shows the timing of the lockdown of Covid-19 in England (no data was collected that month). The shaded band shows the 95% confidence interval.

Prevalence of (a) high-risk alcohol consumption in all adults; (b) Reduction attempts by high-risk drinkers; and (c) use of evidence-based support and (d) use of remote alcohol reduction support by high risk drinkers who attempted alcohol reduction in England from August 2019 to July 2020. The line break in March 2020 shows the timing of the lockdown of Covid-19 in England (no data was collected that month). The shaded band shows the 95% confidence interval.

Younger adults showed greater changes in smoking behavior

Adults ages 18 to 34 reported higher smoking rates during lockdown than older adults. The authors provide several explanations for this finding, including the elderly, who are a high risk group during the pandemic and are therefore more health conscious. They also suggest that younger adults may have used smoking as a coping mechanism for losing significant life changes and other pandemic-related stresses.

The results also showed a 156.4% increase in smoking cessation among smokers over the past year and a 39.9% increase in attempts to quit while on lockdown. Attempts to quit were more common in the 18 to 34 age group than in older adults in the 35 to 59 and over 60 age group.

"The apparent discordance between increased prevalence and increased drop-out attempts in younger adults has no obvious explanation and warrants further investigation," the authors wrote.

Women and socio-economic status were factors in heavy drinking

The results showed that all adults increased their alcohol consumption by 39.5% compared to the same period last year. Women were the heavier drinkers, with alcohol consumption increasing by 55.4% compared to the previous year. In addition, people in less socio-economically favored groups reported a 30.7% increase in alcohol consumption.

Among high-risk drinkers, researchers found a 75.5% increase in attempts to limit drinking during the pandemic lockdown over the same period in 2018/2019. About 120.5% of younger adults and 81.7% of older adults tried to reduce alcohol consumption.

The researchers find that the 35- to 59-year-old age group had the smallest changes in limiting their alcohol consumption. However, this could be due to an already sharp increase in alcohol reduction attempts before the lockdown.

Only people with higher socioeconomic status reported more attempts to restrict drinking.

Public health effects of lockdowns

With over 4 million coronavirus cases in the UK and over 110 million coronavirus cases worldwide, the likelihood of future bans is high.

The researchers propose expanding these findings to better understand how lockdowns affect public health. "Further analysis of longer-term trends beyond the initial lockdown and in later periods of different Covid-19 restrictions will provide interesting insights into the duration of these changes and the extent to which they are repeated in subsequent locks." The study results can help promote more important evidence-based reduction techniques to avoid high drug use.

* *Important NOTE

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.

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