The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19 infection in early 2020 prompted many nations to close their borders and institute mandatory lockdowns. While lockdowns abruptly stopped daily life, researchers from the University College London and the University of Sheffield found drug-seeking behaviors did not.
The research team previously analyzed behavioral changes in April 2020, which was the first month of lockdown.
“The first Covid-19 lockdown in England in March-July 2020 was associated with increased smoking prevalence among younger adults, and increased prevalence of high-risk drinking among all sociodemographic groups,” wrote the study authors.
While they found an increase in drug use, whether this was a short-term or long-term response to the pandemic had remained unknown.
The study “Moderators of changes in smoking, drinking, and quitting behavior associated with the first Covid-19 lockdown in England” is available as a preprint on the medRxiv* server, while the article undergoes peer review.
Changes in smoking and alcohol use are not temporary
The researchers looked at how smoking and drinking behavior changed because of lockdown. The researchers randomly sampled 1,700 adults per month and interviewed them about their drug experience through phone or the computer. A total of 36,980 adults participated in the study.
They compared people’s drug use a year before lockdown, months before the lockdown defined as August 2019 to February 2020, to the first lockdown in England, which took place from April to July 2020. Because the lockdown was lifted on July 4, 2020, the researchers excluded data for that particular month.
Comparing drug use over a similar time period helped researchers rule out seasonal changes as a possible explanation for behavioral changes.
They found various changes in smoking and drinking behavior during lockdown than before lockdown. In addition, the increased drug behavior observed in the first month of lockdown persisted for the whole four months of lockdown.
“The only exception was a change in the use of support, which fluctuated and was not statistically significant. This suggests increases in high-risk drinking, efforts to reduce alcohol consumption and quit smoking, and success in the latter were not short-lived, acute reactions to lockdown,” wrote the researchers.
Prevalence of (a) high-risk drinking among all adults; (b) reduction attempts by high-risk drinkers; and (c) use of evidence-based support and (d) use of remote support for alcohol reduction by high-risk drinkers who made a reduction attempt in England, August 2019 through July 2020. The break in the line at March 2020 indicates the timing of the Covid-19 lockdown in England (no data were collected this month). The shaded band shows the 95% confidence interval.
Younger adults showed greater changes in smoking behavior
Adults aged 18 to 34 reported higher rates of smoking during lockdown compared to older adults. The authors provide several explanations for this result, including older people being a high-risk group during the pandemic and thus, being more conscientious of their health. They also suggest younger adults may have been using smoking as a coping mechanism for the loss of significant life changes and other pandemic-related stress.
Results also showed a 156.4% increase in smoking cessation in past-year smokers and an increased 39.9% attempt to quit smoking during the lockdown. Attempts to quit were more prevalent amongst the 18-34 age group than older adults in the 35-59 and over 60 group.
“The apparent discordance between increased prevalence and increased quit attempts among younger adults does not have an obvious explanation and warrants further investigation,” wrote the authors.
Women and socioeconomic status were factors for heavy drinking
Results showed all adults increased their alcohol use by 39.5% while in lockdown compared to the same time period the year before. Women were the heavier drinkers, with a 55.4% increase in alcohol use compared to the previous year. Additionally, people in less socioeconomically advantaged groups reported a 30.7% increase in drinking.
For high-risk drinkers, the researchers found a 75.5% increase in attempts to limit drinking during the pandemic lockdown compared to the same time period in 2018/2019. About 120.5% of younger adults and 81.7% of older adults attempted to reduce alcohol use.
The researchers note that the 35-59 age group showed the smallest changes in limiting their alcohol intake, but this might be due to an already high rise in alcohol reduction attempts before lockdown.
Only people of higher socioeconomic status reported more attempts to limit drinking.
Effect of lockdowns on public health
With over 4 million coronavirus cases in the United Kingdom and over 110 million coronavirus cases worldwide, the possibility for future lockdowns is high.
The researchers suggest expanding on these findings to better inform how lockdowns impact public health. “Further analyses of longer-term trends beyond the first lockdown and during subsequent periods of differing Covid-19 restrictions will provide interesting insight into the duration of these changes and the extent to which they recurred during later lockdowns.” The study results may help promote more vital evidence-based reduction techniques to avoid high drug use.
*Important Notice
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
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