Association of the COVID‐19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019–20 data

Abstract

Aim

To examine changes in smoking, drinking and quitting/reduction behaviour following the COVID‐19 lockdown in England.

Design/setting

Monthly cross‐sectional surveys representative of the adult population in England, aggregated before (April 2019–February 2020) versus after (April 2020) lockdown.

Participants

A total of 20 558 adults (≥ 16 years).

Measurements

The independent variable was the timing of the COVID‐19 lockdown (before versus after March 2020). Dependent variables were: prevalence of smoking and high‐risk drinking, past‐year cessation and quit attempts (among past‐year smokers), past‐year attempts to reduce alcohol consumption (among high‐risk drinkers) and use of evidence‐based (e.g. prescription medication/face‐to‐face behavioural support) and remote support [telephone support/websites/applications (apps)] for smoking cessation and alcohol reduction (among smokers/high‐risk drinkers who made a quit/reduction attempt). Covariates included age, sex, social grade, region and level of nicotine and alcohol dependence (as relevant).

Findings

The COVID‐19 lockdown was not associated with a significant change in smoking prevalence [17.0% (after) versus 15.9% (before), odds ratio (OR) = 1.09, 95% CI = 0.95–1.24], but was associated with increases in quit attempts [39.6 versus 29.1%, adjusted odds ratio (OR _adj ) = 1.56, 95% CI = 1.23–1.98], quit success (21.3 versus 13.9%, OR _adj = 2.01, 95% CI = 1.22–3.33) and cessation (8.8 versus 4.1%, OR _adj = 2.63, 95% CI = 1.69–4.09) among past‐year smokers. Among smokers who tried to quit, there was no significant change in use of evidence‐based support (50.0 versus 51.5%, OR _adj = 1.10, 95% CI = 0.72–1.68) but use of remote support increased (10.9 versus 2.7%, OR _adj = 3.59, 95% CI = 1.56–8.23). Lockdown was associated with increases in high‐risk drinking (38.3 versus 25.1%, OR = 1.85, CI = 1.67–2.06), but also alcohol reduction attempts by high‐risk drinkers (28.5 versus 15.3%, OR _adj = 2.16, 95% CI = 1.77–2.64). Among high‐risk drinkers who made a reduction attempt, use of evidence‐based support decreased (1.2 versus 4.0%, OR _adj = 0.23, 95% CI = 0.05–0.97) and there was no significant change in use of remote support (6.9 versus 6.1%, OR _adj = 1.32, 95% CI = 0.64–2.75).

Conclusions

Following the March 2020 COVID‐19 lockdown, smokers and high‐risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high‐risk drinking prevalence increased post‐lockdown and use of evidence‐based support for alcohol reduction by high‐risk drinkers decreased with no compensatory increase in use of remote support.

SciScore for 10.1101/2020.05.25.20112656: (What is this?)

Please note, not all rigor criteria are appropriate for all manuscripts.

Table 1: Rigor

Institutional Review Board Statement	not detected.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.
Sex as a biological variable	not detected.

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

However, there were also limitations. There was a change in the modality of data collection from face-to-face (before the lockdown) to telephone (after the lockdown started), which may be associated with the changes observed rather than the inferred association with the lockdown. However, we ran diagnostic analyses to compare the representativeness of the sample before and after the modality change, which suggested the comparisons were reasonable. While we identified some differences in the unweighted sociodemographic profiles of the face-to-face and telephone samples, the weighting required to achieve a representative sample was similar across modalities, and we observed expected associations between smoking, high-risk drinking, and sociodemographic characteristics on unweighted data in the telephone sample. A second limitation is that with only one wave of post-lockdown data collected to date, this study provides a simple assessment of changes in the prevalence of key indicators of smoking and alcohol use. The optimal design to evaluate the impact of the Covid-19 lockdown on these behaviours is an interrupted time series design, which models the effect of an intervention (in this case, the lockdown), taking account of long-term trends in the data. This will not be possible for at least a year. Given the importance of health behaviours for public health, and the need for up-to-date information in this unprecedented health and social landscape, we believed it was important to...

Results from TrialIdentifier: No clinical trial numbers were referenced.

Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

Results from JetFighter: We did not find any issues relating to colormaps.

Results from rtransparent:

Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
No protocol registration statement was detected.

Read the original source