The UK Coronavirus Job Retention Scheme and smoking, alcohol consumption and vaping during the COVID-19 pandemic: evidence from eight longitudinal population surveys

  1. Michael J. Green
  2. Jane Maddock
  3. Giorgio Di Gessa
  4. Bożena Wielgoszewska
  5. Sam Parsons
  6. Gareth J. Griffith
  7. Jazz Croft
  8. Anna J. Stevenson
  9. Charlotte F. Huggins
  10. Charlotte Booth
  11. Jacques Wels
  12. Richard J. Silverwood
  13. Praveetha Patalay
  14. Alun D. Hughes
  15. Nishi Chaturvedi
  16. Laura D. Howe
  17. Emla Fitzsimons
  18. Srinivasa Vittal Katikireddi
  19. George B. Ploubidis

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Abstract

Background

Employment disruptions can impact smoking and alcohol consumption. During the COVID-19 pandemic, many countries implemented furlough schemes to prevent job loss. We examine how furlough was associated with smoking, vaping and alcohol consumption in the UK.

Methods

Data from 27,841 participants in eight UK adult longitudinal surveys were analysed. Participants self-reported employment status and current smoking, current vaping and alcohol consumption (>4 days/week or 5+ drinks per typical occasion) both before and during the early stages of the pandemic (April–July 2020). Risk ratios were estimated within each study using modified Poisson regression, adjusting for a range of potential confounders, including pre-pandemic behaviour. Findings were synthesised using random effects meta-analysis.

Results

Compared to stable employment and after adjustment for pre-pandemic characteristics, furlough was not associated with smoking (ARR = 1.05; 95% CI: 0.95–1.16; I 2 : 10%), vaping (ARR = 0.89; 95% CI: 0.74–1.08; I 2 : 0%) or drinking (ARR = 1.03; 95% CI: 0.94–1.13; I 2 : 48%). There were similar findings for no longer being employed, and stable unemployment, though this varied by sex: stable unemployment was associated with smoking for women (ARR = 1.35; 95% CI: 1.00–1.82; I 2 : 47%) but not men (0.84; 95% CI: 0.67–1.05; I 2 : 0%). No longer being employed was associated with vaping among women (ARR = 2.74; 95% CI: 1.59–4.72; I 2 : 0%) but not men (ARR = 1.25; 95% CI: 0.83–1.87; I 2 : 0%).

Conclusions

We found no clear evidence of furlough or unemployment having adverse impacts on smoking, vaping or drinking behaviours during the early stages of the COVID-19 pandemic in the UK. Differences in risk compared to those who remained employed were largely explained by pre-pandemic characteristics.

Article activity feed

  1. Version published to 10.1186/s12916-022-02511-0
  2. Version published to 10.1101/2021.10.28.21265593v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.10.28.21265593: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variableConfounders and Moderators: Confounders included: sex (female vs male); ethnicity (non-white ethnic minority vs White -including white ethnic minorities); age; education (degree vs no degree); UK nation (i.e. England, Wales, Scotland or Northern Ireland or other); household composition (based on presence of a spouse/partner and presence of children); pre-pandemic psychological distress (indicated by symptoms above thresholds on standard screening scales); pre-pandemic self-assessed health (excellent-good vs fair-poor); and pre-pandemic measures of smoking, vaping and drinking.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot 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:
    While combining analyses from several UK prospective studies represents a clear contribution to understanding the potential impact of furlough, there are limitations that should be taken into account. Firstly, we were not able to achieve full harmonisation of measures across studies, for example, a number of studies had only asked questions on recent pre-pandemic smoking of those who were smoking during the pandemic, meaning smoking cessation during the pandemic was unobserved in those studies. This means the analyses of change in smoking for these studies focused only on reductions in cigarettes smoked, rather than outright cessation. The main analyses will be less affected, though there may have been some residual confounding from participants who had smoked but given up before being surveyed during the pandemic. Focusing on maximising comparability of measures across studies also limited our scope to explore more varied definitions with respect to frequency, quantity or other aspects of use, such as binge drinking, or concurrence of smoking and vaping behaviour. Our findings focus on the initial stages of the pandemic (April-July 2020) and observed relationships could change with the duration of lockdown or furlough, and subsequent changes to restrictions and the furlough scheme. Further research is needed to explore potential heterogeneity over the course of the pandemic, within workers who retained employment, and between different measurement definitions/thresholds. As ...

    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.

    Results from scite Reference Check: We found no unreliable references.

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  4. Version published to 10.1101/2021.10.28.21265593v1 on medRxiv