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 (ORadj) = 1.56, 95% CI = 1.23–1.98], quit success (21.3 versus 13.9%, ORadj = 2.01, 95% CI = 1.22–3.33) and cessation (8.8 versus 4.1%, ORadj = 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%, ORadj = 1.10, 95% CI = 0.72–1.68) but use of remote support increased (10.9 versus 2.7%, ORadj = 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%, ORadj = 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%, ORadj = 0.23, 95% CI = 0.05–0.97) and there was no significant change in use of remote support (6.9 versus 6.1%, ORadj = 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.

Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

“…Due to the increased use of remote modalities to support cessation at this time, it is crucial to understand how smokers react to these forms of support [47]. The evidencebased text message program supported the cessation efforts of some participants during the pandemic [48].…”

Smoking, distress and COVID-19 in England: cross-sectional population surveys from 2016 to 2020

“…Diagnostic analyses have suggested it is reasonable to compare data from before and after the lockdown, despite the change in data collection method. 16 Ethical approval for the STS is granted by the UCL Ethics Committee (ID 0498/001; ID: 2808/005). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline were used in the design and reporting of this study.…”

“…Between 2014 and 2015 the prevalence of adult smoking in England was estimated to be 16.4%. 1 Across the same period smoking prevalence was higher among those with anxiety or depression (28.0%), a long-term mental health condition (34.0%) and serious mental illness (40.5%).…”

“…12,[13][14][15] Research has suggested that following the March 2020 government restrictions, smokers were more likely to try and quit, and rates of smoking cessation were higher. 16 However, a deterioration in mental health among smokers may negatively impact quitting behaviour given that smokers with distress have been found to be less likely to quit and remain abstinent. 5,6 Our previous research has highlighted an age gradient in distress among smokers, with younger groups reporting higher levels of distress compared with older age groups.…”

Carpe covid: using COVID-19 to communicate about harms of tobacco products

“…5 In the UK, the early COVID-19 lockdown did not reduce smoking rates, but was associated with increased quit attempts and successful cessation. 6 Research on how vaping behaviour might have changed during the COVID-19 pandemic is even scanter but urgently needed.…”