Association of the COVID‐19 Lockdown With Smoking, Drinking and Attempts To Quit in England: An Analysis of 2019–20 Data
To examine changes in smoking, alcohol use and quitting/reduction behavior following the COVID‐19 lockdown in England.
Monthly cross‐sectional surveys representative of the adult population in England, aggregated before (April 2019–February 2020) versus after (April 2020) lockdown.
A total of 20 558 adults (≥ 16 years).
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 alcohol use, past‐year cessation and quit attempts (among past‐year smokers), past‐year attempts to reduce alcohol consumption (among high‐risk alcohol users) and use of evidence‐based (e.g. prescription medication/face‐to‐face behavioral support) and remote support [telephone support/websites/applications (apps)] for smoking cessation and alcohol reduction (among smokers/high‐risk alcohol users who made a quit/reduction attempt). Covariates included age, sex, social grade, region and level of nicotine and alcohol dependence (as relevant).
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 alcohol use (38.3 versus 25.1%, OR = 1.85, CI = 1.67–2.06), but also alcohol reduction attempts by high‐risk alcohol users (28.5 versus 15.3%, ORadj = 2.16, 95% CI = 1.77–2.64). Among high‐risk alcohol users 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).
Following the March 2020 COVID‐19 lockdown, smokers and high‐risk alcohol users 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 alcohol use prevalence increased post‐lockdown and use of evidence‐based support for alcohol reduction by high‐risk alcohol users decreased with no compensatory increase in use of remote support.