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
20,558 adults (≥16y).
Measurements
The independent variable was the timing of the Covid‐19 lockdown (before vs. 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/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) vs. 15.9% (before), OR=1.09[95%CI 0.95‐1.24]), but was associated with increases in quit attempts (39.6% vs. 29.1%, ORadj=1.56[1.23‐1.98]), quit success (21.3% vs. 13.9%, ORadj=2.01[1.22‐3.33]), and cessation (8.8% vs. 4.1%, ORadj=2.63[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% vs. 51.5%, ORadj=1.10[0.72‐1.68]) but use of remote support increased (10.9% vs. 2.7%, ORadj=3.59[1.56‐8.23]). Lockdown was associated with increases in high‐risk drinking (38.3% vs. 25.1%, OR=1.85[1.67‐2.06]) but also alcohol reduction attempts by high‐risk drinkers (28.5% vs. 15.3%, ORadj=2.16[1.77‐2.64]). Among high‐risk drinkers who made a reduction attempt, use of evidence‐based support decreased (1.2% vs. 4.0%, ORadj=0.23[0.05‐0.97]) and there was no significant change in use of remote support (6.9% vs. 6.1%, ORadj=1.32[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.