Did the acute impact of the COVID-19 pandemic on drinking or nicotine use persist? Evidence from a cohort of emerging adults followed for up to nine years

Effects of Expanding Direct-to-Consumer Alcohol Home Delivery Policies: Evidence From 18 States of Increases in Alcohol Use and Consequences

OBJECTIVE

After the COVID-19 pandemic onset, several U.S. states passed legislation to begin or expand direct-to-consumer (DTC) alcohol home delivery. We examined changes in DTC use and associations between DTC use, drinking patterns, and negative consequences by different DTC policies.

METHOD

We conducted a cross-sectional, retrospective survey of 5,360 U.S. adults who consumed alcohol (ages 21-62 years), using an online Qualtrics survey panel. Participants were recruited from 18 states representing four DTC policy groupings pertaining to on- and off-premises outlets (no DTC, no change in existing DTC policy, new DTC policy, expanded DTC policy). DTC use and drinking patterns (average drinks/week, binge drinking days/month) were self-reported for four pandemic-related periods at pre- (2019-February 2020), early (March-May 2020), mid- (June 2020-March 2021), and late pandemic (April 2021-October 2023). Participants self-reported the total number of negative drinking consequences (out of 17) they experienced during the entire pandemic. Multivariate regressions examined time and policy group predicting DTC use, time and DTC use predicting drinking patterns, and DTC use and drinks/week predicting negative consequences.

RESULTS

Compared to adults in states with no delivery, odds of DTC use were highest among adults in states that expanded DTC policies (odds ratio [OR] = 2.11, 95% confidence interval [CI] [1.78, 2.50]). DTC use was associated with consuming approximately 4.43 (p < .001) more average drinks per week, more binge days per month (incidence rate ratio [IRR] = 1.33, 95% CI [1.27, 1.39]), and more negative consequences (IRR = 1.28, 95% CI [1.17, 1.39]), controlling for current drinking.

CONCLUSIONS

Our findings suggest that expanding DTC delivery policies increased alcohol accessibility, and DTC use was associated with increases in excessive alcohol use and consequences. Such data can inform future decisions about states' DTC alcohol policies.

Beyond Confinement: A Systematic Review on Factors Influencing Binge Drinking Among Adolescents and Young Adults During the Pandemic

Objectives: This study aimed to enhance the understanding of factors influencing changes in binge drinking (BD) behavior during the COVID-19 pandemic, with a particular focus on its impact on the health of individuals aged 12 to 25 years. Methods: A systematic review was conducted, encompassing studies published between January 2020 and September 2024. Articles were retrieved from PubMed, Web of Science, and Scopus, following PRISMA guidelines and the Joanna Briggs Institute (JBI) review protocols. Inclusion criteria targeted studies focusing on BD during the COVID-19 pandemic in adolescents or school-aged individuals without specific medical conditions. Exclusions included studies limited to a single gender, ethnicity, or profession, as well as doctoral theses and editorials. JBI tools were used to assess the quality of the selected studies. Results: From 33 studies (19 cross-sectional and 14 longitudinal), trends in BD during the pandemic varied: 2 studies reported an increase, while 21 indicated a decrease. Key factors linked to increased BD included pandemic stressors (e.g., isolation, social disconnection and non-compliance with restrictions), psychosocial issues (e.g., depression, anxiety, boredom, and low resilience), prior substance use, and sociodemographic variables (e.g., low education, economic extremes, living arrangements, and limited family support). Female gender and academic disengagement were also risk factors. Conversely, factors like stay-at-home orders, fear of contagion, family support, studying health sciences, and resilient coping strategies contributed to reduced BD. Other variables, such as pandemic stress and self-efficacy, had inconsistent effects. Conclusions: Factors contributing to increased BD included pandemic-related stress, mental health conditions, and unhealthy habits, while protective factors included stay-at-home orders, social support, and resilient coping. The study highlights the need for effective prevention and intervention strategies, emphasizing a holistic approach in healthcare, early detection, and tailored interventions, particularly for vulnerable groups such as adolescents.

The impact of the COVID-19 pandemic on dietary behaviors among school-age children, adolescents, and young adults: a systematic review and meta-analysis

CONTEXT

The COVID-19 pandemic has had a global impact on food security and nutrition, both in the short and long term. The influence on school-age children, adolescents, and young adults may be particularly significant and long-lasting.

OBJECTIVE

This systematic review and meta-analysis aimed to quantify the impact of the COVID-19 pandemic on dietary habits among school-age children, adolescents, and young adults worldwide.

DATA SOURCES

PubMed, Web of Science, and Embase were searched from inception to October 5, 2023.

DATA EXTRACTION

We included observational studies published in English that reported dietary quality scores and dietary intake quantities during and before the COVID-19 pandemic among school-age children, adolescents, and young adults. We included a total of 22 cohort studies and 20 cross-sectional studies of high or moderate quality.

DATA ANALYSIS

We conducted a meta-analysis, expressing dietary quality scores and dietary intake quantities as standardized mean differences (SMD) with 95% confidence intervals (CIs). For studies with low heterogeneity, we used a fixed-effects model; otherwise, we applied a random-effects model. The Newcastle-Ottawa Scale was employed by 2 reviewers independently to evaluate methodological quality. The analysis indicated that, overall, juice intake increased (SMD = 0.12, 95% CI: 0.04 to 0.20), while alcohol consumption reduced during the COVID-19 pandemic (SMD = -0.28, 95% CI: -0.47 to -0.08). However, the age-stratified results varied. Among school-age children, intake of fruit, dairy products, sugar, and juice increased. Adolescents showed an increase in meal frequency and vegetable intake. Young adults showed reduced carbohydrate and alcohol intakes, while protein and dairy product intakes increased, based on limited included studies.

CONCLUSION

Dietary changes in school-age children from before to during the pandemic were mixed, while dietary behavior changes in adolescents and young adults tended to be more positive. Considering the lasting effects of negative dietary behaviors, attention should be given to addressing the increased sugar and juice intakes. It is also crucial that caregivers and researchers monitor whether positive dietary behaviors will rebound after returning to normal study and life.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023420923.

Co-created improvement goals and strategies for implementing SBIRT and MAUD in primary care settings in a facilitator-supported, tailored implementation study

Evidence-based approaches to screening and treatment for unhealthy alcohol use have the potential to reduce morbidity and mortality but are currently underutilized in primary care settings. To support implementation of screening, brief intervention, and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) by identifying goals co-developed by clinics and practice facilitators in a flexible implementation study. In a pragmatic implementation study, we used practice facilitation to support the implementation of SBIRT and MAUD in 48 clinical practices across Oregon, Washington, and Idaho. Our study used a tailored approach, in which facilitators and clinics co-identified implementation goals based on clinic needs. We used clinic contact logs, individual interviews, group periodic reflections with practice facilitators, and exit interviews with clinic staff to inform qualitative analysis. With support from practice facilitators, clinics identified goals spanning SBIRT, MAUD, reporting, targeted patient outreach, and quality improvement capacity. Goals addressed both the technical (e.g. data tracking) and social (e.g. staff training) aspects of SBIRT and MAUD. A decision tree summarizes emergent findings into a tool to support future implementation of SBIRT in primary care settings. A facilitator-supported, tailored approach to SBIRT implementation enabled clinics to identify a variety of goals to improve SBIRT and MAUD implementation. These identified priorities, along with a decision tree describing the hierarchical structure of these goals, could support future implementation efforts.

A Source Control Model for Treatment-Resistant Substance Use Disorder

ABSTRACT

We propose applying the "source control" model of infectious disease treatment to the management of treatment-resistant substance use disorder (SUD). We believe that this conceptual framework complements other models for understanding SUD, fills a gap in our current understanding of treatment-resistant SUD, and advances the destigmatization of SUD by reinforcing SUD as a disease similar to other medical conditions. The model also harmonizes the need for multimodal treatment and novel interventions for both acute supportive care and long-term treatment of SUD. In this manuscript, we discuss the justification for, as well as the strengths and limitations of, the "source control" model for the management of treatment-resistant SUD. We also discuss the model's potential to direct innovative research questions and therapeutic interventions.

Our perception may not be reality: A longitudinal study of the relationship between perceived and actual change in smoking behavior

INTRODUCTION

Results of the impact of lockdowns and stay-at-home orders during the COVID-19 pandemic on changes in cigarette smoking are mixed. Previous studies examining smoking changes during the early stages of the pandemic in 2020 have mainly focused on smoker's perception of changes in cigarette consumption. Such measure has not been widely used in other contexts, and therefore we aim to compare the discrepancy between smokers' perceived changes in cigarette smoking and the actual change in the number of cigarettes smoked, using repeated measurements.

METHODS

We included 134 smokers from the French TEMPO cohort with repeated measurements of their perceived changes in smoking habits during the first phase of the COVID-19 pandemic and the number of cigarettes smoked repeatedly from March to May 2020. We used generalized estimation equations (GEE) to examine the association between changes in the number of cigarettes smoked and the odds of mismatched answers.

RESULTS

The results suggest that at each study wave, 27-45% of participants provided mismatching answers between their perceived change in smoking habits and the actual change in the number of cigarettes smoked daily, measured repeatedly. Results from GEE analysis demonstrated that a mismatching assessment of smoking behavior was elevated among those who had an increase (OR = 2.52 [1.37;4.65]) or a decrease (OR = 5.73 [3.27;10.03]) in number of cigarettes smoked.

DISCUSSION

Our findings highlight the possibility of obtaining different results depending on how changes in tobacco smoking are measured. This highlights the risk of underestimating the actual changes in cigarette smoking during the COVID-19 pandemic, but also more generally when validating public health interventions or smoking cessation programs. Therefore, objective measures such as the actual consumption of psychoactive substances should be utilized, preferably on a longitudinal basis, to mitigate recall bias.

Pharmaceutical and Recreational Drug Usage Patterns during and Post COVID-19 Determined by Wastewater-Based Epidemiology

Wastewater-based epidemiology (WBE) was applied to evaluate the consumption trends of pharmaceuticals (i.e., antibiotics, non-steroidal anti-inflammatory drugs, antiepileptics, antihypertensives, and others), as well as recreational drugs (caffeine, alcohol, and nicotine), in Latvia from December 2020 to July 2023. The time period covers both the COVID-19 pandemic and the post-pandemic periods; therefore, the impact of the implemented restrictions and the consequences of the illness in terms of the usage of pharmaceuticals thereon were investigated. Additionally, the seasonality and impact of the seasonal flu and other acute upper respiratory infections were studied. The results revealed that the pandemic impacted the consumption of alcohol, nicotine, and caffeine, as well as several pharmaceuticals, such as antihypertensives, antidepressants, psychiatric drugs, and the painkiller ibuprofen. The findings suggest that the imposed restrictions during the pandemic may have had a negative effect on the population's health and mental well-being. Distinct seasonal trends were discovered in the consumption patterns of caffeine and alcohol, where lower use was observed during the summer. The seasonal consumption trends of pharmaceuticals were discovered in the case of antibiotics, the antiasthmatic drug salbutamol, and the decongestant xylometazoline, where higher consumption occurred during colder seasons.

College Students' Day-to-Day Maladaptive Drinking Responses to Stress Severity and Stressor-Related Guilt and Anger

BACKGROUND

Stress is a common part of college students' daily lives that may influence their physical activity (PA) and alcohol use. Understanding features of daily stress processes that predict health behaviors could help identify targets for just-in-time interventions.

PURPOSE

This study used intensive longitudinal data to examine whether prior day stress processes predict current day PA or alcohol use.

METHODS

Participants (N=58, Mage=20.5, 59% women, 70% White) were 18-to-25-year-old students who engaged in binge drinking at least twice monthly and used cannabis or tobacco in the past year. They wore activity (activPAL4) and alcohol (Secure Continuous Remote Alcohol Monitor) monitors for 11 days to assess daily PA (e.g., step counts) and alcohol use (e.g., drinking day), and completed daily surveys about yesterday's stress, including number of stressors (i.e., frequency), stressor intensity (i.e., severity), and frequency of affective states (e.g., guilt). Multilevel models examined prior day stress predicting current day PA or alcohol use.

RESULTS

Participants had higher odds of current day drinking (odds ratio=1.21) and greater area under the curve (B=0.08) when they experienced greater than usual stress severity the prior day. Participants had higher current day peak transdermal alcohol concentration (B=0.12) and area under the curve (B=0.11) when they more frequently experienced guilt due to stressors the prior day.

CONCLUSIONS

College students' unhealthy response of increasing alcohol use due to stress could adversely impact health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.

Generation COVID: Young adult substance use

Opposing theories posited that young adult substance use during the COVID-19 pandemic would decline due to restricted access and social engagement or increase due to efforts to cope with rising distress, loneliness, and isolation. Peer-reviewed global longitudinal studies found (a) overall declines in commonly used substances in 2020 with some rebounding in 2021; (b) individual differences in this pattern, with declines linked to factors limiting access and increases to pre-existing risk; and (c) under-developed evidence to evaluate increased coping-related use. Given potential links between surging mental health disorders and substance use, further surveillance and wider dissemination of substance use programming is needed, particularly for vulnerable individuals and settings.

Pandemic-Related Changes in the Prevalence of Early Adolescent Alcohol and Drug Use, 2020-2021: Data From a Multisite Cohort Study

PURPOSE

Evaluate changes in early adolescent substance use from May 2020 to May 2021 during the coronavirus disease 2019 pandemic using data from a prospective nationwide cohort: the Adolescent Brain Cognitive Development Study.

METHODS

In 2018-2019, 9,270 youth aged 11.5-13.0 completed a prepandemic assessment of past-month alcohol and drug use, then up to seven during-pandemic assessments between May 2020 and May 2021. We compared the prevalence of substance use among same-age youth across these eight timepoints.

RESULTS

Pandemic-related decreases in the past-month prevalence of alcohol use were detectable in May 2020, grew larger over time, and remained substantial in May 2021 (0.3% vs. 3.2% prepandemic, p <.001). Pandemic-related increases in inhalant use (p = .04) and prescription drug misuse (p < .001) were detectable in May 2020, shrunk over time, and were smaller but still detectable in May 2021(0.1%-0.2% vs. 0% pre-pandemic). Pandemic-related increases in nicotine use were detectable between May 2020 and March 2021 and no longer significantly different from prepandemic levels in May 2021 (0.5% vs. 0.2% prepandemic, p = .09). There was significant heterogeneity in pandemic-related change in substance use at some timepoints, with increased rates among youth identified as Black or Hispanic or in lower-income families versus stable or decreased rates among youth identified as White or in higher-income families.

DISCUSSION

Among youth ages 11.5-13.0 years old, rates of alcohol use remained dramatically reduced in May 2021 relative to prepandemic and rates of prescription drug misuse and inhalant use remained modestly increased. Differences remained despite the partial restoration of prepandemic life, raising questions about whether youth who spent early adolescence under pandemic conditions may exhibit persistently different patterns of substance use.

Trends in Young Adult Alcohol and Cannabis Use Through the First 1.5 Years of the COVID-19 Pandemic From a Community Cohort Sample

OBJECTIVE

There has been concern regarding increased substance use during the COVID-19 pandemic, particularly among young adults, but much of this concern stemmed from cross-sectional or short-term data collected early in the pandemic. This study followed a young adult community cohort throughout the first 1.5 years of the pandemic to examine longer-term trends/trajectories in alcohol and cannabis use behaviors.

METHOD

Beginning before the COVID-19 pandemic (January 2020), 656 young adults completed up to eight surveys on substance use and other behaviors, which extended through August 2021. Multilevel spline growth models estimated changes in alcohol/cannabis use in three segments: (a) from pre-pandemic to April 2020, (b) from April 2020 to September/October 2020, and (c) from September/October 2020 to July/August 2021. Abstainers were removed from the analyses, yielding subsamples for alcohol models (n = 545; M age = 25.6 years; 59.8% female) and cannabis models (n = 303; M age = 25.6; 61.4% female).

RESULTS

Drinking frequency initially increased (3% per month), decreased in the second segment (4% per month), and plateaued in the final segment. Drinking quantity significantly decreased in all three segments: 4% per month in segment one, 3% per month in segment two, and 1% per month in the final segment. Cannabis frequency and quantity showed no significant changes across the first two segments, then significantly decreased in the final segment (3% and 6% per month, respectively). The significant changes for cannabis frequency/quantity were moderated by age, such that older participants had steeper decreases in the final segment.

CONCLUSIONS

Findings highlight that young adult alcohol and cannabis use generally declined across the first 1.5 years of the COVID-19 pandemic, contrary to widespread concerns.

How COVID-19 pandemic period influences on the selected mental health parameters of Polish respondents?

Introduction

There are many different articles about COVID-19 pandemic period and its influence on people and their behavior. Nevertheless, there is little research on the slightly later period of the pandemic, that is, the time when specific adaptation mechanisms in society should start to take place.

Methods

Our research was conducted by means of an online survey. Four hundred and eighty five adults participated, including 349 (71.96%) women and 136 (28.04%) men. The Buss-Perry aggression scale, Alcohol Use Disorders Identification Test and Generalized Anxiety Disorder 7 scale were used. The results were statistically processed using Statistica 13.3 software.

Results

Within the study population, positive correlations were noted between anxiety and generalized aggression, anger, hostility, physical and psychological aggression. In the female group, anxiety correlates positively with generalized aggression, anger, hostility, verbal and physical aggression. Among male subjects, anxiety correlates positively with aggression, anger, and hostility. Alcohol consumption has a significant association with verbal aggression. Statistically, more women experience anxiety, more men have inflated scores on the AUDIT scale and on verbal and physical aggression. Younger people are more likely than older people to experience anxiety and have inflated scores on hostility. Those with secondary education scored significantly higher on the GAD-7 scale and the aggression scale (and all subscales except anger) compared to respondents with higher education.

Discussion

As a result of adaptation to the COVID-19 pandemic, anxiety is no longer a factor in increased evels of alcohol consumption. The pandemic has not affected differences in alcohol consumption between men and women. The presence of a positive correlation between anxiety and aggression and the sociodemographic structure of those characterized by increased aggression are also unchanged. Anxiety directly influences aggressive behavior in a relatively strong way. Appropriate health-promoting measures should be implemented to protect the public from the negative effects of the COVID-19 pandemic.