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Davies NP, Murray RL, Langley T, Morling JR, Bains M. Perceptions of Children and Young People in England on the Smokefree Generation Policy: A Focus Group Study. Nicotine Tob Res 2025; 27:1066-1072. [PMID: 39688186 PMCID: PMC12095808 DOI: 10.1093/ntr/ntae300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 11/01/2024] [Accepted: 12/04/2024] [Indexed: 12/18/2024]
Abstract
BACKGROUND Modeling shows smokefree generation (SFG) policies could effectively reduce smoking rates by banning tobacco sales to those born after a specific year. Little is known about how young people perceive the legitimacy and impact of the planned SFG policy in England. METHODS We conducted seven semi-structured focus groups with 36 participants aged 12-21 (mean = 15) in England over video call and in person. Twenty-one participants were female and 15 male. Participants were purposively sampled to include those from areas of greater deprivation and for use of tobacco or e-cigarettes. Data was analyzed using the framework approach. RESULTS Participants expressed broadly negative perceptions toward tobacco and its manufacturers. Most participants supported SFG policy goals and its focus on freedom from addiction and harm; some believed it should also encompass electronic cigarettes. Many believed the law would only be successful if it included stringent enforcement, accompanying tobacco licensing, and input from young people. A minority raised concerns about the loss of freedom to purchase tobacco. CONCLUSIONS Communication of the freedom-giving nature of SFG is likely to resonate with many young people. Enforcement, communication, and involvement of young people in SFG should be considered carefully to maximize policy impact. IMPLICATIONS The smokefree generation (SFG) policy's potential to offer freedom from addiction and disease can resonate with young people. Its effectiveness could be maximized through targeted enforcement in areas with high youth smoking rates and low adherence to age-of-sale laws, and through the introduction of additional policies that offer restrictive licensing of tobacco retailers. A phased approach to SFG, initially covering tobacco and later incorporating e-cigarettes as smoking prevalence declines, could balance reducing youth vaping and harm reduction; future research could investigate optimal policy conditions for this approach.
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Affiliation(s)
- Nathan P Davies
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
| | - Rachael L Murray
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Tessa Langley
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Joanne R Morling
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust with the University of Nottingham, Nottingham, UK
| | - Manpreet Bains
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
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2
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Vincent H, Laverty AA, Brown J, Beard E, Bogdanovica I. Association between the implementation of standardised tobacco packaging legislation and illicit tobacco and cross-border purchasing in England: a time-series analysis between 2012 and 2020. Tob Control 2025; 34:330-334. [PMID: 38184372 DOI: 10.1136/tc-2023-058253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND In May 2016, the UK announced standardising packaging legislation for tobacco products. There was a 12-month transition period with both branded and standardised packs on the market until May 2017. The aim of this study was to investigate whether the implementation of standardised packaging in England was associated with changes in illicit tobacco and cross-border purchasing. METHODS We used Smoking Toolkit Study data covering the time period from 2012 to 2020. We ran time-series analysis using Autoregressive Integrated Moving Average with Exogenous Variable models to investigate the monthly changes in illicit tobacco and cross-border purchasing in England. The model was adjusted for other tobacco control policies implemented during the relevant time period and tobacco pricing. We used May 2017 as an implementation point and run sensitivity analysis using July 2016 and February 2017 as alternative implementation points given phased introduction of the policy. RESULTS The average prevalence of illicit tobacco and cross-border purchasing in the past 6 months was 14.4%. The implementation of standardised tobacco packaging legislation was associated with a monthly decline in illicit tobacco and cross-border purchases after May 2017 by 0.16% per month (beta=-0.158, 95% CI -0.270 to -0.046). The results were robust to considering different implementation points for the policy (July 2016: beta=-0.109, 95% CI -0.213 to -0.005; February 2017: beta=-0.141, 95% CI -0.245 to -0.036). CONCLUSIONS In contrast to the tobacco industry's argument that the legislation would lead to an increase in the illicit tobacco and cross-border market, this study demonstrates that the implementation of the policy is associated with a decline in illicit tobacco and cross-border purchases in England.
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Affiliation(s)
- Hannah Vincent
- School of Medicine, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Ilze Bogdanovica
- SPECTRUM Consortium, London, UK
- School of Medicine, University of Nottingham, Nottingham, UK
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3
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Okahara S, Fujino Y, Nagata T, Kuwamura M, Mafune K, Muramatsu K, Tateishi S, Ogami A, Mori K. Self-reported symptoms or activity limitations and job loss during the COVID-19 pandemic in Japan. Occup Med (Lond) 2025; 75:50-57. [PMID: 39661400 DOI: 10.1093/occmed/kqae132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2024] Open
Abstract
BACKGROUND Previous studies have reported the impact of a diagnosed disease or self-perceived poor overall health on job loss. However, evidence is lacking on which self-reported symptoms or activity limitations are related to job loss, especially during the coronavirus disease 2019 (COVID-19) pandemic. AIMS We investigated whether self-reported symptoms or activity limitations were correlated with the occurrence of job loss within 1 year during the COVID-19 pandemic. METHODS In this prospective cohort study, we used questionnaires administered to Japanese workers. A baseline survey conducted in December 2020 was used to determine workers' symptoms or activity limitations. Experiencing job loss since the baseline survey was ascertained with a follow-up survey in December 2021. The odds ratios of experiencing job loss were estimated using a logistic model with adjusted covariates. RESULTS Men (n = 8682) accounted for 58% of the total sample (n = 14 910), and the respondent mean age was 48.2 years. Multivariate analysis showed that workers with pain-related problems; limited physical movement and mobility; fatigue, loss of strength or appetite, fever, dizziness and moodiness; mental health problems; sleep-related problems or eye-related matters had a greater probability of experiencing job loss owing to health reasons. CONCLUSIONS Several self-reported symptoms or activity limitations can lead to job loss after 1 year, indicating that prevention and resolution of symptoms or activity limitations are important to reduce workers' risk of losing their jobs.
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Affiliation(s)
- S Okahara
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Y Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - T Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - M Kuwamura
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - K Mafune
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - K Muramatsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - S Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - A Ogami
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - K Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
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Jackson SE, Tattan-Birch H, Buss V, Shahab L, Brown J. Trends in Daily Cigarette Consumption Among Smokers: A Population Study in England, 2008-2023. Nicotine Tob Res 2025; 27:722-732. [PMID: 38692652 PMCID: PMC11997653 DOI: 10.1093/ntr/ntae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION This study aimed to estimate time trends in cigarette consumption among smokers in England between 2008 and 2023 and to explore differences by key potential moderators. AIMS AND METHODS We used data from 57 778 adult cigarette smokers participating in a nationally representative monthly cross-sectional survey between January 2008 and September 2023. We estimated monthly time trends in mean daily consumption of (1) any, (2) manufactured, and (3) hand-rolled cigarettes among all smokers and by main type of cigarettes smoked, smoking frequency, age, gender, occupational social grade, region, nicotine replacement therapy use, and vaping status. RESULTS Overall cigarette consumption fell from 13.6 [95% CI = 13.3 to 13.9] to 10.6 [10.5 to 10.8] per day between January 2008 and October 2019 (a 22% decrease), then remained stable up to September 2023. Over this period, the proportion mainly or exclusively smoking hand-rolled cigarettes increased (from 30.6% [29.1%-32.1%] in 2008 to 52.1% [49.7%-54.5%] in 2023). As a result, manufactured cigarette consumption fell by 47%, from 9.5 [9.2-9.8] per day in January 2008 to 5.0 [4.7-5.3] in September 2023, while hand-rolled cigarette consumption increased by 35%, from 4.2 [3.9-4.4] to 5.6 [5.3-5.9], respectively. The decline in overall cigarette consumption was observed across all subgroups, but was greater among non-daily smokers, younger smokers, and those who vaped. CONCLUSIONS Over the last 15 years, the average number of cigarettes consumed each day by smokers in England has fallen by almost a quarter, but has plateaued since October 2019. There has been a sharp decline in the number of manufactured cigarettes consumed and an increase in the number of hand-rolled cigarettes consumed, as smokers have increasingly shifted towards using hand-rolled tobacco. IMPLICATIONS While average cigarette consumption in England has fallen over the past 15 years, this declining trend has stalled (and reversed in some population groups) since 2019. The availability of cheap, hand-rolled tobacco appears to be undermining policies that aim to reduce smoking by raising the price of tobacco (eg, through taxation) and could be targeted to reignite the decline in cigarette consumption.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Vera Buss
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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Merlo A, Koyun AH, Hendriksen PA, Garssen J, Bruce G, Stock A, Verster JC. Effects of COVID-19 Lockdowns on Alcohol Consumption, Hangovers and Smoking Among Young Adults (n = 140) in Germany: An On-Line Study. Hum Psychopharmacol 2025; 40:e70000. [PMID: 39887587 PMCID: PMC11780482 DOI: 10.1002/hup.70000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 12/27/2024] [Accepted: 01/17/2025] [Indexed: 02/01/2025]
Abstract
OBJECTIVE This study investigated the impact of 2019 coronavirus disease (COVID-19) lockdowns on alcohol consumption and smoking behavior among young adults from Germany. METHODS An online survey was completed by N = 317 young adults living in Germany. Of these, 140 (44.2%) consumed alcohol and were included in the analysis. They reported on alcohol consumption, hangover frequency and severity, and smoking behavior across four time periods: (1) "BP" (the period before the COVID-19 pandemic), (2) "L1" (the first lockdown; March-May, 2020), (3), NL1 (the no lock-down period; summer 2020), and (4) L2 (the second lockdown, November 2020 to May 2021). RESULTS During L1, a significant decrease was observed in weekly alcohol intake, the number of drinking days, and the number of days where more than eight alcoholic drinks were consumed. Whereas hangover frequency was significantly increased during L1, hangover severity was significantly reduced. During NL1, drinking behaviors returned to BP levels. During L2, the decrease in alcohol consumption was much smaller, and not significantly different from BP. However, compared to BP, during L2 hangover frequency was significantly increased and hangover severity was significantly reduced. With regards to smoking, no significant differences compared to BP were found. CONCLUSIONS During the COVID-19 lockdown periods in Germany, a significant decrease in alcohol consumption was observed among this group of young adults. Whereas hangover frequency was significantly increased during the lockdown periods, hangover severity was significantly reduced.
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Affiliation(s)
- Agnese Merlo
- Division of PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Anna H. Koyun
- Cognitive Neurophysiology Department of Child and Adolescent PsychiatryFaculty of MedicineDresdenGermany
| | - Pauline A. Hendriksen
- Division of PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
| | - Johan Garssen
- Division of PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
- Danone Global Research & Innovation CenterUtrechtThe Netherlands
| | - Gillian Bruce
- School of Education and Social SciencesUniversity of the West of ScotlandPaisleyUK
| | - Ann‐Kathrin Stock
- Cognitive Neurophysiology Department of Child and Adolescent PsychiatryFaculty of MedicineDresdenGermany
| | - Joris C. Verster
- Division of PharmacologyUtrecht Institute for Pharmaceutical SciencesUtrecht UniversityUtrechtThe Netherlands
- Cognitive Neurophysiology Department of Child and Adolescent PsychiatryFaculty of MedicineDresdenGermany
- Centre for Mental Health and Brain SciencesSwinburne UniversityMelbourneAustralia
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Jackson SE, Tattan‐Birch H, Brown J. Trends in where people buy their vaping products and differences by user and device characteristics: A population study in England, 2016-23. Addiction 2025; 120:539-548. [PMID: 37963674 PMCID: PMC11813730 DOI: 10.1111/add.16387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023]
Abstract
AIMS To explore where people in England typically buy e-cigarettes/vaping products, how their characteristics and the types of products purchased differ according to the source of purchase and whether this is changing over time. DESIGN This was a nationally representative monthly cross-sectional survey. SETTING The study was conducted in England, 2016-23. PARTICIPANTS A total of 6507 adults (≥ 18 years) who reported current vaping. MEASUREMENTS Participants were asked where they usually buy their vaping products: vape shops, supermarkets/convenience stores, on-line or other sources ('other' or cheap from friends). FINDINGS Up to 2020, vape shops were the most common source of purchase (mean monthly proportion = 43.3%), followed by supermarkets/convenience stores (29.7%) and on-line retailers (20.5%). In 2020, these purchasing patterns shifted: on-line purchasing increased and vape-shop purchasing fell. The rise in on-line purchasing was short-lived, peaking at 33.6% [95% confidence interval (CI) = 31.0-36.5%] in July 2021, and soon returned to baseline levels. However, the fall in vape-shop purchasing persisted, remaining below 31% from July 2021 onwards, displaced by a rapid rise in purchasing from supermarkets and convenience stores from 31.6% (95% CI = 29.6-33.7%) in January 2021 to 48.5% (95% CI = 42.9-54.8%) by April 2023. This rise was most pronounced among younger adults (aged 18-35 years; Pinteraction < 0.001) and those mainly using disposable devices (Pinteraction = 0.013). Purchasing from other sources was relatively rare, and declined from 9.1% (95% CI = 6.6-12.7%) in July 2016 to 4.3% (95% CI = 2.6-7.1%) in April 2023. CONCLUSIONS Supermarkets and convenience stores have recently overtaken vape shops to become the most popular places to buy vaping products in England. This change appears to have been driven by the rising popularity of new disposable e-cigarettes among younger adults, who tend to buy these products from supermarkets/convenience stores.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumLondonUK
| | - Harry Tattan‐Birch
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumLondonUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumLondonUK
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7
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Jackson SE, Oldham M, Garnett C, Brown J, Shahab L, Cox S. Smoking, and to a lesser extent non-combustible nicotine use, is associated with higher levels of alcohol consumption and risky drinking. Sci Rep 2025; 15:6851. [PMID: 40011541 PMCID: PMC11865552 DOI: 10.1038/s41598-025-89750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 02/07/2025] [Indexed: 02/28/2025] Open
Abstract
This study aimed to estimate differences in alcohol consumption, receipt of alcohol brief intervention, and alcohol reduction attempts by smoking status and use of non-combustible nicotine (including e-cigarettes, nicotine replacement therapy, heated tobacco products, or nicotine pouches). Data were from a representative household survey of adults in England (n = 188,878). Participants who reported former or current smoking scored approximately 1 point higher, on average, on the AUDIT-C (which measures alcohol consumption) than those who had never regularly smoked (Badj=0.97 [95%CI 0.93-1.00] and 0.92 [0.87-0.96], respectively) and had double the odds of risky drinking (AUDIT-C ≥ 5: ORadj=2.04 [1.98-2.10] and 2.03 [1.97-2.10], respectively), while differences for those who did versus did not use non-combustible nicotine use were less pronounced (AUDIT-C: Badj=0.14 [0.08-0.21]; AUDIT-C ≥ 5: ORadj=1.09 [1.04-1.13]). Among participants who engaged in risky drinking, those who smoked (vs. not) were more likely to report receiving alcohol brief interventions, and those attempting to quit smoking (vs. not) were more likely to report alcohol reduction attempts. Overall, combustible and - less so - non-combustible nicotine use is associated with higher levels of alcohol consumption and risky drinking.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
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Xiao QQ, Huang XH, Yang J, Wang C, Mu YF, Cai J, Deng ZY, Wang Y, Deng AP, Song HJ, Chen J, Qiu CJ, Zhang J, Li B, Long J, Meng XD, Zhang L, Huang Y, Gao R, Zhao JS, Zhang BZ, Ran MS. Effects of life rules on mental health and behavioral problems among adolescent and youth students: A survey after the lifting of COVID-19 restrictions in China. BMC Public Health 2025; 25:722. [PMID: 39984898 PMCID: PMC11846201 DOI: 10.1186/s12889-025-21968-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 02/14/2025] [Indexed: 02/23/2025] Open
Abstract
OBJECTIVE To explore the impact of life rules (including individual's life habits and life patterns, such as diet, sleep, and learning styles) on mental health and behavioral problems among adolescent and youth students after the lifting of COVID-19 restrictions in Sichuan, China and analyze the influencing factors of life rules. METHODS An online survey was conducted in middle schools, high schools, colleges and universities in Sichuan Province, China, from December 14, 2022, to February 28, 2023. Demographic information, COVID-19 epidemic-related questions, behavioral and mental health information were collected. Pearson chi-square tests and One-way ANOVA were used to compare the differences of drinking/smoking, suicidal ideation and attempts, internet addiction, anxiety, depression and PTSD among groups with different life rules. Multiple logistic regression analysis was used to analyze the influencing factors of life rules. RESULTS A total of 82,873 eligible participants (aged 12-24 years) were included in this study, 40,519 participants (48.9%) reported that their life rules were partially impacted by the COVID-19 pandemic, and 6,461 participants (7.8%) reported that their life rules were severely disrupted. A total of 61.2% of participants partially recovered their life rules, and 8.6% of participants did not recover their life rules. There were statistically significant differences among different groups in terms of drinking/smoking habits, frequency of drinking/smoking in the past year, volume of drinking/smoking, internet addiction, anxiety and depression symptoms, PTSD, suicidal ideation and attempts (all P < 0.01). There were significant differences in the degree of impact and recovery of life rules among different genders, residence, grade, family economic level, home study status, academic level, infection and isolation status (all P < 0.01). CONCLUSIONS Adolescent and youth students with disrupted life rules during and after the COVID-19 pandemic had significantly more mental health and behavioral problems. Targeted and specific psychosocial interventions should be urgently needed to reduce the mental health and behavioral problems among students.
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Affiliation(s)
- Qing-Qing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xue-Hua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Jing Yang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Cong Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yun-Fei Mu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jia Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhong-Yue Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yu Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ai-Ping Deng
- School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China
- West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hong-Jun Song
- School of Nursing, Sichuan University, Chengdu, 610041, Sichuan, China
- West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jin Chen
- Department of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Chang-Jian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jun Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jiang Long
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ru Gao
- Wenjiang People's Hospital, Chengdu, 610037, Sichuan, China
| | - Jun-Shu Zhao
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Bing-Zhi Zhang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Department of Social Psychiatry, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Munroe C, Surace A, Martinez P. "My Health Is More Important than Drinking": A Qualitative Analysis of Alcohol Use During COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:224. [PMID: 40003450 PMCID: PMC11855319 DOI: 10.3390/ijerph22020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/24/2025] [Accepted: 01/31/2025] [Indexed: 02/27/2025]
Abstract
(1) Background: Although alcohol use increased overall in the US during the COVID-19 pandemic, approximately 16% of people decreased their drinking. Understanding reasons for decreasing or discontinuing alcohol use during a time of crisis could inform alcohol messaging during future crises. (2) Methods: We conducted hour-long interviews with 26 participants who reported drinking above NIAAA guidelines at the second wave of the National Alcohol Survey COVID Cohort (a longitudinal study of alcohol use during the COVID-19 pandemic). Data were analyzed using codebook thematic analysis. (3) Results: Many participants reported decreasing use after a period of heavy drinking. Four themes emerged as reasons for doing so: (1) health conditions attributed to or worsened by drinking, (2) concerns about developing the same alcohol problems as a family member, (3) life demands and transitions that limited drinking opportunities, and (4) disliking the side- and after-effects of drinking (e.g., hangovers). (4) Conclusions: Concerns about negative health consequences from heavy alcohol use and limited opportunities to use alcohol due to competing life demands were salient reasons for reducing or abstaining from alcohol use during COVID-19. Incorporating themes about health and life obligations into messaging to reduce alcohol use during crises may improve message relevance.
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Affiliation(s)
- Cat Munroe
- Department of Psychology, Purchase College SUNY, Purchase, NY 10577, USA
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (A.S.); (P.M.)
| | - Anthony Surace
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (A.S.); (P.M.)
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Priscilla Martinez
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (A.S.); (P.M.)
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10
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Angus C, Oldham M, Burton R, Dina LM, Field M, Hickman M, Kaner E, Loebenberg G, Munafò M, Pizzo E, Brown J, Garnett C. Modeling the Potential Health, Health Economic, and Health Inequality Impact of a Large-Scale Rollout of the Drink Less App in England. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2025; 28:215-223. [PMID: 39694259 DOI: 10.1016/j.jval.2024.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 11/07/2024] [Accepted: 11/15/2024] [Indexed: 12/20/2024]
Abstract
OBJECTIVES Alcohol places a significant burden on the National Health Service (NHS); yet, uptake of cost-effective approaches remains low. Digital interventions may overcome some barriers to delivery. The Drink Less app has evidence of being effective at supporting heavier drinkers to reduce their alcohol intake. In this study, we estimate the longer-term health impacts, cost-effectiveness, and health inequality impact of a large-scale rollout of the Drink Less app. METHODS We used the Sheffield Alcohol Policy Model to estimate changes in alcohol consumption, hospital admissions, mortality, and NHS costs of 2 rollout scenarios over a 20-year time horizon: (1) a mass media awareness campaign and (2) a targeted drive to embed referral to Drink Less within primary care. We modeled the cost-effectiveness and inequality impact of each approach in a distributional cost-effectiveness analysis. RESULTS A mass media campaign is estimated to reduce per capita alcohol consumption by 0.07 units/week and avert 108 556 hospital admissions and 2606 deaths over 20 years, gaining 24 787 quality-adjusted life-years at a net saving to the NHS of £417 million. Embedding in primary care is estimated to reduce consumption by 0.13 units/week, saving 188 452 admissions and 4599 deaths and gaining 38 897 quality-adjusted life-years at a net saving of £590 million. Both scenarios are estimated to reduce health inequalities, with a larger reduction for the primary care approach. CONCLUSIONS A large-scale rollout of the Drink Less app is estimated to be health improving, cost saving, and reducing health inequalities. Embedding the use of Drink Less within primary care is likely to be the more effective approach.
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Affiliation(s)
- Colin Angus
- School of Medicine and Population Health, University of Sheffield, Sheffield, England, UK.
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, London, England, UK
| | - Robyn Burton
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
| | - Larisa-Maria Dina
- Department of Behavioural Science and Health, University College London, London, England, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, England, UK
| | - Mattew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, England, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, England, UK
| | - Gemma Loebenberg
- Department of Behavioural Science and Health, University College London, London, England, UK
| | - Marcus Munafò
- School of Psychological Science, University of Bristol, Bristol, England, UK
| | - Elena Pizzo
- Department of Applied Health Research, University College London, London, England, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, England, UK
| | - Claire Garnett
- School of Psychological Science, University of Bristol, Bristol, England, UK
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11
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Jackson SE, Shahab L, Brown J. Trends in Exclusive Non-Cigarette Tobacco Smoking in England: A Population Survey 2013-2023. Nicotine Tob Res 2025; 27:342-350. [PMID: 38439612 PMCID: PMC11750737 DOI: 10.1093/ntr/ntae021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION The UK Government intends to implement a "smokefree generation" policy prohibiting the sale of all tobacco products to people born after 2008. National surveys provide comprehensive data on cigarette smoking, but little is known about patterns of non-cigarette tobacco smoking across key population groups. AIMS AND METHODS Using data from a nationally representative cross-sectional survey of adults in England, collected monthly between September 2013 and September 2023 (n = 196 721), we estimated time trends in exclusive non-cigarette tobacco (eg, cigar/pipe/shisha) smoking prevalence, overall and by age, gender, occupational social grade, region, ethnicity, and vaping status. Interviews were conducted face-to-face until March 2020 and via telephone thereafter. RESULTS From September 2013 to September 2023, there was a non-linear increase in exclusive non-cigarette tobacco smoking prevalence (from 0.36% to 1.68%; prevalence ratio = 4.72 [95% CI = 3.43-6.48]). Prevalence was relatively stable up to February 2020 (at an average of 0.46%), then increased sharply at the start of the COVID-19 pandemic (at the same time as survey methods changed), to 0.90% (0.82%-0.99%) in March 2020. This was followed by a steadier rise, peaking at 1.97% in May 2022, before falling slightly to 1.68% by September 2023. In 2022/2023, 1 in 10 smokers (10.8% [9.64%-12.0%]) exclusively used non-cigarette tobacco. The rise in prevalence was observed across all subgroups but was most pronounced among younger adults (eg, reaching 3.21% of 18-year-olds vs. 1.09% of 65-year-olds). Prevalence was consistently higher among men and current vapers. CONCLUSIONS Although exclusive use of non-cigarette combustible tobacco remains rare among adults in England, it has increased in recent years, particularly among younger ages. As of September 2023, there were approximately 772 800 adult exclusive non-cigarette tobacco smokers in England; around five times more than a decade earlier. IMPLICATIONS The proportion of adults in England who do not use cigarettes at all but smoke other combustible tobacco products has increased substantially in recent years, with a particularly pronounced rise among young people. The inclusion of non-cigarette combustible tobacco products under the proposed "smokefree generation" policy is therefore likely to be important for achieving the greatest reduction in youth uptake of tobacco smoking, as it would ensure young people who are unable to legally buy cigarettes do not buy other combustible tobacco products that are similarly harmful to health.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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12
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Buss VH, Shahab L, Cox S, Kock L, Oldham M, Bauld L, Cheeseman H, Reid G, Brown J. Exploring public support for novel tobacco and alcohol control policies in Great Britain 2021-2023: A population-based cross-sectional survey. Heliyon 2025; 11:e41303. [PMID: 39807506 PMCID: PMC11728982 DOI: 10.1016/j.heliyon.2024.e41303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 11/25/2024] [Accepted: 12/16/2024] [Indexed: 01/16/2025] Open
Abstract
Objective and rationale This study assessed support for novel tobacco compared with alcohol control policies among adults in Great Britain in 2021-2023. Objectives were to assess 1) overall level of support for tobacco compared to alcohol control policies; 2) level of support for tobacco compared to alcohol control policies among people who smoke tobacco or who consume alcohol at increasing and higher risk levels, or who do both; 3) level of support for tobacco compared to alcohol control policies among different sociodemographic groups? Methods Data were collected in September/October 2021-2023 in a monthly population-based survey on smoking and drinking behaviour of adults across Great Britain (N = 6311), weighted to match the overall population. Outcome measure was level of support for each seven tobacco and alcohol control policies. Results More people were in support of tobacco than alcohol control policies (e.g., 57 % vs. 51 % for tax-related policies). This trend was apparent across all sociodemographic subgroups. With one exception, the policies included in this study were supported by more than half of the participants. The exception was decreasing the visibility of alcohol products in shops, which received 41 % of support. People who engaged in the behaviour targeted by policies (tobacco more so than alcohol use) were generally less supportive. Conclusion Overall, public support for tobacco and alcohol control policies is high in Great Britain. With one exception, the policies were supported by over half of participants, suggesting that the public is in favour of government regulations to reduce smoking and drinking prevalence in Great Britain.
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Affiliation(s)
- Vera Helen Buss
- Department of Behavioural Science and Health, University College London, UK
- Spectrum Research Consortium, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, UK
- Spectrum Research Consortium, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, UK
- Spectrum Research Consortium, UK
- Behavioural Research UK, UK
| | - Loren Kock
- Department of Behavioural Science and Health, University College London, UK
- Vermont Center on Behavior and Health, University of Vermont, Vermont, USA
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, UK
- Spectrum Research Consortium, UK
| | - Linda Bauld
- Spectrum Research Consortium, UK
- Behavioural Research UK, UK
- Usher Institute, University of Edinburgh, UK
| | - Hazel Cheeseman
- Spectrum Research Consortium, UK
- Action on Smoking and Health (ASH), London, UK
| | - Garth Reid
- Spectrum Research Consortium, UK
- Public Health Scotland, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, UK
- Spectrum Research Consortium, UK
- Behavioural Research UK, UK
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13
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Mansour S, Hammoud RA, Hamoud R, El Sayed S, Kerbage H, Assi B, Assi A, Elbejjani M. Lifestyle and Health Behavior Changes in the COVID-19 Pandemic: A Role for Mental Health Symptoms and Diagnosis and Daily Life Difficulties During Lockdown in Lebanon. Behav Med 2025:1-13. [PMID: 39814595 DOI: 10.1080/08964289.2024.2447377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 11/28/2024] [Accepted: 12/12/2024] [Indexed: 01/18/2025]
Abstract
Several studies report significant changes in lifestyle habits during the COVID-19 pandemic, yet results are largely heterogeneous across populations. We examined changes in lifestyle and health behaviors during the first COVID-19 lockdown in Lebanon and assessed whether mental and physical health indicators and outbreak- and lockdown-related factors are related to these changes. Data come from a cross-sectional online survey (May-June 2020) which assessed changes in smoking, alcohol, diet, eating behavior, physical activity, sleep hours, sleep satisfaction, social media use, self-rated health, and life satisfaction (n = 494). We examined these changes' association with current depressive and anxiety symptoms, presence of physical and mental disorders, outbreak-related worries, and lockdown-related factors using regression models adjusted for sociodemographic and socioeconomic covariates. Most prevalent changes were increased social media use (63.2%) and decreased life satisfaction (54.9%) and physical activity (53.4%). Higher depressive and anxiety symptoms, higher daily life difficulties, and presence of diagnosed mental disorder were related to worsening of almost all behaviors. Participants with higher outbreak worries had less healthy diet and increased social media use. Higher adherence to lockdown and preventive measures were associated with increased social media use and lower life satisfaction, respectively. Results show a clear clustering of negative lifestyle and health behavioral changes with current mental health symptoms, existing mental health disorder, and daily life challenges during lockdowns. Findings highlight the importance of tracking higher-risk mental health subgroups to mitigate further adverse impact on mental and physical health.
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Affiliation(s)
- Sara Mansour
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rawan A Hammoud
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ranam Hamoud
- Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Samya El Sayed
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hala Kerbage
- Saint-Eloi University Hospital, Montpellier, France
- INSERM U 1018 Developmental Psychiatry, Paris-Saclay University, Gif-sur-Yvette, France
| | - Batoul Assi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ahmad Assi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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14
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Arulsamy K, McNamee P, Mendolia S. The gendered impact of Covid-19 on health behaviours and mental health: Evidence from the UK. Soc Sci Med 2025; 365:117565. [PMID: 39647181 DOI: 10.1016/j.socscimed.2024.117565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/21/2024] [Accepted: 11/25/2024] [Indexed: 12/10/2024]
Abstract
The purpose of this paper is to assess whether the COVID-19 pandemic affected the health behaviours of men and women differently, and to estimate whether the associations between health behaviours and mental health differed by gender. By employing nationally representative panel data (UKHLS) and a difference-in-differences strategy, we provide evidence that the pandemic adversely affected health behaviours among women more than men in the UK. Compared to men, women were 3.2 percentage points less likely to adopt a healthy lifestyle and reported 0.09 fewer healthy behaviours (corresponding to 7.0 per cent of a standard deviation) during the pandemic. These changes are primarily driven by smaller improvements rather than absolute declines in health behaviours for women compared to men. The changes in health behaviours among women appear to persist over time when lockdown policies were relaxed. Importantly, we find that the pandemic considerably weakened the protective effect of health behaviours on mental health for women but not for men. For women, adopting a healthy lifestyle was strongly correlated with mental health before the pandemic, but this relationship was no longer significant during the pandemic. This loss in significance corresponds to a 0.61-points decline in the GHQ-12 Likert score, equivalent to 10.5 per cent of a standard deviation. However, we observe a partial return of the protective effect of health behaviours on mental health once lockdown measures had eased.
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Affiliation(s)
| | - Paul McNamee
- Health Economics Research Unit, University of Aberdeen, Scotland, United Kingdom.
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15
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Jackson SE, Beard E, Brown J. Evaluation of a Regional Tobacco Control Program (Greater Manchester's Making Smoking History) on Quitting and Smoking in England 2014-2022: A Time-Series Analysis. Nicotine Tob Res 2024; 26:1728-1736. [PMID: 38850042 PMCID: PMC11581995 DOI: 10.1093/ntr/ntae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
INTRODUCTION This study aimed to assess the impact of Greater Manchester's Making Smoking History program-a region-wide smoking cessation programs launched in January 2018-on key smoking and quitting outcomes. METHODS Data were from a nationally representative monthly survey, 2014-2022 (n = 171 281). We used interrupted time-series analyses (Autoregressive Integrated Moving Average [ARIMA] and generalized additive models [GAM]) to examine regional differences between Greater Manchester and the rest of England, before and during the program's first five years. Outcomes were rates of quit attempts and overall quits among smokers, quit success rates among smokers who tried to quit (preregistered outcomes), and current smoking prevalence among adults (unregistered outcome). RESULTS Results showed mixed effects of the program on quitting. Primary ARIMA models showed comparative reductions in quit success rates (change in quarterly difference between regions = -11.03%; 95% CI -18.96; -3.11) and overall quit rates in Greater Manchester compared with the rest of England (-2.56%; 95% CI -4.95; -0.18), and no significant change in the difference in the quit attempt rate (+2.95%; 95% CI -11.64; 17.54). These results were not consistently observed across sensitivity analyses or GAM analyses. Exploratory ARIMA models consistently showed smoking prevalence in Greater Manchester declined more quickly than in the rest of England following the initiation of the program (-2.14%; 95% CI -4.02; -0.27). CONCLUSIONS The first five years of Greater Manchester's Making Smoking History program did not appear to be associated with substantial increases in quitting activity. However, exploratory analyses showed a significant reduction in the regional smoking rate, over and above changes in the rest of England over the same period. IMPLICATIONS Taken together, these results show a relative decline in smoking prevalence in Greater Manchester but equivocal data on quitting, introducing some uncertainty. It is possible the program has reduced smoking prevalence in the absence of any substantial change in quitting activity by changing norms around smoking and reducing uptake, or by reducing the rate of late relapse. It is also possible that an undetected effect on quitting outcomes has still contributed to the program's impact on reducing prevalence to some degree. It will be important to evaluate the overall impact of the program over a longer timeframe.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Emma Beard
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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16
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Jackson S, Oldham M, Angus C, Garnett C, Wilson L, Holmes J, Brown J. Trends in alcohol expenditure among risky drinkers: A population study in England, 2014-2023. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 133:104615. [PMID: 39388915 DOI: 10.1016/j.drugpo.2024.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 09/27/2024] [Accepted: 10/04/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND This study aimed to estimate time trends in alcohol expenditure among risky drinkers in England over the past decade, to understand whether these trends are driven by changes in prices paid or volumes purchased, and to explore differences between population subgroups. METHODS Nationally-representative monthly cross-sectional survey. Participants were 44,382 adults (≥18y) drinking at risky levels (AUDIT-C ≥ 5; 'risky drinkers'). Linear regression modelled trends between March-2014 and October-2023 in (i) mean weekly inflation-adjusted expenditure on alcohol, (ii) mean weekly alcohol consumption in units, and (iii) mean inflation-adjusted expenditure per unit of alcohol, overall and by age, gender, social grade, region, and smoking status. RESULTS There was an uncertain decrease in mean weekly expenditure from £18.90 [95 %CI=£18.30-£19.50] in March-2014 to £17.90 [£17.60-£18.30] in May-2016, then an uncertain increase to £18.60 [£18.30-£18.90] between May-2016 and June-2018. This was followed by a further decline to £16.90 [£16.60-£17.30] by April-2021 and subsequent rise to £18.60 [£17.90-£19.40] by October-2023. Changes in weekly alcohol expenditure were more closely mirrored by changes in mean expenditure per unit of alcohol than by changes in mean weekly alcohol consumption in units. Notable subgroup differences included sharp rises in weekly alcohol expenditure since 2021 among younger ages (driven by a rise in expenditure per unit of alcohol) and current smokers (driven by a rise in weekly units of alcohol consumed). CONCLUSIONS In England, the average amount adult risky drinkers reported spending on alcohol each week has fluctuated since 2014, with a notable decrease around the start of the COVID-19 pandemic in 2020 and a subsequent rise since restrictions were lifted and since the cost-of-living crisis has led to high rates of inflation. Except for current smokers, this pattern appears to have been driven predominantly by changes in the price paid per unit rather than changes in consumption.
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Affiliation(s)
- Sarah Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom; SPECTRUM Consortium, United Kingdom.
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom; SPECTRUM Consortium, United Kingdom
| | - Colin Angus
- SPECTRUM Consortium, United Kingdom; School of Medicine and Population Health, University of Sheffield, United Kingdom
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom; School of Psychological Science, University of Bristol, United Kingdom
| | - Luke Wilson
- SPECTRUM Consortium, United Kingdom; School of Medicine and Population Health, University of Sheffield, United Kingdom
| | - John Holmes
- SPECTRUM Consortium, United Kingdom; School of Medicine and Population Health, University of Sheffield, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom; SPECTRUM Consortium, United Kingdom
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17
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Jackson SE, Brown J, Shahab L, Cox S. Trends in non-daily cigarette smoking in England, 2006-2024. BMC Med 2024; 22:426. [PMID: 39444038 PMCID: PMC11515449 DOI: 10.1186/s12916-024-03635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/13/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Cigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption. METHODS Data were collected monthly between November 2006 and April 2024 as part of a nationally representative, repeat cross-sectional survey of adults (≥ 18 years; n = 353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods. RESULTS The proportion who smoked non-daily was relatively stable between November 2006 and November 2013, at an average of 10.5% [10.1-10.9%] of cigarette smokers, then increased to 27.2% [26.0-28.4%] of cigarette smokers (4.0% [3.7-4.2%] of adults) by April 2024. This increase was particularly pronounced among younger adults (e.g. reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April 2024) and those who vape (reaching 34.2% among vapers vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers' mean weekly cigarette consumption (from 34.3 in 2006-2009 to 21.1 in 2021-2024), urges to smoke (e.g. the proportion reporting no urges increased from 29.2 to 38.0%), and motivation to stop smoking (e.g. the proportion highly motivated to quit within the next 3 months decreased from 30.8 to 21.0%). CONCLUSIONS An increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
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18
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Jackson SE, Cox S, Brown J. Trends in cross-border and illicit tobacco purchases among people who smoke in England, 2019-2022. Tob Control 2024; 33:688-692. [PMID: 37463758 PMCID: PMC11503207 DOI: 10.1136/tc-2023-057991] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES The last 5 years have seen substantial changes in England's social and economic landscape as a result of Brexit, the COVID-19 pandemic and cost of living crisis. We aimed to examine changes in cross-border and illicit tobacco purchasing over this period. DESIGN Nationally representative monthly cross-sectional survey. SETTING England, 2019-2022. PARTICIPANTS 11 232 adults (≥18 years) who smoked in the past year. MAIN OUTCOME MEASURES We estimated time trends in the proportion reporting purchasing tobacco from (1) cross-border and (2) illicit sources in the past 6 months. RESULTS Between February 2019 and October 2022, there was a non-linear increase in the proportion of participants reporting cross-border tobacco purchases (from 5.2% to 16.1% overall; prevalence ratio (PR)=3.10, 95% CI 2.03-4.73). Prevalence first increased from 5.2% to 15.4% between February 2019 and April 2020, before falling to 7.8% between April 2020 and September 2021 during the COVID-19 pandemic, and then increasing again to 16.1% by the end of the period. Changes in cross-border tobacco purchasing were more pronounced among participants from more advantaged (from 6.6% to 23.3%; PR=3.52, 95% CI 2.05-5.91) compared with less advantaged (4.4% to 11.5%; PR=2.61, 95% CI 1.17-5.20) social grades (pinteraction=0.034). There was no overall change in the proportion reporting illicit tobacco purchases (from 9.2% to 8.5%; PR=0.92, 95% CI 0.70-1.21), nor any significant difference in trends by social grade (pinteraction=0.783). CONCLUSIONS Despite a fall in cross-border tobacco purchasing during the first year of the COVID-19 pandemic among adults in England who smoke, the proportion reporting cross-border tobacco purchases is now three times higher than it was at the start of 2019. The proportion reporting illicit tobacco purchases has not changed substantially.
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Affiliation(s)
| | - Sharon Cox
- Behavioural Science and Health, UCL, London, UK
| | - Jamie Brown
- Behavioural Science and Health, UCL, London, UK
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Pannoi T, Sottiyotin T, Waleewong O, Adulyarat N. Perceived social measures and drinking behavior during the COVID-19 pandemic in Thailand. J Public Health Policy 2024:10.1057/s41271-024-00521-1. [PMID: 39294344 DOI: 10.1057/s41271-024-00521-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2024] [Indexed: 09/20/2024]
Abstract
During the COVID-19 pandemic, national policymakers implemented many public health social measures to cease the spread of the disease, while, those interventions also affected population health behaviors, including drinking alcohol. We analyzed national survey data of 7731 respondents to investigate drinking behavioral patterns, as well as measure the strength of association between social measures and alcohol consumption among the Thai populations during the COVID-19 pandemic. We demonstrated that perceptions on temporary suspension of entertainment events and a ban on alcohol sales during the pandemic were significantly associated with alcohol consumption behaviors. Specifically, the negative perceptions of these social measures were associated with the increase of drinking: OR = 1.42; 95% CI = [1.19, 1.69] and OR = 2.50; 95% CI = [2.11, 2.97], respectively. We recommended to assess the long-term effects of targeted social measures on drinking behavior, especially the post pandemic.
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Affiliation(s)
- Tanavij Pannoi
- Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Nakhonsrithammarat, Thailand
| | - Tida Sottiyotin
- Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Nakhonsrithammarat, Thailand
| | | | - Najmee Adulyarat
- Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Nakhonsrithammarat, Thailand.
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Stepankova L, Zvolska K, Pankova A, Rafl J, Donin G, Tichopad A, Kralikova E. Changes in the Success and Characteristics of Tobacco Dependence Treatment before and during the COVID-19 Pandemic: Clinical Sample Comparisons. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1459. [PMID: 39336500 PMCID: PMC11434142 DOI: 10.3390/medicina60091459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/26/2024] [Accepted: 09/02/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017-2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020-2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist.
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Affiliation(s)
- Lenka Stepankova
- Centre for Tobacco Dependent of the 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic; (L.S.); (A.P.)
| | - Kamila Zvolska
- Centre for Tobacco Dependent of the 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic; (L.S.); (A.P.)
| | - Alexandra Pankova
- Centre for Tobacco Dependent of the 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic; (L.S.); (A.P.)
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic
| | - Jakub Rafl
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 27201 Kladno, Czech Republic; (J.R.); (G.D.)
| | - Gleb Donin
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 27201 Kladno, Czech Republic; (J.R.); (G.D.)
| | - Ales Tichopad
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, 27201 Kladno, Czech Republic; (J.R.); (G.D.)
| | - Eva Kralikova
- Centre for Tobacco Dependent of the 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic; (L.S.); (A.P.)
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague and General University Hospital, 12808 Prague, Czech Republic
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21
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Shank F, Korovich M, Nicoletti A, Angelone DJ, Jones MC. The Influence of Health-Related Behavior Profiles on College Students' Perceptions of COVID-19 Safety Measures. J Community Health 2024; 49:1-9. [PMID: 38413406 PMCID: PMC11306267 DOI: 10.1007/s10900-024-01342-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Abstract
College students often engage in multiple health-related behaviors simultaneously which can lead to negative outcomes and further risky behaviors. During the COVID-19 pandemic, college students reported decreased condom use, increased solitary cannabis use, and increased alcohol consumption. This current study aimed to (1) identify profiles of health-related behaviors (i.e., alcohol consumption, cannabis use, and sexual behaviors), and (2) determine if these profiles would differ in engagement and perceived effectiveness of COVID-19 preventative measures. Participants were 273 college students from a large Northeastern U.S. public university who completed surveys about health-related behaviors during the 2021 academic year. We used a latent profile analysis to identify distinct subgroups of college students based on their engagement in health-related behaviors. Based on fit indices a three-profile solution showed the best fit: low (N = 196), moderate (N = 54), and high (N = 23). Two one-way ANOVAs examined whether profile membership predicted engagement and perceived effectiveness of COVID-19 safety measures. Participants in the low health-related behaviors profile engaged in preventative measures more than students in the other two profiles. However, profile membership did not predict perceived effectiveness of preventative behaviors. Taken together, our results indicate that college students reporting lower levels of health-related behaviors engage in more preventative measures during a pandemic. Understanding distinct health-related behaviors profiles among college students, and their links with COVID-preventative health-related behaviors, can inform prevention strategies.
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Affiliation(s)
- Faith Shank
- Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA.
| | - Megan Korovich
- Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Alexandra Nicoletti
- Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - D J Angelone
- Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
| | - Meredith C Jones
- Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ, 08028, USA
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22
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Jackson SE, Tattan-Birch H, Shahab L, Brown J. Trends in long term vaping among adults in England, 2013-23: population based study. BMJ 2024; 386:e079016. [PMID: 39019543 PMCID: PMC11253215 DOI: 10.1136/bmj-2023-079016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE To examine trends in long term (>6 months) vaping among adults in England. DESIGN Population based study. SETTING England. PARTICIPANTS 179 725 adults (≥18 years) surveyed between October 2013 and October 2023. MAIN OUTCOME MEASURES Time trends in prevalence of long term vaping using logistic regression, overall and by vaping frequency (daily or non-daily), and main type of device used (disposable, refillable, or pod). RESULTS The proportion of adults reporting long term vaping increased non-linearly, from 1.3% (95% confidence interval 1.1% to 1.5%) in October 2013 to 10.0% (9.2% to 10.9%) in October 2023, with a particularly pronounced rise from 2021. This rise included an increase in long term daily vaping, from 0.6% (0.5% to 0.8%) to 6.7% (6.0% to 7.4%). Absolute increases in long term vaping were larger among people with a history of regular smoking (current smokers: 4.8% (4.0% to 5.8%) to 23.1% (20.4% to 25.9%); recent former smokers: 5.7% (3.4% to 9.2%) to 36.1% (27.6% to 45.4%); long term former smokers: 1.4% (1.0% to 1.9%) to 16.2% (14.2% to 18.4%)), but an increase also occurred among people who had never regularly smoked (0.1% (0.0% to 0.2%) to 3.0% (2.3% to 3.8%)). Growth was also more pronounced in young adults (eg, reaching 22.7% (19.2% to 26.5%) of 18 year olds v 4.3% (3.6% to 5.2%) of 65 year olds), including among those who had never regularly smoked (reaching 16.1% (11.1% to 22.7%) of 18 year olds v 0.3% (0.1% to 0.6%) of 65 year olds). Between October 2013 and March 2021, most long term vapers mainly or exclusively used refillable electronic cigarettes (2.5% to 3.3% of adults) and few (0.1% of adults) used disposable devices. However, prevalence of long term vaping using disposable devices subsequently rose rapidly, and by October 2023 similar proportions of adults mainly or exclusively used disposable and refillable devices (4.9% (4.2% to 5.7%) and 4.6% (4.0% to 5.3%), respectively). CONCLUSIONS The prevalence of long term vaping increased substantially among adults in England during 2013-23. Much of this increase occurred from 2021, coinciding with the rise in popularity of disposable e-cigarettes. Half of long term vapers now mainly or exclusively use disposable devices. The growth was concentrated among people with a history of regular smoking, but an increase also occurred among people who never regularly smoked, especially young adults.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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Jackson SE, Brown J, Tattan‐Birch H, Shahab L. Impact of the disruption in supply of varenicline since 2021 on smoking cessation in England: A population study. Addiction 2024; 119:1203-1210. [PMID: 38688323 PMCID: PMC11753482 DOI: 10.1111/add.16485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/26/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND AIMS Varenicline is one of the most effective smoking cessation treatments. Its supply in England was disrupted in July 2021 due to nitrosamine impurities found by its supplier, Pfizer. This study measured the impact of this disruption on smoking cessation in England. DESIGN, SETTING AND PARTICIPANTS The study used repeated cross-sectional surveys conducted monthly, from June 2018 to December 2022. Set in England, it comprised a total of 3024 adults who reported smoking during the past year and had made at least one serious attempt to quit in the past 6 months. MEASUREMENTS Generalized additive models analyzed the association of the varenicline supply disruption with the trend in self-reported varenicline use in the most recent quit attempt. We used these results to estimate the population-level impact of the disruption on smoking cessation. FINDINGS Before July 2021, the proportion of past 6-month quit attempts using varenicline was stable at approximately 3.9% [risk ratio (RR)trend = 1.034, 95% confidence interval (CI) = 0.823-1.298]. The trend in varenicline use has changed sharply since the supply disruption (RRΔtrend = 0.297, 95% CI = 0.120-0.738), with prevalence falling by 69.3% per year since; from 4.1% in June 2021 to 0.8% in December 2022. Convergently, National Health Service general practitioner prescribing data reported that just 0.1% of prescriptions for smoking cessation treatments in December 2022 were for varenicline. Assuming that varenicline does not return to the market, we estimate that this could result in ~8400 fewer people stopping smoking for at least 6 months, ~4200 fewer long-term ex-smokers and ~1890 more avoidable deaths each year. CONCLUSIONS In England, the disruption in supply of varenicline since 2021 has coincided with a substantial fall in the use of varenicline in attempts to quit smoking.
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Affiliation(s)
- Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumEdinburghUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumEdinburghUK
| | - Harry Tattan‐Birch
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumEdinburghUK
| | - Lion Shahab
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
- SPECTRUM ConsortiumEdinburghUK
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Tattan-Birch H, Brown J, Shahab L, Beard E, Jackson SE. Trends in vaping and smoking following the rise of disposable e-cigarettes: a repeat cross-sectional study in England between 2016 and 2023. THE LANCET REGIONAL HEALTH. EUROPE 2024; 42:100924. [PMID: 39070753 PMCID: PMC11281926 DOI: 10.1016/j.lanepe.2024.100924] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 07/30/2024]
Abstract
Background There has been a rapid rise in disposable (single-use) e-cigarette vaping among young adults in England since June 2021 (leading to a planned ban on these products). We examined how this has affected population trends in current (i) vaping, (ii) tobacco smoking, and (iii) inhaled nicotine use. Methods We used data from a nationally-representative monthly repeat cross-sectional survey of adults (≥18) in England (n = 132,252; July-2016-May-2023). Using interrupted time-series analyses (segmented logistic regression), we estimated yearly trends in current tobacco smoking, vaping, and inhaled nicotine use (smoking and/or vaping) before ('pre-disposables') and after June-2021 ('post-disposables'), stratified by age group (18 to 24, 25 to 44, 45 and over). We also examined trends in daily use and in vaping among never-smokers. Findings Pre-disposables, vaping and smoking prevalence had been stable or declining across all age groups. However, post-disposables, the odds of current vaping increased by 99% per year among 18 to 24-year-olds (odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.71 to 2.31), compared with 39% (OR = 1.39; 95% CI = 1.26 to 1.52) in 25 to 44-year-olds and 23% (OR = 1.23; 95% CI = 1.12 to 1.35) in those aged 45 or older. Smoking rates continued to decline - albeit modestly - in 18 to 24-year-olds (OR = 0.88, 95% CI = 0.77 to 1.00) and 25 to 44-year-olds (OR = 0.93, 95% CI = 0.86 to 1.00), but increased among those aged 45 or older (OR = 1.12, 95% CI = 1.05 to 1.20). As a result, post-disposables, the overall prevalence of inhaled nicotine use increased across all age groups. Trends were similar for daily use, but post-disposables increases in vaping were greatest among people who had never regularly smoked (e.g., 18 to 24-year-olds: OR = 2.50, 95% CI = 1.82 to 3.43). Interpretation Since disposable vapes started becoming popular in England, historic declines in nicotine use have reversed. Now, nicotine use appears to be rising, driven primarily by sharp increases in vaping among young people. Smoking declines have been most pronounced in age groups with the largest increases in vaping. Funding Cancer Research UK.
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Affiliation(s)
- Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Sarah E. Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
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25
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Nakkash R, Tleis M, Khalil J, Romani M, Salloum RG. A qualitative study on tobacco use during the COVID-19 pandemic in Lebanon: Waterpipe and cigarette smokers' views, risk perceptions, and behaviors. Tob Prev Cessat 2024; 10:TPC-10-27. [PMID: 38938265 PMCID: PMC11209738 DOI: 10.18332/tpc/189770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/26/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Since the beginning of the COVID-19 pandemic, a growing number of studies have documented more severe COVID-19 symptoms and worse outcomes among smokers compared to non-smokers. The aim of this research is to understand the views, risk perceptions, and behaviors of Lebanese adult smokers during the pandemic. METHODS We conducted 18 qualitative online structured interviews with adults who smoke cigarettes and waterpipe tobacco residing in Lebanon from November 2020 through April 2021. Participants were recruited predominantly via paid social media ads. Interviews were audio-recorded using Zoom software then transcribed verbatim. Data were analyzed thematically. RESULTS The findings showed three main themes: changes to smoking behaviors, concerns over the susceptibility and severity of COVID-19, and using coping methods to protect smokers from COVID-19. Although there was an increased risk perception of COVID-19 in relation to smoking, most participants reported an increase in smoking. Instead of being encouraged to quit, participants developed coping strategies against COVID-19 while smoking. CONCLUSIONS Smoking behavior did not seem to decrease during the COVID-19 pandemic. To support cessation initiatives and raise awareness, effective health messaging aimed at smokers is pivotal. Smoking cessation programs need to be better equipped at supporting people who smoke in finding healthier coping mechanisms during a pandemic. Moreover, policies to regulate the propagation of misinformation are required to prevent the development of a false sense of safety and protection from COVID-19.
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Affiliation(s)
- Rima Nakkash
- Global and Community Health Department, College of Public Health, George Mason University, Fairfax, Virginia, United States
| | - Malak Tleis
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Joanna Khalil
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Maya Romani
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, United States
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26
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Jackson SE, Brown J, Beard E. Associations of Prevalence of E-cigarette Use With Quit Attempts, Quit Success, Use of Smoking Cessation Medication, and the Overall Quit Rate Among Smokers in England: A Time-Series Analysis of Population Trends 2007-2022. Nicotine Tob Res 2024; 26:826-834. [PMID: 38214664 PMCID: PMC11190046 DOI: 10.1093/ntr/ntae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/06/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION This study aimed to (1) provide up-to-date estimates of how changes in the prevalence of e-cigarette use have been associated with changes in smoking cessation activities and use of licensed treatments among smokers in England and (2) explore any changes in these associations over time. METHODS Data were aggregated quarterly on 67 548 past-year smokers between Q1-2007 and Q4-2022. Explanatory variables were the prevalence of (1) current e-cigarette use among smokers and (2) e-cigarette use during a quit attempt. Outcomes were rates of quit attempts and overall quits among past-year smokers, and the quit success rate and use of licensed treatments among those who made a quit attempt. RESULTS The success rate of quit attempts increased by 0.040% (95% CI 0.019; 0.062) for every 1% increase in the prevalence of e-cigarette use during a quit attempt. No clear evidence was found for an association between current e-cigarette use and the quit attempt rate (Badj = 0.008 [95% CI -0.045; 0.061]) or overall quit rate (Badj = 0.063 [-0.031; 0.158]); or between use of e-cigarettes during a quit attempt and the overall quit rate (Badj = 0.030 [-0.054; 0.114]), use of prescription medication (varenicline/bupropion/nicotine replacement therapy [NRT]: Badj = -0.036 [-0.175; 0.102]), or use of over-the-counter NRT (Badj = -0.052 [-0.120; 0.015]). There was no clear evidence this pattern of associations has changed substantially over time. CONCLUSIONS Changes in the prevalence of e-cigarette use in England through 2022 have been positively associated with the success rate of quit attempts but not clearly associated with the quit attempt rate, overall quit rate, or use of licensed smoking cessation treatments. IMPLICATIONS If the association between the increase in e-cigarette use and the quit success rate is causal, then the use of e-cigarettes in quit attempts has helped in the region of 30 000 to 50 000 additional smokers in England to successfully quit each year since they became popular in 2013, over and above the number who were quitting before the advent of e-cigarettes.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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27
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Jackson SE, Cox S, Buss V, Brown J. Trends in motives for trying to stop smoking: a population study in England, 2018-2023. BMJ PUBLIC HEALTH 2024; 2:e000420. [PMID: 40018217 PMCID: PMC11812782 DOI: 10.1136/bmjph-2023-000420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/23/2024] [Indexed: 03/01/2025]
Abstract
Introduction Since 2020, people in England have lived through a global pandemic and national cost-of-living and healthcare crises, each of which might have affected motivations to stop smoking. Objective To examine changes in the factors motivating people to stop smoking over this period. Methods Data were drawn from a nationally representative monthly cross-sectional survey in England, 2018-2023. Participants were 5777 past-year smokers who made one or more serious attempt to quit in the past year. Participants reported factors contributing to their most recent attempt to quit. We estimated time trends in the proportion of attempts to quit that were motivated by (i) health concerns, (ii) cost, (iii) social factors and (iv) health professional advice, and calculated prevalence ratios (PRs) for the change in prevalence across the whole time series (May 2023 vs March 2018). Results Up to 2020, one in two attempts to quit were motivated by health concerns (mean monthly proportion 51.0%), one in five by social factors (20.2%) and cost (19.9%) and one in six by health professional advice (16.5%). In 2020, the proportion of attempts to quit motivated by health concerns, social factors and cost increased-to high levels of 56.2%, 23.9% and 25.8%, respectively-and those motivated by health professional advice fell to 8.0%. Rises in health-related and social motives soon returned to baseline levels (52.0% in May 2023 vs 52.5% in March 2018; PR=0.99, 95% CI 0.86 to 1.14) or below baseline (16.0% vs 21.6%; PR=0.74, 95% CI 0.54 to 1.01), respectively. However, attempts to quit motivated by cost increased further during 2022-2023 (reaching 25.4% in May 2023 vs 19.1% in March 2019; PR=1.33, 95% CI 1.01 to 1.76) and those motivated by health professional advice remained suppressed (8.5% vs 14.2%; PR=0.60, 95% CI 0.40 to 0.89). Conclusions Health concerns are the most common motive for trying to stop smoking. The relative importance of other motives has shifted since 2020, with cost motivating a greater proportion of attempts to quit, and social factors and health professional advice motivating a smaller proportion.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, UCL, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, UCL, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Vera Buss
- Department of Behavioural Science and Health, UCL, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, UCL, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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28
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Angus C, Henney M, Pryce R. Modelling the longer-term health and health inequality impacts of changes in alcohol consumption during the COVID-19 pandemic in England. J Public Health (Oxf) 2024; 46:286-293. [PMID: 38304989 DOI: 10.1093/pubmed/fdae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/12/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Alcohol consumption changed substantially during the COVID-19 pandemic for many people. This study quantified how these changes in drinking varied across the population and their potential longer-term impact on health and health inequalities. METHODS We analyzed data from the Alcohol Toolkit Study to estimate how alcohol consumption changed during the pandemic (April 2020-November 2021) and how these changes varied with age, sex, drinking level and socioeconomic position. We combined these estimates with a range of alternative scenarios of future alcohol consumption and used the Sheffield Alcohol Policy Model to assess the long-term health and health inequality impacts of these changes. RESULTS Alcohol consumption in 2020-21 increased in heavier drinkers but fell in moderate drinkers. If alcohol consumption returns to pre-pandemic levels in 2022, we estimate a total of 42 677 additional hospital admissions and 1830 deaths over 20 years because of these changes. If consumption remains at 2021 levels in the long-term these figures rise to 355 832 and 12 849, respectively. In all scenarios, the biggest increase in harm occurs in the most deprived 20% of the population. CONCLUSIONS Pandemic-era changes in alcohol consumption are likely to have a significant negative impact on public health and health inequalities, even under optimistic assumptions about future drinking.
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Affiliation(s)
- Colin Angus
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
| | - Madeleine Henney
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
| | - Robert Pryce
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK
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Zafar M, Zaidi TH, Zaidi NH, Nisar Ahmed MW, Shah M, Habiba UE, Dar MS, Ain NU, Shahid F, Meer HH. Assessment of lifestyle changes in combating the COVID-19 pandemic among people of Karachi, Pakistan. Future Sci OA 2024; 10:2340266. [PMID: 38841183 PMCID: PMC11152586 DOI: 10.2144/fsoa-2023-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/07/2023] [Indexed: 06/07/2024] Open
Abstract
Aim: COVID-19 arose as a pandemic that wreaked havoc all over the world. Study determines lifestyle changes adopted by people of Karachi in response to COVID-19 pandemic. Methods: This was the cross-sectional study and carried out at public sector hospital and 218 participants were selected through random sampling method. Results: Lifestyle changes a statistically significant difference in nutrition (p = 0.000), physical activity (p = 0.000), workout (p = 0.000), smoking (p = 0.000), sleep hours (p = 0.000), and supplements (p = 0.000) before and during lockdown. Face masks were utilized by 38% of individuals, gloves by 19%, and social isolation was observed by 26%. 11% of participants did not follow any protocols. Conclusion: Study found significant differences in lifestyle habits such as diet, sleep, smoking and physical activity.
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Affiliation(s)
- Mubashir Zafar
- Department of Family and Community Medcine, College of Medcine, University of Hail, Hail, Kingdom of Saudi Arabia
| | - Tafazzul Hyder Zaidi
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Nadira Hyder Zaidi
- Shaheed Zulfiqar Ali Bhutto Institute of Science & Technology, Karachi, Pakistan
| | | | - Mahjabeen Shah
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Umm e Habiba
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Marrium Sultan Dar
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Noor ul Ain
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Fatima Shahid
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
| | - Hiba Hamid Meer
- Community Medicine Department, Sindh Medical College, Jinnah Sindh Medical University, Pakistan
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Hemrage S, Parkin S, Kalk NJ, Shah N, Deluca P, Drummond C. Inequity in clinical research access for service users presenting comorbidity within alcohol treatment settings: findings from a focused ethnographic study. Int J Equity Health 2024; 23:103. [PMID: 38778351 PMCID: PMC11110345 DOI: 10.1186/s12939-024-02197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND While healthcare policy has fostered implementation strategies to improve inclusion and access of under-served groups to clinical care, systemic and structural elements still disproportionately prevent service users from accessing research opportunities embedded within clinical settings. This contributes to the widening of health inequalities, as the absence of representativeness prevents the applicability and effectiveness of evidence-based interventions in under-served clinical populations. The present study aims to identify the individual (micro), organisational (meso) and structural (macro) barriers to clinical research access in patients with comorbid alcohol use disorder and alcohol-related liver disease. METHODS A focused ethnography approach was employed to explore the challenges experienced by patients in the access to and implementation of research processes within clinical settings. Data were collected through an iterative-inductive approach, using field notes and patient interview transcripts. The framework method was utilised for data analysis, and themes were identified at the micro, meso and macro levels. RESULTS At the micro-level, alcohol-related barriers included encephalopathy and acute withdrawal symptoms. Alcohol-unrelated barriers also shaped the engagement of service users in research. At the meso-level, staff and resource pressures, as well as familiarity with clinical and research facilities were noted as influencing intervention delivery and study retention. At the wider, macro-level, circumstances including the 'cost of living crisis' and national industrial action within healthcare settings had an impact on research processes. The findings emphasise a 'domino effect' across all levels, demonstrating an interplay between individual, organisational and structural elements influencing access to clinical research. CONCLUSIONS A combination of individual, organisational and structural barriers, exacerbated by the COVID-19 pandemic, and the socioeconomic landscape in which the study was conducted further contributed to the unequal access of under-served groups to clinical research participation. For patients with comorbid alcohol use disorder and alcohol-related liver disease, limited access to research further contributes towards a gap in effective evidence-based treatment, exacerbating health inequalities in this clinical population.
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Affiliation(s)
- Sofia Hemrage
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Stephen Parkin
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicola J Kalk
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Naina Shah
- Institute of Liver Studies, Cheyne Wing (Third Floor), King's College Hospital, London, UK
| | - Paolo Deluca
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Colin Drummond
- Department of Addictions, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Jackson SE, Brown J, Notley C, Shahab L, Cox S. Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England. BMC Med 2024; 22:99. [PMID: 38632570 PMCID: PMC11025250 DOI: 10.1186/s12916-024-03311-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Tobacco smoking affects women's fertility and is associated with substantial risks of adverse pregnancy outcomes. This study explored trends by socioeconomic position in patterns of smoking, use of non-combustible nicotine products, and quitting activity among women of reproductive age in England. METHODS Data come from a nationally representative monthly cross-sectional survey. Between October 2013 and October 2023, 197,266 adults (≥ 18 years) were surveyed, of whom 44,052 were women of reproductive age (18-45 years). Main outcome measures were current smoking, vaping, and use of nicotine replacement therapy (NRT), heated tobacco products (HTPs), and nicotine pouches; mainly/exclusively smoking hand-rolled cigarettes and level of dependence among current smokers; past-year quit attempts among past-year smokers; and success of quit attempts among those who tried to quit. We modelled time trends in these outcomes, overall and by occupational social grade (ABC1 = more advantaged/C2DE = less advantaged). RESULTS Smoking prevalence among women of reproductive age fell from 28.7% [95%CI = 26.3-31.2%] to 22.4% [19.6-25.5%] in social grades C2DE but there was an uncertain increase from 11.7% [10.2-13.5%] to 14.9% [13.4-16.6%] in ABC1. By contrast, among all adults and among men of the same age, smoking prevalence remained relatively stable in ABC1. Vaping prevalence among women of reproductive age more than tripled, from 5.1% [4.3-6.0%] to 19.7% [18.0-21.5%], with the absolute increase more pronounced among those in social grades C2DE (reaching 26.7%; 23.3-30.3%); these changes were larger than those observed among all adults but similar to those among men of the same age. The proportion of smokers mainly/exclusively smoking hand-rolled cigarettes increased from 40.5% [36.3-44.9%] to 61.4% [56.5-66.1%] among women of reproductive age; smaller increases were observed among all adults and among men of the same age. Patterns on other outcomes were largely similar between groups. CONCLUSIONS Among women of reproductive age, there appears to have been a rise in smoking prevalence in the more advantaged social grades over the past decade. Across social grades, there have been substantial increases in the proportion of women of reproductive age who vape and shifts from use of manufactured to hand-rolled cigarettes among those who smoke. These changes have been more pronounced than those observed in the general adult population over the same period.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Caitlin Notley
- Faculty of Medicine and Health Sciences, Norwich Medical School, Lifespan Health Research Centre, University of East Anglia, Norwich, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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Michalak A, Lach T, Szczygieł K, Cichoż-Lach H. COVID-19, Possible Hepatic Pathways and Alcohol Abuse-What Do We Know up to 2023? Int J Mol Sci 2024; 25:2212. [PMID: 38396888 PMCID: PMC10888568 DOI: 10.3390/ijms25042212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon-previously existing hepatic disorder or acute liver failure due to SARS-CoV-2-is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.
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Affiliation(s)
- Agata Michalak
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Tomasz Lach
- Department of Orthopedics and Traumatology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Karolina Szczygieł
- Clinical Dietetics Unit, Department of Bioanalytics, Medical University of Lublin, Chodźki 7, 20-093 Lublin, Poland;
| | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
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Atieh MA, Aldhanhani A, Shah M, Tawse‐Smith A, Alsabeeha NHM. Changes in oral home care and smoking habits during COVID-19 pandemic: A cross-sectional study. Clin Exp Dent Res 2024; 10:e840. [PMID: 38345464 PMCID: PMC10847705 DOI: 10.1002/cre2.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/15/2023] [Accepted: 01/01/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The coronavirus disease-19 (COVID-19) pandemic has caused disruption in the health behavior in many aspects of life. While hand hygiene was promoted as one of the precautionary measures to mitigate and contain COVID-19, oral health and smoking might have received less attention in the media campaigns. The aim of this study was to examine health behavioral changes in terms of oral home care habits, smoking, and perception of dental care during the COVID-19 pandemic. MATERIAL AND METHODS An online survey was designed to assess oral home care, smoking habits, and attitude toward dental services of participants aged 18 years and older. The data were collected between September and November 2021. The strength of association between changes in oral home care habits, smoking, and attitude toward invasive/long dental procedures and each variable was measured by χ2 analysis. Estimates of relative risk were also calculated for all variables. Predictors of avoiding dental procedures were estimated by a binary logistic regression. RESULTS A total of 532 participants, based in the United Arab Emirates, took part in this online survey with a response rate of 88.7%. The age of the participants ranged between 18 and 67 with mean age of 34.9 ± 9.0 years. The majority of the participants have adopted changes in their routine oral home care habits, with 82.1% of them changing the toothbrush more frequently. Participants who changed their oral home care habits were more likely to have received sufficient information on the importance of maintaining oral health. Likewise, the changes in smoking habits were significantly associated with receiving information on the relationship between smoking and the severity of the COVID-19 (p < 0.001). CONCLUSIONS The findings showed that positive behavior toward oral home care and smoking was noticed during the pandemic particularly when public receives sufficient and up-to-date information.
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Affiliation(s)
- Momen A. Atieh
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health SciencesDubai Healthcare CityDubaiUnited Arab Emirates
- Department of Periodontology, Faculty of Dentistry, Sir John Walsh Research InstituteUniversity of OtagoDunedinNew Zealand
- Department of Periodontology, School of DentistryUniversity of JordanAmmanJordan
| | - Afrah Aldhanhani
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health SciencesDubai Healthcare CityDubaiUnited Arab Emirates
| | - Maanas Shah
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health SciencesDubai Healthcare CityDubaiUnited Arab Emirates
| | - Andrew Tawse‐Smith
- Department of Periodontology, Faculty of Dentistry, Sir John Walsh Research InstituteUniversity of OtagoDunedinNew Zealand
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Kock L, Shahab L, Garnett C, Oldham M, Tattan-Birch H, Angus C, Brose L, Brown J. Brief interventions for smoking and alcohol associated with the COVID-19 pandemic: a population survey in England. BMC Public Health 2024; 24:76. [PMID: 38172788 PMCID: PMC10763226 DOI: 10.1186/s12889-023-17559-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Following the onset of the COVID-19 pandemic, in March 2020 health care delivery underwent considerable changes. It is unclear how this may have affected the delivery of Brief Interventions (BIs) for smoking and alcohol. We examined the impact of the COVID-19 pandemic on the receipt of BIs for smoking and alcohol in primary care in England and whether certain priority groups (e.g., less advantaged socioeconomic positions, or a history of a mental health condition) were differentially affected. METHODS We used nationally representative data from a monthly cross-sectional survey in England between 03/2014 and 06/2022. Monthly trends in the receipt of BIs for smoking and alcohol were examined using generalised additive models among adults who smoked in the past-year (weighted N = 31,390) and those using alcohol at increasing and higher risk levels (AUDIT score 38, weighted N = 22,386), respectively. Interactions were tested between social grade and the change in slope after the onset of the COVID-19 pandemic, and results reported stratified by social grade. Further logistic regression models assessed whether changes in the of receipt of BIs for smoking and alcohol, respectively, from 12/2016 to 01/2017 and 10/2020 to 06/2022 (or 03/2022 in the case of BIs for alcohol), depended on history of a mental health condition. RESULTS The receipt of smoking BIs declined from an average prevalence of 31.8% (95%CI 29.4-35.0) pre-March 2020 to 24.4% (95%CI 23.5-25.4) post-March 2020. The best-fitting model found that after March 2020 there was a 12-month decline before stabilising by June 2022 in social grade ABC1 at a lower level (~ 20%) and rebounding among social grade C2DE (~ 27%). Receipt of BIs for alcohol was low (overall: 4.1%, 95%CI 3.9-4.4) and the prevalence was similar pre- and post-March 2020. CONCLUSIONS The receipt of BIs for smoking declined following March 2020 but rebounded among priority socioeconomic groups of people who smoked. BIs for alcohol among those who use alcohol at increasing and higher risk levels were low and there was no appreciable change over time. Maintaining higher BI delivery among socioeconomic and mental health priority groups of smokers and increasing and higher risk alcohol users is important to support reductions in smoking and alcohol related inequalities.
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Affiliation(s)
- Loren Kock
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Research Consortium, Edinburgh, UK.
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Melissa Oldham
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Colin Angus
- SPECTRUM Research Consortium, Edinburgh, UK
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Leonie Brose
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Research Consortium, Edinburgh, UK
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Jackson SE, Tattan-Birch H, Shahab L, Beard E, Brown J. Have there been sustained impacts of the COVID-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017-2022. BMC Med 2023; 21:474. [PMID: 38093317 PMCID: PMC10720231 DOI: 10.1186/s12916-023-03157-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Studies conducted during the early stages of the pandemic documented mixed changes in smoking behaviour: more smokers quitting successfully but little change in prevalence. This study aimed to examine whether there have been sustained impacts of the COVID-19 pandemic on smoking patterns in England. METHODS Data were from 101,960 adults (≥ 18 years) participating in the Smoking Toolkit Study, a monthly representative household survey, between June 2017 and August 2022. Interviews were conducted face-to-face until March 2020 and via telephone thereafter. Generalised additive models estimated associations of the pandemic onset (March 2020) with current smoking, uptake, cessation, quit attempts, and use of support. Models adjusted for seasonality, sociodemographic characteristics, and (where relevant) dependence and tobacco control mass-media expenditure. RESULTS Before the COVID-19 pandemic, smoking prevalence fell by 5.2% per year; this rate of decline slowed to 0.3% per year during the pandemic (RRΔtrend = 1.06, 95% CI = 1.02, 1.09). This slowing was evident in more but not less advantaged social grades (RRΔtrend = 1.15, 1.08, 1.21; RRΔtrend = 1.00, 0.96, 1.05). There were sustained step-level changes in different age groups: a 34.9% (95% CI = 17.7, 54.7%) increase in smoking prevalence among 18-24-year-olds, indicating a potential rise in uptake, in contrast to a 13.6% (95% CI = 4.4, 21.9%) decrease among 45-65-year-olds. In both age groups, these step-level changes were followed by the pre-pandemic declines stopping, and prevalence remaining flat. There were sustained increases in quitting among past-year smokers, with a 120.4% (95% CI = 79.4, 170.9%) step-level increase in cessation and a 41.7% (95% CI = 29.7, 54.7%) increase in quit attempts. The main limitation was the change in modality of data collection when the pandemic started; while this may have contributed to the step-level changes we observed, it is unlikely to explain changes in the slope of trends. CONCLUSIONS In England, the rate of decline in adult smoking prevalence stagnated during the COVID-19 pandemic through to 2022. At the start of the pandemic, a potential reduction in smoking prevalence among middle-aged adults and increases in quitting among smokers may have been offset by an increase in smoking among young adults. The slowing in the rate of decline was pronounced in more advantaged social grades.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Consortium, London, UK.
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
| | - Emma Beard
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
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Harwood-Gross A, Bergman YS, Pat-Horenczyk R, Schiff M, Benbenishty R. Parenthood during the COVID-19 pandemic: Post-traumatic growth amongst university students. FAMILY PROCESS 2023; 62:1608-1623. [PMID: 36572646 PMCID: PMC9880650 DOI: 10.1111/famp.12847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 10/27/2022] [Accepted: 12/01/2022] [Indexed: 06/18/2023]
Abstract
This study sought to investigate a positive dimension of coping with the COVID-19 pandemic, that of post-traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian-Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID-19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post-traumatic growth, in addition to the prevention of COVID-19-related distress.
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Affiliation(s)
- Anna Harwood-Gross
- Hebrew University of Jerusalem, Jerusalem, Israel
- Metiv, Israel Psychotrauma Center, Herzog Medical Center, Jerusalem, Israel
| | | | | | | | - Rami Benbenishty
- Hebrew University of Jerusalem, Jerusalem, Israel
- Andres Bello National University, Santiago, Chile
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Buss VH, Cox S, Moore G, Angus C, Shahab L, Bauld L, Brown J. Alcohol and smoking brief interventions by socioeconomic position: a population-based, cross-sectional study in Great Britain. BJGP Open 2023; 7:BJGPO.2023.0087. [PMID: 37549977 PMCID: PMC11176676 DOI: 10.3399/bjgpo.2023.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Alcohol and smoking brief interventions (BIs) in general practice have been shown to be effective in lowering alcohol and smoking-related harm. AIM To assess prevalence of self-reported BI receipt among increasing or higher-risk drinkers and past-year smokers in England, Scotland, and Wales, and associations between intervention receipt and socioeconomic position. DESIGN & SETTING Cross-sectional study using data from a monthly population-based survey in England, Scotland, and Wales. METHOD The study comprised 47 799 participants (15 573 increasing or higher-risk drinkers [alcohol use disorders identification test consumption score ≥5] and 7791 past-year smokers) surveyed via telephone in 2020-2022 (during the COVID-19 pandemic). All data were self-reported. Prevalence of self-reported BI receipt was assessed descriptively; associations between receipt and socioeconomic position were analysed using logistic regression. RESULTS Among adults in England, Scotland, and Wales, 32.2% (95% confidence interval [CI] = 31.8 to 32.7) reported increasing or higher-risk drinking and 17.7% (95% CI = 17.3 to 18.1) past-year smoking. Among increasing or higher-risk drinkers, 58.0% (95% CI = 57.1 to 58.9) consulted with a GP in the past year, and of these, 4.1% (95% CI = 3.6 to 4.6) reported receiving BIs. Among past-year smokers, 55.8% (95% CI = 54.5 to 57.1) attended general practice in the past year; of these, 41.0% (95% CI = 39.4 to 42.7) stated receiving BIs. There was a tendency for patients from socioeconomically disadvantaged backgrounds to receive more alcohol (adjusted odds ratio [aOR] 1.38, 95% CI = 1.10 to 1.73) or smoking BIs (aOR 1.11, 95% CI = 0.98 to 1.26), but for the latter the results were statistically non-significant. Results did not differ notably by nation within Great Britain. CONCLUSION BIs in general practice are more common for smoking than for alcohol. A greater proportion of BIs for alcohol were found to be delivered to people who were from socioeconomically disadvantaged backgrounds and who were increasing or higher-risk drinkers.
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Affiliation(s)
- Vera Helen Buss
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Graham Moore
- SPECTRUM Research Consortium, Edinburgh, UK
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Colin Angus
- SPECTRUM Research Consortium, Edinburgh, UK
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Research Consortium, Edinburgh, UK
| | - Linda Bauld
- SPECTRUM Research Consortium, Edinburgh, UK
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Research Consortium, Edinburgh, UK
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Thomas T, Sykes B, Shah S, Corlett S. Pharmacist prescriber smoking cessation intervention during the COVID-19 pandemic. Tob Induc Dis 2023; 21:142. [PMID: 37901881 PMCID: PMC10603824 DOI: 10.18332/tid/170580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 10/31/2023] Open
Abstract
INTRODUCTION During the pandemic, smokers who wished to access support to quit faced additional barriers. A smoking cessation service which utilized pharmacist independent prescribers working within community pharmacy was implemented. Clients received behavioral advice via a consultation with an advisor and then three consultations with a pharmacist, who prescribed varenicline, where appropriate. Consultations were by phone or video. This evaluation assessed the self-reported outcomes and experiences of clients and pharmacists. METHODS A mixed-methods approach was used involving both on-line questionnaires to clients and interviews with a sample of questionnaire respondents and participating prescribing pharmacists. RESULTS The questionnaire was completed by 85 clients with 59% reporting they had quit. Eleven clients and seven out of eight pharmacists were interviewed. Varenicline had been received by 96% of clients. The best aspects of the service reported by clients in the questionnaire and at interview were support received from the pharmacist and ease of access to varenicline. Clients regarded the service as being 'safe' to access during the pandemic. Nearly three-quarters of client respondents (72%) stated no service improvements were required. However, national supply challenges made collection of varenicline from the nominated pharmacy an issue. Some clients experienced a long wait-time before accessing the service. For pharmacists, the service offered flexibility including the opportunity to contact clients 'out of office' hours without distractions. However, not being physically in the pharmacy could result in them not being able to access the client's medicine history. Pharmacists identified that remote consultations were not ideal for all clients. CONCLUSIONS Pharmacist prescribers can deliver effective smoking cessation services through remote consultations. Greater flexibility would allow the service to be tailored to the client's need.
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Affiliation(s)
- Trudy Thomas
- Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Kent, United Kingdom
| | - Bronte Sykes
- Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Kent, United Kingdom
| | - Shilpa Shah
- Kent LPC, Kent, United Kingdom
- Community Pharmacy North East London, London, United Kingdom
| | - Sarah Corlett
- Medway School of Pharmacy, Universities of Greenwich and Kent at Medway, Kent, United Kingdom
- Pharmacy Department, Medway NHS Foundation Trust, Gillingham, Kent, United Kingdom
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Sakuma F, Yamamiya A, Abe Y, Nagashima K, Minaguchi T, Kashima K, Kunogi Y, Fukushi K, Inaba Y, Sugaya T, Tominaga K, Goda K, Irisawa A. Investigating COVID-19 Pandemic Effects on Acute Pancreatitis Development-From the Perspective of Alcohol Sales (Consumption) in a Japanese Regional Hospital. Healthcare (Basel) 2023; 11:2769. [PMID: 37893843 PMCID: PMC10606278 DOI: 10.3390/healthcare11202769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
[Aim and Background] People's lifestyles changed considerably due to the coronavirus disease 2019 (COVID-19) pandemic. The number of patients with acute pancreatitis (AP) can be expected to decrease as alcohol consumption decreases. This study was conducted to assess COVID-19 pandemic effects on AP patients in a Japanese regional hospital. [Methods] Based on the first and second states of emergency declarations in Tochigi Prefecture, the survey periods were set as follows: period A, 16 April-14 May; period B, 15 May-13 January; period C, 14 January-7 February; and period D, 8 February-15 April. Using data acquired in 2017, 2018, 2019, and 2020, we retrospectively reviewed the number of patients admitted to our hospital with a diagnosis of AP, and their clinical characteristics. [Results] According to a National Tax Agency survey, the average alcohol sales per adult in Tochigi Prefecture were 71.3 L in 2017 before the pandemic, and 64.0 L in 2021 under the pandemic. The number of AP patients in 2020 was 38% lower than in 2017. Comparing 2017 with 2020, the number of alcoholic AP patients was lower in 2020 (p = 0.007). [Conclusions] The findings suggest that COVID-19-pandemic-related lifestyle changes contributed to the decrease in AP patients.
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Affiliation(s)
| | - Akira Yamamiya
- Department of Gastroenterology, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan; (F.S.); (Y.A.); (K.N.); (T.M.); (K.K.); (Y.K.); (K.F.); (Y.I.); (T.S.); (K.T.); (K.G.); (A.I.)
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Wang X, Peng P, Liu Y, Yang WF, Chen S, Wang Y, Yang Q, Li M, Wang Y, Hao Y, He L, Wang Q, Zhang J, Ma Y, He H, Zhou Y, Long J, Qi C, Tang YY, Liao Y, Tang J, Wu Q, Liu T. Gender differences in alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period (October 20, 2020-April 5, 2021) in China. BMC Psychiatry 2023; 23:753. [PMID: 37845643 PMCID: PMC10577989 DOI: 10.1186/s12888-023-05260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 10/07/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND This study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID‑19 pandemic period in China. METHOD The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence. RESULTS A total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence. CONCLUSION Alcohol abuse/dependence was common among medical undergraduates during the post-COVID‑19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted.
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Affiliation(s)
- Xin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Pu Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yueheng Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Winson Fuzun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yunfei Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Qian Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Manyun Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yingying Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Li He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Junhong Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yuejiao Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Haoyu He
- Department of Psychology, College of Education, Hunan First Normal University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital, Changsha, China
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P. R. China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P. R. China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P. R. China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Peña S, Ilmarinen K, Kestilä L, Ruokolainen O, Ollila H, Parikka S, Karvonen S. Changes in prevalence and sociodemographic correlates of tobacco and nicotine use in Finland during the COVID-19 pandemic. Eur J Public Health 2023; 33:844-850. [PMID: 37400989 PMCID: PMC10567130 DOI: 10.1093/eurpub/ckad104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on tobacco and nicotine use remains debated. We examined whether the prevalence of tobacco and nicotine use and nicotine-replacement therapy (NRT) changed during the COVID-19 pandemic and whether changes differed by sociodemographic groups. METHODS Repeated cross-sectional study of three national surveys in Finland (2018, 2019 and 2020; n = 58 526 adults aged 20 and over). Outcomes were daily and occasional smoking, smokeless tobacco (snus) use, e-cigarettes use, total tobacco or nicotine use and NRT use. We examined changes for each outcome by sex, age, educational tertiles, marital status, mother tongue and social participation. RESULTS Daily smoking decreased among males by 1.15 percentage points (pp) [95% confidence interval (CI) -2.10 to -0.20] between 2018 and 2020 and 0.86 pp among females (95% CI -1.58 to -0.15). Daily snus use remained stable in both sexes. Daily e-cigarette use was below 1% and remained stable. We found weak evidence of a reduction in total tobacco or nicotine use between 2018 and 2020 (males -1.18 pp, 95% CI -2.68 to 0.32 and females -0.8 pp, 95% CI -1.81 to 0.22). NRT use remained stable. Snus and NRT use decreased among 60- to 74-year-olds but remained stable in other age groups. We did not find evidence of interactions by subgroup for other outcomes. CONCLUSIONS Daily smoking decreased in Finland between 2018 and 2020, but other forms of tobacco use did not experience a reduction. The COVID-19 pandemic does not seem to have altered the sustained reduction of smoking in Finland, although substantial sociodemographic differences persist.
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Affiliation(s)
- Sebastián Peña
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Ilmarinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Kestilä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Otto Ruokolainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi Parikka
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sakari Karvonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Jackson SE, Tattan-Birch H, Shahab L, Brown J. How has Expenditure on Nicotine Products Changed in a Fast-Evolving Marketplace? A Representative Population Survey in England, 2018-2022. Nicotine Tob Res 2023; 25:1585-1593. [PMID: 37226851 PMCID: PMC10439490 DOI: 10.1093/ntr/ntad074] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION In the last 5 years, there has been a dramatic shift in the types of nicotine products being purchased. This study aimed to estimate how much users spend on types of cigarettes and alternative nicotine products (e-cigarettes, nicotine replacement therapy (NRT), heated tobacco, and nicotine pouches) and describe changes between 2018 and 2022. AIMS AND METHODS Monthly representative cross-sectional survey in England. 10 323 adults who smoked cigarettes or used alternative nicotine reported their average weekly expenditure on these products, adjusted for inflation. RESULTS Smokers spent £20.49 [95% CI = 20.09-20.91] on cigarettes each week (£27.66 [26.84-28.50] and £15.96 [15.49-16.28] among those who mainly smoked manufactured and hand-rolled cigarettes, respectively), e-cigarette users spent £6.30 [5.99-6.55] (£8.41 [7.17-9.78], £6.42 [5.58-7.39], and £5.93 [5.64-6.30] among those who mainly used disposable, pod, and refillable devices, respectively), NRT users £6.11 [5.53-6.69], and heated tobacco users £13.87 [9.58-20.09]. Expenditure on cigarettes grew by 10% from September 2018 to July 2020, then fell by 10% from July 2020 to June 2022. These changes coincided with a 13% reduction in cigarette consumption and a 14% increase in the proportion mainly smoking hand-rolled cigarettes. Expenditure on e-cigarettes was stable between 2018 and late 2020, then rose by 31% up to mid-2022. Expenditure on NRT increased slowly in 2018-2020 (+4%) and more quickly thereafter (+20%). CONCLUSIONS Inflation-adjusted expenditure on cigarettes has fallen since 2020, such that the average smoker in England currently spends the same on cigarettes each week as in 2018. This has been achieved by smoking fewer cigarettes and switching to cheaper hand-rolled cigarettes. Expenditure on alternative nicotine has increased above inflation; users spent around a third more on these products in 2022 than between 2018-2020. IMPLICATIONS People in England continue to spend substantially more on smoking cigarettes than using alternative nicotine products. The average smoker in England spends around £13 a week (~£670 a year) more than people using only e-cigarettes or NRT. The average expenditure on manufactured cigarettes is double that of hand-rolled cigarettes.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK
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Perreault G, Ching C, Nobel YR. COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management. Therap Adv Gastroenterol 2023; 16:17562848231188586. [PMID: 37521085 PMCID: PMC10372508 DOI: 10.1177/17562848231188586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/02/2023] [Indexed: 08/01/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had enormous implications for the care of patients with chronic liver disease (CLD), cirrhosis, and liver transplant (LT). Clinical outcomes of COVID-19 vary in patients with CLD and cirrhosis compared to healthy controls, and in patients with LT compared to patients without LT. Several special considerations apply to the approach to vaccination and treatment in patients with CLD and LT. The practice of liver transplantation has also been heavily impacted by the pandemic, including persistent reductions in living donor LT and increases in LT for an indication of alcohol-related liver disease. Recent medical society guidelines strive to standardize severe acute respiratory syndrome coronavirus 2 testing in donors and recipients and the approach to transplantation after recovered from COVID-19 infection, but certain controversies remain.
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Affiliation(s)
- Gabriel Perreault
- Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Charlotte Ching
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Oliván-Blázquez B, Lear-Claveras A, Samper-Pardo M, León-Herrera S, Magallón-Botaya R. Worsening of alcohol abuse disorder in a Spanish population during the first twelve months of the COVID-19 pandemic and associated factors: retrospective, ecological and community study. BMC Psychiatry 2023; 23:504. [PMID: 37438682 PMCID: PMC10339574 DOI: 10.1186/s12888-023-04993-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023] Open
Abstract
PURPOSE To analyse: (1) Changes in clinical parameters and in the use of social healthcare resources by patients with alcohol abuse disorder between the six months prior to the start of the pandemic and the first year of the pandemic. (2) The factors related to a worsening of clinical parameters among patients with alcohol abuse disorder. METHODS A retrospective and observational study of a population who have been diagnosed with alcohol abuse disorders according to their primary health care (PHC) electronic medical records was performed. The total sample was made up of 11,384 patients. The variables (sociodemographic variables, chronic comorbidities, analytical parameters related to alcohol abuse disorder, COVID-19 infection, and use of healthcare resources) were collected in three different time periods: (i) six months before the onset of the strict lockdown, (ii) six months following the end of lockdown and (iii) from six to twelve months after the end of lockdown. Paired Student's T-test and a multivariate logistic regression were performed. RESULTS Along the first year after the onset of the pandemic, between 44% and 54% of the patients suffered a decline in every clinical parameter. The number of PHC nursing, GP visits and social worker visits reduced significantly. As regards the associated factors related to deterioration of alcohol abuse disorder, being younger than 40 years old, having an income of over 18,000 euros/year and not having visited the social worker were associated with a worsening of the disorder. CONCLUSIONS These results suggest that the impact of COVID-19 on this group has been high, and the social care offered to these patients plays a significant role in minimising the repercussions of the pandemic.
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Affiliation(s)
- Bárbara Oliván-Blázquez
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, 50.009, Spain
| | - Ana Lear-Claveras
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
| | - Mario Samper-Pardo
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Institute for Health Research Aragon (IISAragon), Zaragoza, Spain.
| | - Sandra León-Herrera
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, 50.009, Spain
| | - Rosa Magallón-Botaya
- Aragonese Research Group in Primary Care (Grupo Aragonés de Investigación en Atención Primaria/GAIAP), Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, 08007, Spain
- Department of Medicine, University of Zaragoza, Zaragoza, Spain
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Jackson SE, Guo X, Holmes J, Brown J. Trends in Public Awareness and Knowledge of Drinking Guidelines: a Representative Population Survey in England, 2016-2022. Alcohol Alcohol 2023; 58:415-425. [PMID: 36756933 PMCID: PMC10331929 DOI: 10.1093/alcalc/agad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
AIM To examine trends in public awareness and knowledge of drinking guidelines in the UK since their revision in 2016, which had moved from a daily to a weekly guideline, made the guideline the same for men and women, and reduced the guideline for men by around one-third. METHOD Data were from a representative, repeat cross-sectional survey. We analysed changes in awareness and knowledge of drinking guidelines among 8168 adult drinkers between 2016 and 2022 and associations with sociodemographic characteristics, smoking status and level of alcohol consumption. RESULTS The proportion of drinkers aware of guidelines declined from 86.0% (95%CI 84.0-88.0%) in 2016 to 81.7% (79.5-84.0%) in 2019, then increased during the COVID-19 pandemic, peaking at 91.6% (90.1-93.1%) in 2020. The proportion who correctly identified the guideline as a maximum of exactly 14 units/week remained at around a quarter from 2016 (25.0%, 22.4-27.5%) to 2018 (25.8%, 23.2-28.3%), whereas the proportion who gave a figure of 14 units or fewer rose from 52.1 (49.2-55.0%) to 57.4% (54.6-60.3%). However, by 2022, guideline knowledge had worsened significantly, with these figures falling to 19.7 (17.4-21.9%) and 46.5% (43.6-49.4%), respectively. Changes over time were similar across subgroups. Odds of guideline awareness and knowledge were higher among drinkers who were aged ≥35, female, more educated and from more advantaged social grades. CONCLUSIONS The majority of adult drinkers in the UK are aware of low-risk drinking guidelines. However, 6 years since their announcement, knowledge of the revised drinking guidelines remains poor. Less than a quarter know the recommended weekly limit and only around half think it is 14 units or less. Inequalities have persisted over time, such that disadvantaged groups remain less likely to know the guidelines.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
- SPECTRUM Consortium, UK
| | - Xiaotang Guo
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DE, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
- SPECTRUM Consortium, UK
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Celidoni M, Costa-Font J, Salmasi L. Mobility restrictions and alcohol use during lockdown: "A still and dry pandemic for the many"? ECONOMICS AND HUMAN BIOLOGY 2023; 50:101268. [PMID: 37517160 DOI: 10.1016/j.ehb.2023.101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 08/01/2023]
Abstract
Unexpected mobility disruptions during lockdown during the first wave of COVID-19 became 'tipping points' with the potential to alter pre-pandemic routines sensitive to socialisation. This paper investigates the impact of lockdown exposure on alcohol consumption. We document two findings using information from the Google Mobility Report and longitudinal data from the Understanding Society survey (UKHLS) in the United Kingdom. First, we find a sharp reduction in both actual mobility and alcohol use (consistent with a "still and dry pandemic for the many" hypothesis). However, we document an increase in alcohol use among heavy drinkers, implying a split behavioural response to COVID-19 mobility restrictions based on alcohol use prior to the pandemic. Second, using the predictions of the prevalence-response elasticity theory, we find that the pandemic's reduction in social contacts is responsible for a 2.8 percentage point reduction in drinking among men.
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Affiliation(s)
- Martina Celidoni
- Department of Economics and Management, University of Padova, Via Del Santo 33, 35123 Padua, Italy
| | - Joan Costa-Font
- Department of Health Policy, London School of Economics and Political Science (LSE), IZA Bonn & CESIfo Munich, Houghton Street WC2A 2AE, London, UK
| | - Luca Salmasi
- Department of Economics and Finance, Catholic University, Rome - Largo Francesco Vito 1, 00168 Rome, Italy.
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Khamees A, Awadi S, Rawashdeh S, Talafha M, Alzoubi M, Almdallal W, al‐Eitan S, Saeed A, Al‐Zoubi RM, Al‐Zoubi MS. The impact of COVID-19 pandemic lockdown on smoking habits and lifestyle: A cross-sectional study. Health Sci Rep 2023; 6:e1392. [PMID: 37396557 PMCID: PMC10314099 DOI: 10.1002/hsr2.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND AND AIMS Throughout the COVID-19 lockdown, the resultant psychological disturbances led to more tobacco consumption and deteriorated smoking behaviors among smokers. In this study, we aimed to investigate the impact of the COVID-19 pandemic on the smoking behaviors of the Jordanian population. METHODS A cross-sectional online survey was designed using the Google Forms service and distributed by social media platforms. Responses were collected starting from November 12, 2020, until November 24, 2020. RESULTS A total of 2511 respondents completed the survey, 77.3% were females. Males were significantly smoking more than females (p < 0.0001). Smoking was significantly more common among respondents who were older than 18 years old, married, held master's and PhD degrees, and working in non-health-related fields (p < 0.0001). Participants who smoke were more likely to adopt an unhealthy lifestyle during the pandemic. Females who started smoking last year were 2.6-fold more than males (p < 0.0001). We also noticed that there is a significant relationship between those who started smoking and are <18 years, living in a family consisting of seven members or more, being unemployed, having a diploma or bachelor's degree in a health-related major, having no chronic illnesses, increasing of daily meals or night meals, almost daily sugar intake, starting to follow social media account concerning physical activity, exercising once or twice a week, and sleeping more hours per day since the beginning of the pandemic (p < 0.01). CONCLUSION The results of our study showed that the lockdown had a significant impact on people's lifestyles including smoking habits. Most of our sample's smoker participants experienced a change in their smoking level mostly, an increase. While those who had a decrease in their smoking level experienced a somehow healthier lifestyle regarding nutrition and other aspects.
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Affiliation(s)
- Almu'atasim Khamees
- Faculty of MedicineYarmouk UniversityIrbidJordan
- Department of SurgeryKing Hussein Cancer CenterAmmanJordan
| | - Sajeda Awadi
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | | | - Muna Talafha
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | - Mai Alzoubi
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | | | | | - Ahmad Saeed
- Faculty of MedicineYarmouk UniversityIrbidJordan
| | - Raed M. Al‐Zoubi
- Surgical Research Section, Department of SurgeryHamad Medical CorporationDohaQatar
- Department of Biomedical Sciences, College of Health Sciences, QU‐HealthQatar UniversityDohaQatar
- Department of ChemistryJordan University of Science and TechnologyIrbidJordan
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Zheng F, Xiong H, Jin Y, Zhang M. Exploring the relationship between unemployment perception and health during COVID-19: a comparative study of rural and urban adults in China. Front Psychol 2023; 14:1169845. [PMID: 37388659 PMCID: PMC10301762 DOI: 10.3389/fpsyg.2023.1169845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction The COVID-19 pandemic has significantly impacted global economies and individual health. This study uses data from the China Family Panel Data (CFPS) in 2018 (before the pandemic) and 2020 (during the pandemic) to a) estimate the relationships between the perceived risk of unemployment and individuals' mental health, physical health, and health behaviors; and b) explore the variations of these relationships between rural and urban adults in China. Methods Ordinary linear regression models or Logit models are employed, depending on the nature (continuous vs. discrete) of the dependent variables. Results We find that the perceived risk of unemployment was statistically and positively associated with the risk of depression, and the association was greater for rural adults than for urban adults. Rural-urban variations were observed in various dimensions. For rural adults, the perceived risk of unemployment was statistically and negatively associated with life satisfaction, the probability of gaining weight and becoming obese, the probability of having adequate sleep, and computer-based screen time. These associations were statistically insignificant for urban adults. On the other hand, the perceived risk of unemployment was statistically and negatively associated with self-rated very-good-to-excellent health condition and health-compromising behaviors (e.g., smoking and drinking) for urban adults; but such associations were statistically insignificant for rural adults. Discussion These findings suggest that rural and urban adults exhibited different psychological and behavioral responses to the unemployment risk during the COVID-19 pandemic. Public policies aiming to improve health and employment should be strategically designed to address the unique needs of urban and rural populations.
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Affiliation(s)
- Fengtian Zheng
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Huanhuan Xiong
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Yanhong Jin
- Department of Agricultural, Food and Resource Economics, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Man Zhang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
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Salehi Z, Motlagh Ghoochani BFN, Hasani Nourian Y, Jamalkandi SA, Ghanei M. The controversial effect of smoking and nicotine in SARS-CoV-2 infection. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2023; 19:49. [PMID: 37264452 PMCID: PMC10234254 DOI: 10.1186/s13223-023-00797-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/18/2023] [Indexed: 06/03/2023]
Abstract
The effects of nicotine and cigarette smoke in many diseases, notably COVID-19 infection, are being debated more frequently. The current basic data for COVID-19 is increasing and indicating the higher risk of COVID-19 infections in smokers due to the overexpression of corresponding host receptors to viral entry. However, current multi-national epidemiological reports indicate a lower incidence of COVID-19 disease in smokers. Current data indicates that smokers are more susceptible to some diseases and more protective of some other. Interestingly, nicotine is also reported to play a dual role, being both inflammatory and anti-inflammatory. In the present study, we tried to investigate the effect of pure nicotine on various cells involved in COVID-19 infection. We followed an organ-based systematic approach to decipher the effect of nicotine in damaged organs corresponding to COVID-19 pathogenesis (12 related diseases). Considering that the effects of nicotine and cigarette smoke are different from each other, it is necessary to be careful in generalizing the effects of nicotine and cigarette to each other in the conducted researches. The generalization and the undifferentiation of nicotine from smoke is a significant bias. Moreover, different doses of nicotine stimulate different effects (dose-dependent response). In addition to further assessing the role of nicotine in COVID-19 infection and any other cases, a clever assessment of underlying diseases should also be considered to achieve a guideline for health providers and a personalized approach to treatment.
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Affiliation(s)
- Zahra Salehi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Yazdan Hasani Nourian
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sadegh Azimzadeh Jamalkandi
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Papini S, López-Castro T, Swarbrick M, Paul LK, Stanley D, Bauer A, Hien DA. Alcohol, cannabis, and nicotine use have distinct associations with COVID-19 pandemic-related experiences: An exploratory Bayesian network analysis across two timepoints. Drug Alcohol Depend 2023; 248:109929. [PMID: 37267744 DOI: 10.1016/j.drugalcdep.2023.109929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Substance use trends during the COVID-19 pandemic have been extensively documented. However, relatively less is known about the associations between pandemic-related experiences and substance use. METHOD In July 2020 and January 2021, a broad U.S. community sample (N = 1123) completed online assessments of past month alcohol, cannabis, and nicotine use and the 92-item Epidemic-Pandemic Impacts Inventory, a multidimensional measure of pandemic-related experiences. We examined links between substance use frequency, and pandemic impact on emotional, physical, economic, and other key domains, using Bayesian Gaussian graphical networks in which edges represent significant associations between variables (referred to as nodes). Bayesian network comparison approaches were used to assess the evidence of stability (or change) in associations between the two timepoints. RESULTS After controlling for all other nodes in the network, multiple significant edges connecting substance use nodes and pandemic-experience nodes were observed across both time points, including positive- (r range 0.07-0.23) and negative-associations (r range -0.25 to -0.11). Alcohol was positively associated with social and emotional pandemic impacts and negatively associated with economic impacts. Nicotine was positively associated with economic impact and negatively associated with social impact. Cannabis was positively associated with emotional impact. Network comparison suggested these associations were stable across the two timepoints. CONCLUSION Alcohol, nicotine, and cannabis use had unique associations to a few specific domains among a broad range of pandemic-related experiences. Given the cross-sectional nature of these analyses with observational data, further investigation is needed to identify potential causal links.
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Affiliation(s)
- Santiago Papini
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA94612, USA
| | - Teresa López-Castro
- Department of Psychology, Colin Powell School of Civic and Global Leadership, The City College of New York, The City University of New York, 160 Convent Avenue, NAC 7/120, New York, NY10031, USA
| | - Margaret Swarbrick
- Center of Alcohol and Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ08854, USA
| | - Lynn K Paul
- Division of the Humanities and Social Sciences, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA91125, USA
| | - Damian Stanley
- Division of the Humanities and Social Sciences, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA91125, USA; Gordon F. Derner School of Psychology, Adelphi University, One South Avenue, Garden City, NY11530, USA
| | - Alexandria Bauer
- Center of Alcohol and Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ08854, USA
| | - Denise A Hien
- Center of Alcohol and Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ08854, USA.
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