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Background The impact of the COVID-19 public health social measures (PHSM) on health behaviours is poorly understood. We aimed to identify factors associated with changes in alcohol and tobacco consumption during the strictest period of PHSM ‘lockdown’. Methods Logistic regression analysis were conducted using secondary data from the Central Statistics Office Social Impact Survey collected during lockdown in Ireland (April 23rd-May 1st, 2020). Results Of the 1,362 (33.8%) individuals that responded to the survey, 80.6% were current drinkers and 26.0% were smokers. The majority of smokers (60.9%) and drinkers (60.6%) reported no change in consumption. However, 30.5% of smokers and 22.2% of drinkers reported increased consumption. Being concerned about household stress from confinement (aOR 1.9, 95% CI 1.3-2.9, p = 0.002), working from home (aOR 2.1, 95 CI 1.4-3.3, p < 0.001) and urban living (aOR 2.0, 95 CI 1.5-2.9, p < 0.001) were associated with increases in alcohol consumption. Feeling very nervous (aOR 2.2, 95% CI 1.2-4.0, p = 0.009), feeling downhearted/depressed (aOR 2.4, 95% CI 1.3-4.4, p = 0.004), being concerned about someone else’s health (aOR 2.0, 95% CI 1.1-3.9, p = 0.031), working from home (aOR 2.3, 95% CI 1.0-5.3, p = 0.046) and increases in alcohol consumption (aOR 3.6, 95% CI 1.7-7.7, p = 0.023) were associated with increases in tobacco consumption. Conclusion A mixed picture was evident in terms of changes in consumption among current smokers and drinkers. Increased consumption was more commonly reported than reductions. Increased consumption was associated with psychological distress and socio-economic factors. Policies and services should consider a response to widening inequalities in harmful consumption.

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ObjectivesThis study evaluated breath carbon monoxide (BCO) testing in identifying maternal smokers as well as the difference between disclosers and non-disclosers of smoking status. We also investigated if other extrinsic factors affected the women’s BCO levels in pregnancy.DesignA prospective observational study.SettingA university obstetric hospital in an urban setting in Ireland.ParticipantsWomen (n=250) and their partners (n=54) were recruited at their first antenatal visit. Women <18 years and those who did not understand English were excluded. A booking history, including recording of smoking status, was collected by midwives. Following this, women were recruited and completed a detailed research questionnaire on smoking and extrinsic/environmental BCO sources. A BCO test was performed on both the woman and her partner.Primary and secondary outcome measuresThe number of self-reported smokers and those that were positive on the BCO test. The characteristics of women who disclosed and did not disclose smoking status. The effect of extrinsic factors on the BCO test results.ResultsBased on the receiver-operating characteristic curve, a BCO cut-off point of ≥3 ppm was the optimal level to identify ongoing smoking. At booking history, 15% of women reported as current smokers. Based on BCO levels ≥3 ppm combined with self-reported smoking in the research questionnaire, the rate increased to 25%. Non-disclosers had similar characteristics to non-smokers. No extrinsic factors affected maternal BCO levels.ConclusionsBased on self-report and BCO levels, a quarter of women presenting for antenatal care continued to smoke, but only 60% reported their smoking to midwives. BCO measurement is an inexpensive, practical method of improving identification of maternal smoking, and it was not effected by extrinsic sources of BCO. Improved identification means more smokers can be supported to stop smoking in early pregnancy potentially improving the short-term and long-term health of both mother and child.

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