Adolescents’ Substance Use and Physical Activity Before and During the COVID-19 Pandemic

Abstract

IMPORTANCE Stay-at-home policies related to the COVID-19 pandemic could disrupt adolescents' substance use and physical activity.OBJECTIVE To compare adolescents' substance use and physical activity behaviors before and after stay-at-home restrictions. DESIGN, SETTING, AND PARTICIPANTSOngoing prospective cohort study of tobacco use behaviors among ninth-and tenth-grade students enrolled at 8 public high schools in Northern California from March 2019 to February 2020 and followed up from September 2019 to September 2020. Race/ethnicity was self-classified from investigator-provided categories and collected owing to racial/ethnic differences in tobacco and substance use.EXPOSURES In California, a COVID-19 statewide stay-at-home order was imposed March 19, 2020. In this study, 521 six-month follow-up responses were completed before the order and 485 were completed after the order. MAIN OUTCOMES AND MEASURESThe prevalence of substance use (ie, past 30-day use of e-cigarettes, other tobacco, cannabis, and alcohol) and physical activity (active Ն5 days/week) was compared at baseline and follow-up. A difference-in-difference approach was used to assess whether changes from baseline to 6-month follow-up varied if follow-up occurred after the stay-at-home order, adjusting for baseline behaviors and characteristics. All models were weighted for losses to follow-up using the inverse probability method. Weights were derived from a logistic regression model for having a follow-up response (dependent variable), as predicted by baseline characteristics and behaviors. RESULTSOf 1423 adolescents enrolled at baseline, 1006 completed 6-month follow-up (623 [62%] were female, and 492 [49%] were non-Hispanic White). e-Cigarette use declined from baseline to 6-month follow-up completed before the stay-at-home order (17.3% [89 of 515] to 11.3% [58 of 515]; McNemar χ 2 = 13.54; exact P < .001) and 6-month follow-up completed after the stay-at-home order (19.9% [96 of 482] to 10.8% [52 of 482]; McNemar χ 2 = 26.16; exact P < .001), but the extent of decline did not differ statistically between groups responding before vs after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.84; 95% CI, 0.47-1.52; P = .58). In contrast, being physically active was unchanged from baseline if follow-up was before the order (53.7% [279 of 520] to 52.9% [275 of 520]; McNemar χ 2 = 0.09; exact P = .82) but declined sharply from baseline if follow-up was after the order (54.0% [261 of 483] to 38.1% [184 of 483]; McNemar χ 2 = 30.72; exact P < .001), indicating a pronounced difference in change from baseline after the stay-at-home order (difference-in-difference adjusted odds ratio, 0.49; 95% CI, 0.35-0.69; P < .001). Overall in the cohort, reported use of other tobacco, cannabis, and alcohol did not differ meaningfully before and after the order. CONCLUSIONS AND RELEVANCEIn this cohort, a reduction in e-cigarette use occurred independently of COVID-19 stay-at-home restrictions, but persistent cannabis and alcohol use suggest continued ne...

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The COVID-19 Pandemic and Sustainable Life of Korean Adolescents: Exploring Gender Differences

“…Physical activity decreased during the pandemic due to the decline in social and outdoor activities (e.g., the cancellation of youth sports, a decline in active commuting, restrictions on visiting friends) and school closures and social distancing [21,48]. Decreased physical activity may lead to unhealthy weight gain and increased screen time [8,9] and may decrease opportunities to acquire social skills, such as perseverance and teamwork, through sports activities [7][8][9].…”

“…The percentage of adolescents who engaged in binge drinking, vaping, and cannabis use significantly decreased post-shutdown; however, no significant change was found in the ratio of alcohol users and the frequency of alcohol and cannabis use increased. In a study of adolescents in Northern California, the overall prevalence of e-cigarette, cannabis, or alcohol use did not meaningfully change with the onset of stay-at-home restrictions [21].…”

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“…Nicotine (n = 17). Fourteen publications (82%) revealed either overall declines (Dumas et al, 2020;Gaiha et al, 2020;Kreslake et al, 2021;Niedzwiedz et al, 2021;Sharma et al, 2020;Sokolovsky et al, 2021;Tavolacci et al, 2021;Thorisdottir et al, 2021;Tucker et al, 2020) or no change in the prevalence and frequency of nicotine consumption among youth during the pandemic period (Bonar, Chapman, et al, 2021;Bourion-Bedes et al, 2021;Chaffee et al, 2021;Hopkins & Al-Hamdani, 2020;Matovu et al, 2021). Nearly half of American young adults participating in a longitudinal study reported reducing their e-cigarette use during the pandemic, although about a quarter of the respondents reported increasing their use (Kreslake et al, 2021).…”