Alcohol- and Cigarette-Use Related Behaviors During Quarantine and Physical Distancing Amid COVID-19 in Indonesia

Changes in Smoking Status and Behaviors After the First 10 Months of COVID-19 Pandemic in Indonesia

INTRODUCTION

There remains inconclusive evidence on potential changes in smoking status and behaviors during the coronavirus disease 2019 (COVID-9) pandemic, especially in developing countries.

AIMS AND METHODS

This study explores the direction of changes in smoking status and behaviors after 10 months of the COVID-19 pandemic in Indonesia as well as examining the association between economic shocks and changes in smoking behaviors. Primary data were gathered through a phone survey targeting productive-age mobile-phone users in Indonesia (n = 1082). Descriptive analysis was employed to determine changes in smoking status and behaviors 10 months into the pandemic, while logistic regression analysis was used to investigate how employment shocks, financial strain, COVID-19-related indicators, and demographic characteristics were associated with smoking behaviors of people who continue smoking.

RESULTS

Respondents experiencing changes in smoking status were dominated by people who persistently smoked during the pandemic, while those who quit, relapsed, and started smoking, was extremely small. Nevertheless, a considerable portion of people who continue smoking adjusted their smoking behaviors: 40.3% reduced smoking intensity and 25.3% switched to lower-price cigarettes. Multivariable regression analysis revealed that, among people who continue smoking, those who experienced financial strain during the pandemic had higher odds of reducing smoking intensity, while those who switched to lower job status had higher odds of switching to cheaper cigarettes.

CONCLUSIONS

The research has shown that smoking status and behaviors of people who continue smoking mostly remained unchanged after 10 months of the COVID-19 pandemic. Changes in employment and financial conditions during the pandemic were associated with modified smoking behaviors.

IMPLICATIONS

This study is the first to determine the direction and analyze the factors of changes in smoking during the COVID-19 pandemic in Indonesia. This new understanding should help improve predicting the trends in smoking in future crises or pandemics in developing countries, specifically Indonesia. The discovered patterns on smokers' reaction to an exogenous shock may provide evidence to support tobacco control policies in Indonesia.

The impact of exposure to cigarette advertising and promotion on youth smoking behavior in Malang Regency (Indonesia) during the COVID-19 pandemic

The prevalence of teen smokers has increased during the Covid-19 pandemic. Smoking behavior occurs due to exposure to advertising and the promotion of cigarettes. This quantitative research was conducted using cross-sectional approach. The purpose of the study was to analyze the relationship between advertising exposure and cigarette promotion on adolescent smoking behavior in Malang Regency during the pandemic using the chi-square test. Random sampling on students from several high schools or equal degree in the Kepanjen District was done with a total of 145 respondents. The results showed that there was no significant relationship between age, types of cigarette advertising media at the point of sale, outdoor media, social media, internet, and newspapers or magazines by adolescent smoking behavior during the Covid-19 pandemic (p-value > 0.05). Exposure to cigarette advertisements on television, total exposure to cigarette advertisements, cigarette promotion, and gender had a significant relationship with adolescent smoking behavior during the pandemic (p value < 0.05). Adolescents are quite highly exposed to the various types of advertisements and promotions of cigarettes that can influence increased smoking behavior during the pandemic.

Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research

Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings of peer-reviewed, published studies relating tobacco product use to SARS-CoV-2 infection and COVID-19 outcomes, with most studies focusing on cigarette smoking in adults. Findings pertaining to the effects of tobacco product use on the incidence of SARS-CoV-2 infection are inconsistent. However, evidence supports a role for cigarette smoking in increasing the risk of poor COVID-19 outcomes, including hospital admission, progression in disease severity, and COVID-19-related mortality. We discuss the potential effects of tobacco use behaviour on SARS-CoV-2 transmission and infection, and highlight the pathophysiological changes associated with cigarette smoking that could promote SARS-CoV-2 infection and increased disease severity. We consider the biological mechanisms by which nicotine and other tobacco product constituents might affect immune and inflammatory responses to SARS-CoV-2 infection. Finally, we identify current knowledge gaps and suggest priorities for research to address acute and post-acute health outcomes of COVID-19 during and after the pandemic.

Prevalence and determinants of internet addiction among adults during the COVID-19 pandemic in Bangladesh: An online cross-sectional study

Background

Globally, internet use has increased significantly during the COVID-19 pandemic, and internet addiction (IA) has become a severe public health issue. Therefore, this study aimed to assess IA prevalence among adults and identify its determinants during the COVID-19 pandemic in Bangladesh.

Methods

Using a cross-sectional design, this study recruited 608 participants through a self-administered online-based e-questionnaire. Young's internet addiction test (YIAT) of 20 items was used to assess the prevalence of IA among adults in Bangladesh. Bivariate and binary logistic regression analyses explored the factors influencing IA.

Results

The overall prevalence of IA was 29.4% among adults during the COVID-19 pandemic. However, the addiction rate was 34.7% among participants under 20 years old. Tobacco smoking (AOR = 1.88, 95% CI 1.15-3.07) and spending more time on the internet during the COVID-19 pandemic (AOR = 2.06, 95% CI 1.08-3.94) were likely the reasons for IA among Bangladeshi adults. Participants aged over 24 years (AOR = 0.39, 95% CI 0.17-0.91), living in rural areas (AOR = 0.51, 95% CI 0.32-0.81), living away from family (AOR = 0.45, 95% CI 0.26-0.79), attached to physical activity (AOR = 0.35, 95% CI 0.24-0.52), and sleeping less than or equal 6 hours (AOR = 0.63, 95% CI 0.42-0.93) had a lower chance of IA during the COVID-19 pandemic.

Conclusion

This study has shown that the prevalence of IA was comparatively higher among younger participants during the COVID-19 pandemic. Smoking, long-time use of the internet, physical activity status, and sleeping duration were the most significant determinants of IA. Thus, raising awareness among the younger generation is the most important strategy to reduce IA. The findings of this study can be used to support health and educational organizations to design their programs, which will help prevent IA in Bangladesh during the COVID-19 pandemic.

Smoking patterns during COVID-19: Evidence from Serbia

INTRODUCTION

Recent research shows that in many countries, smokers who increased smoking during the COVID-19 pandemic outnumbered those who decreased it, despite higher exposure to COVID-19 severity and death. In this study, we compared changes in smoking behavior in the initial and later stages of the pandemic and factors associated with lower smoking intensity.

METHODS

We conducted two survey rounds on representative samples, the first in the initial stage of the pandemic (11–19 May 2020) and the second in the latter stage (4–11 June 2021), in Serbia. Multinomial logistic regression was run to estimate associations between smokers’ characteristics and lower smoking intensity. In contrast to most studies that assess psychological factors affecting smoking in the pandemic, we focused on factual determinants of the change in smoking intensity.

RESULTS

The share of smokers who claimed to smoke more increased significantly, from 22.7% in May 2020 to 35.2% in June 2021. The share of smokers who reported a decrease in smoking only slightly increased, from 11.7% to 13.3%. The persistence of the pandemic considerably increased intentions to cease smoking, from 26.3% to 40%. Higher education (adjusted odds ratio, AOR=2.11; 95% CI: 1.08–4.13), income fall (AOR=2.14; 95% CI: 1.11–4.11), occasional smoking (AOR=4.24; 95% CI: 2.26–7.96) and recovery from COVID-19 (AOR=2.38; 95% CI: 1.23–4.60) increased the odds to reduce smoking during the pandemic.

CONCLUSIONS

Most smokers are unaware that consuming tobacco products increases exposure to health risks related to COVID-19, but those who get coronavirus infected tend to reduce smoking. This research highlights that tobacco control policy needs to be more proactive in creating public campaigns which demonstrate the severity of COVID-19 impact on smokers’ health. Such campaigns should mainly target those groups of smokers who are less able to curb their smoking intensity.

[Drinking behavior at the beginning and during the SARS-CoV-2 pandemic: results of a literature review]

Background and objective

It is well known that alcohol consumption and abuse, as well as alcohol-induced problems, increase during difficult economic times. Previous studies showed increased alcohol consumption in the 2003 SARS outbreak in China. The review examines global changes in alcohol consumption under current SARS-CoV‑2 (severe acute respiratory syndrome coronavirus 2) pandemic.

Materials and methods

The databases PubMed, Ovid, Cochrane Library, Scopus, PsycINFO, and Web of Science with a cut-off date of 11 January 2022 were used. An initial hit count of 791 publications was found. After reading the title and abstract, 62 texts were still eligible. After reviewing the full text, 40 studies were included in this review.

Results

Study results were available from North and South America, Europe, Asia and Oceania. Increases as well as reductions in alcohol consumption were shown. Studies examining multiple waves of the pandemic found that alcohol consumption increased with duration of the pandemic. Binge drinking played a large role in this. There were very large regional differences in the increase in alcohol consumption: from about 10% of respondents to > 45%. In most studies, alcohol consumption was about the same for 40-50% of respondents and decreased for 30-40%.

Conclusions

Further study follow-ups under the continuing pandemic are relevant. Since the populations studied were predominantly of working age, occupational prevention measures of elevated stress levels for some of the respondents with increased alcohol consumption seem reasonable.

Adherence to the healthy lifestyle guideline in relation to the metabolic syndrome: Analyses from the 2013 and 2018 Indonesian National Health Surveys

In this study, we aimed to investigate differences in lifestyle factors and prevalence of metabolic syndrome (MetS) in the Indonesian population between 2013 and 2018. In addition, we investigated whether adherence to the 2015-released national healthy lifestyle guideline (‘GERMAS’) is associated with MetS in different sex, age, urban/rural, and BMI categories. We performed cross-sectional analyses in individuals aged >15 of the 2013 (n = 34,274) and 2018 (n = 33,786) Indonesian National Health Surveys. A stratified, multi-stage, systematic random sampling design and the probability proportional to size method were used to select households in the 34 provinces across the country. MetS was defined according to the Joint Interim Statement Criteria, and adherence to ‘GERMAS’ guideline was defined as fulfilling the national healthy lifestyle recommendations of ≥150 min/week physical activity (PA), ≥5 portions/day fruit and vegetable (FV), no smoking (NS), and no alcohol consumption (NA). We examined the associations of each lifestyle factor with MetS using logistic regression categorised by sex, age groups, urban/rural, and BMI, and adjusted for sociodemographic factors. We observed that men who adhered to the guideline had lower odds ratio of MetS [OR(95%CI) associated with PA: 0.85(0.75–0.97); NA: 0.75(0.56–1.00)] than non-adherent men. Middle-aged adults who adhered to the guideline had lower OR of MetS [PA: 0.85(0.72–1.01); FV: 0.78(0.62–0.99); NA: 0.66(0.46–0.93)] than non-adherent adults <45 years. The adherent urban population had lower OR of MetS [FV: 0.85(0.67–1.07); NA: 0.74(0.52–1.07)] than the non-adherent urban population. Those with overweight or obesity who adhered to the guideline had relatively lower odds of MetS than those who did not. In conclusion, in this nationally representative study, adherence to the ‘GERMAS’ guideline may confer cardiometabolic health benefits to several groups of the Indonesian population, particularly men, middle-aged, those with overweight and obesity, and potentially urban population.

Alcohol Consumption and Smoking During Covid-19 Pandemic: Association with Sociodemographic, Behavioral, and Mental Health Characteristics

The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health factors. Thus, the aim of this study was to assess the association between alcohol consumption and cigarette smoking with sociodemographic, behavioral and mental health characteristics. This study used data from two population-based studies conducted in two cities from Southern Brazil amid the Covid-19 pandemic. Individuals aged 18 years or older were included and selected using a multistage sampling procedure. Alcohol consumption and smoking and changes in such consumption during the Covid-19 pandemic were evaluated. Sociodemographic, behavioral, pandemic-related, and mental health variables were also included. A hierarchical model was used to conduct the adjusted analyses, and Poisson regression with robust adjustment was used for variance. A total of 2170 individuals were studied. The prevalence of alcohol consumption and smoking were 9.3% and 14.2%, respectively. The rates of increase in alcohol consumption and smoking during the Covid-pandemic were about 20% and 30%, respectively. They were higher among those with depressive symptoms, feeling of sadness and self-reported stress. Those with poor diet quality had higher prevalence of alcohol consumption (PR: 1.82) and were 1.58 times more likely to smoke. The findings may help stakeholders in health and political systems to better understand the consequences of the Covid-19 pandemic and develop strategies to mitigate these consequences in Brazil and elsewhere.

Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: A systematic review and meta-analysis

OBJECTIVE

The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes.

METHOD

Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized.

RESULTS

One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression).

CONCLUSIONS

The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A multicentric survey among patients with substance use disorders during the COVID-19 lockdown in India

BACKGROUND

The unprecedented first wave of the COVID-19 pandemic severely impacted mental health services globally. However, the negative impact of such disruptions on people with substance use disorders (SUD) seeking treatment remains unclear. We aim to explore the behaviors adopted by these individuals to overcome the service disruptions.

MATERIALS AND METHODS

We explored the changes related to substance use behavior (quit attempts, withdrawal experienced, treatment-seeking, and risky behaviors), and behavioral changes in response to COVID-19 lockdown. A cross-sectional survey was conducted among 404 people with SUD seeking treatment from seven centers across India. They were assessed by a specially designed structured questionnaire during the first wave (June-September) of the pandemic.

RESULTS

An overwhelming majority experienced withdrawal symptoms, with close to half making quit attempts and seeking treatment during the lockdown. Three-fourth of the sample reported difficulty in accessing treatment services and medications. Patients with opioid use were significantly more likely to think about quitting (χ² = 20.408, P = 0.000), make attempts (χ² = 12.436, P = 0.000), seek treatment (χ ² = 7.536, P = 0.006), and self-medicate for withdrawal symptoms (χ² = 5.885, P = 0.015). In turn, those with alcohol use were more likely to use telepsychiatry services (χ² = 35.143, P = 0.000) and experience stigma by family members (χ² = 29.951, P = 0.000) and neighbors (χ² = 17.725, P = 0.000). Among COVID-19 safety precautions, majority practised wearing masks and social distancing but not others.

CONCLUSION

COVID-19 lockdown led a significant proportion of substance users, especially opioid users, to make quit attempts and seek help. However, these could not be sustained due to difficulty in accessing treatment services. Further, significant proportion failed to adhere to COVID-19 safety precautions.

Economic factors influencing the health behavior changes during COVID-19 pandemic: multiple correspondence analysis results

This research aimed to investigate how health behaviors changed during the COVID-19 pandemic and to identify the economic factors influencing these changes. There were considered income situation and labor market situation as the potential economic factors. Additionally, in the analysis, there were included other characteristics: age, gender, and education level. Health condition was considered through the prism of certain unhealthy characteristics: alcohol consumption, smoking cigarettes, lack of physical activity, and unfavorable eating habits. The study was carried out on the stratified sample of adult inhabitants of Poland (N=1067) in November 2020. To achieve the aim multiple correspondence analysis was used. The results show that the pandemic has changed health behaviors. The negative changes mainly concerned physical activity and eating habits, and only one-sixth reported an increase in alcohol use and cigarette smoking. An increase in negative health behavior was mostly associated with the following characteristics: male, lower age (between 30 and 59), employed persons, tertiary education, and higher income (the fourth and the fifth income quintile group). The exception was a physical activity, where all changes (both negative and positive) were associated with females, people with basic vocational and secondary education, the second and third quintile group, pensioners and retirees, 60 and above age.