Changes in Tobacco and Alcohol Consumption in France during the Spring 2020 Lockdown: Results of the Coviprev and Viquop Surveys.

This study aims to describe changes in tobacco and alcohol consumption in France during the first COVID-19 lockdown in March 2020 and its gradual lifting in May. The associated factors and the reasons reported explaining those changes are also studied. Data came from five waves of the CoviPrev online cross-sectional survey (approximately n = 2000 per wave) and the ViQuoP qualitative survey (n = 60), which took place between April and June. Most people self-reported stable consumption compared to before the lockdown, but 27% to 32% of smokers and 10% to 16% of drinkers had increased their consumption, depending on the wave of the survey. Boredom, stress and the search for pleasure were the main reasons reported. While the sociodemographic factors associated with an increase in tobacco and alcohol use differed according to the product and month, poor mental health was associated with an increase in both products in April and May. Between 10% and 19% of smokers and 22% to 25% of drinkers reported having reduced their consumption for their health or through constraints. The measures taken to manage the spring 2020 epidemic appear to have had contrasting impacts on tobacco and alcohol consumption in France. People whose lifestyles and mental health was most affected appear to have modified their consumption more frequently.

Barriers Against and Motivations for Quitting Smoking during the COVID-19 Health Crisis: Results of a Qualitative Study in France.

The COVID-19 epidemic and its psychological, economic and social consequences could have an impact on the evolution of tobacco-smoking prevalence and attitudes towards quitting. The aim of this study is to analyse the specific characteristics of the motivations for and barriers against smoking cessation in this period. The study is based on qualitative data collected from late 2020 to early 2021 in France from 89 smokers with a low or intermediate socio-economic level. Among the motivations for quitting smoking, health concerns and the financial cost of cigarettes carried increased importance among the smokers in this period. Inversely, perceived stress, isolation, and a lack of social or healthcare support prevented some smokers from attempting to quit. These results are useful for explaining the evolution of smoking prevalence and preparing future interventions in the context of the health crisis and its aftermath. They highlight the relevance of educational messages, of the promotion of validated smoking-cessation aids and, in particular, remote support, as well as the implementation of community-based actions.

Nationwide Initiation of Cardiovascular Risk Treatments During the COVID-19 Pandemic in France: Women on a Slippery Slope?

Objectives: This study examines the initiation of prescribed medication treatments for cardiovascular risk (antihypertensives, lipid-lowering drugs, oral anticoagulants in atrial fibrillation, and smoking cessation medications) during the COVID-19 pandemic in the French population. Methods: For each year between 2017 and 2021, we used the French National Insurance Database to identify the number of people with at least one reimbursement for these medications but no reimbursement in the previous 12 months. We computed incidence rate ratios (IRRs) between 2017-2019 and, respectively 2020 and 2021 using Poisson regression adjusted for age and 2017-2019 time trends. We recorded the number of lipid profile blood tests, Holter electrocardiograms, and consultations with family physicians or cardiologists. Results: In 2020, IRR significantly decreased for initiations of antihypertensives (-11.1%[CI95%, -11.4%;-10.8%]), lipid-lowering drugs (-5.2%[CI95%, -5.5%;-4.8%]), oral anticoagulants in atrial fibrillation (-8.6%[CI95%, -9.1%;-8.0%]), and smoking cessation medications (-50.9%[CI95%, -51.1%;-50.7%]) compared to 2017-2019. Larger decreases were found in women compared to men except for smoking cessation medications, with the sex difference increasing with age. Similar analyses comparing 2021 to 2017-2019 showed an increase in the initiation of lipid-lowering drugs (+ 11.6%[CI95%, 10.7%;12.5%]) but even lower rates for the other medications, particularly in women. In addition, the 2020 number of people visiting a family physician or cardiologist decreased by 8.4 and 7.4%. A higher decrease in these visits was observed in those over 65 years of age compared to those under 65 years of age. A greater use of teleconsultation was found in women. Conclusion: The COVID-19 pandemic heavily impacted the initiation of medication treatments for cardiovascular risk in France, particularly in women and people over 65 years.

Changes in smoking and alcohol consumption during COVID-19-related lockdown: a cross-sectional study in France.

BACKGROUND: In many countries, lockdown measures were implemented to curb the COVID-19 pandemic. This situation may have an impact on mental health, tobacco smoking and alcohol consumption. The aim of this research report is therefore to describe changes in tobacco and alcohol consumption in the general French population during the first 2 weeks of lockdown and identify any associated factors. METHODS: Self-reported changes in smoking and alcohol consumption following the lockdown implemented in France on 17 March 2020 were collected from 2003 respondents aged 18 years and older in an online cross-sectional survey carried out from 30 March to 1 April 2020. Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale. RESULTS: Among current smokers, 26.7% reported an increase in their tobacco consumption since lockdown and 18.6% reported a decrease, while it remained stable for 54.7%. The increase in tobacco consumption was associated with an age of 18-34 years, a high level of education, and anxiety. Among alcohol drinkers, 10.7% reported an increase in their alcohol consumption since lockdown and 24.4% reported a decrease, while it remained stable for 64.8%. The increase in alcohol consumption was associated with an age of 18-49 years, living in cities of more than 100 000 inhabitants, a high socio-professional category, and a depressive mood. CONCLUSIONS: The national lockdown implemented in France during the COVID-19 pandemic influenced tobacco and alcohol consumption in different ways according to sociodemographic group and mental health.

Tobacco and COVID-19: a crisis within a crisis?

During the pandemic, the world's media have publicized preliminary findings suggesting that tobacco use is protective against COVID-19. An ad hoc multidisciplinary group was created to address the major public health implications of this messaging. Key messages of this commentary are as follows: 1) The COVID-19 crisis may increase tobacco consumption and decrease access to healthcare. As a result, smoking-related morbidity and mortality could increase in the coming months and years; 2) Smoking and tobacco-related diseases are prognostic factors for severe COVID-19; and 3) In theory, smokers may be at lower risk of COVID-19 infection because of having fewer social contacts. In conclusion, tobacco control is a greater challenge than ever in the context of the COVID-19 pandemic. Public decision-makers must be vigilant in ensuring that public health practices are consistent and compliant with the principles of the WHO Framework Convention on Tobacco Control. In addition, researchers and the media have a responsibility to be cautious in communicating preliminary results that may promote non-evidence-based research, self-destructive individual behaviours, and commercial agendas.

RéSUMé: Pendant la pandémie, des résultats préliminaires sur l'effet protecteur du tabac sur la COVID-19 ont été largement diffusés dans le monde entier. Dans ce contexte, et en raison des questions de santé publique liées à ce sujet, un groupe multidisciplinaire ad hoc a été créé en réponse aux demandes des institutions de santé publique. Les messages clés de ce commentaire sont les suivants : 1) La crise de la COVID-19 pourrait entraîner une augmentation de la consommation de tabac et une diminution de l'accès aux soins. En conséquence, la morbidité et la mortalité liées au tabagisme pourraient augmenter dans les mois et les années à venir; 2) Le tabagisme et les maladies liées au tabac sont des facteurs pronostiques de formes graves de la COVID-19; et 3) Hypothétiquement, les fumeurs, notamment en réduisant la fréquence et la durée des contacts sociaux, pourraient être moins susceptibles d'être contaminés. En conclusion, même pendant et malgré la crise sanitaire due à la pandémie de la COVID-19, la lutte contre le tabagisme reste plus que jamais un défi. Les décideurs publics doivent être particulièrement vigilants pour assurer la cohérence des pratiques publiques, y compris le respect des principes de la Convention-cadre de l'OMS pour la lutte antitabac. Il incombe également aux chercheurs et aux médias de communiquer avec prudence des résultats préliminaires susceptibles de générer des comportements individuels contre-productifs et d'être instrumentalisés à des fins commerciales.