Substance Use Down With COVID-19 Especially in Those Aged 13 to 20

Cannabis, alcohol, and tobacco use among individuals aged 13 to 20 declined from pre-COVID-19 to the first year of the COVID-19 pandemic. Tobacco use declined among individuals aged at least 25 years while cannabis use increased in this population. These findings were published in the Journal of the American Medical Association Open.

The investigators aimed to assess substance use prevalence in the early COVID-19 pandemic (2020) and how that use differed from pre-pandemic periods.

They conducted a cross-sectional study, repeating analysis of data from 2018 to 2020 of adolescents and adults in the PATH (Population Assessment of Tobacco and Health) Study. PATH interviewed noninstitutionalized residents aged 13 or older in-person from 2016 to 2019 and by telephone in 2020. The 2020 survey included 7129 individuals (aged 13 to 17), 3628 individuals (aged 18 to 20), and 8874 individuals (at least aged 21). The 2018-2019 survey included 10,323 (aged 13 to 17), 6046 (aged 18 to 20), and 26,640 (at least aged 21 years).

Among individuals aged 13 to 15, comparing 2018 to 2019 with 2020, tobacco use declined significantly from 6.9% to 2.6% (absolute difference, -4.3 percentage points; 95% CI, -5.1 to -3.6 percentage points), cannabis use declined from 5.1% to 1.7%, alcohol use declined from 7.1% to 4.6% (all P for difference <.001), and binge drinking declined from 0.8% to 0.3% (P for difference =.005).

Among individuals aged 16 to 17, comparing 2018 to 2019 with 2020, tobacco use declined significantly from 19.5% to 9.2% (absolute difference, -10.3 percentage points; 95% CI, -11.6 to -9.0 percentage points), cannabis use declined from 14.9% to 7.6%, alcohol use declined from 18.2% to 12.9%, and binge drinking declined from 4.0% to 2.4% (all P for difference <.001).

Among individuals aged 18 to 20, comparing 2018 to 2019 with 2020, tobacco use declined significantly from 37.8% to 22.8% (absolute difference, -15.1 percentage points; 95% CI, -16.8 to -13.3 percentage points), cannabis use declined by 5.9 percentage points, binge drinking declined by 2.2 percentage points, (all P for difference ≤.001). Alcohol use remained virtually the same, declining 0.6 percentage points, a nonstatistically significant difference.

Among individuals aged 21 to 24, comparing 2018 to 2019 with 2020, tobacco use declined significantly from 39.0% to 30.9% (absolute difference, -8.2 percentage points; 95% CI, -10.6 to -5.7 percentage points), and alcohol use increased significantly from 60.2% to 65.2% (all P for difference <.001). Binge drinking and cannabis use had statistically nonsignificant small increases (all P for difference >.6).

Among individuals aged at least 25 years, comparing 2018 to 2019 with 2020, tobacco use declined significantly from 26.5% to 23.1% (absolute difference, -3.4 percentage points; 95% CI, -4.2 to -2.6 percentage points), and cannabis use increased significantly from 11.3% to 12.4% (all P for difference ≤.004). Binge drinking and alcohol use had statistically nonsignificant changes of -0.5% and 0.0%, respectively (all P for difference >.18).

Study limitations include differences in sample size, and period of data collection, the PATH Study (self-report survey) was subject to response bias and recall bias, exclusion of homeless individuals and those institutionalized, and COVID-19 pandemic data only from later months of 2020 with no data from 2021 or 2022.

“Substance use decreased between 2019 and 2020 among those aged 13 to 20 years; consistent declines were not seen in older persons other than tobacco use reductions, and cannabis use increased among adults ages 25 years and older,” investigators concluded. They wrote, “While social changes during the COVID-19 pandemic could have affected substance use, findings should be interpreted with caution.”

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Psychiatry Advisor