JMIR Publications

ABSTRACT

Background:

The international outbreak of the COVID-19 pandemic has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations would foster addiction-related habits, such as caloric food intake, screen use, and substance use. However, no data has supported this assumption until now.

Objective:

To assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France

Methods:

Online survey among 11,391 participants, opened from day-8 to day-13 of the containment (started 03/17/2020). Questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress ([1-10] Visual Analog Scale), Warwick–Edinburgh Mental Well-being Scale (WEMWBS), and reported changes in several addiction-related behaviors. Global changes were described, and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals (95%CI).

Results:

Overall, increases in addiction-related habits were more frequent than decreases, as they were reported by 30.0% (caloric food), 64.5% (screens), 35.6% (tobacco), 24.8% (alcohol), and 31.2% (cannabis) of the concerned subjects, respectively. Reduced well-being score and increase stress score were general factors of increase in addiction-related habits (p<0.001 for all types of habits). The main specific factors of increase in caloric food intake (n=10,771) were female gender (aOR=1.62; 95%CI=1.48-1.77), being aged less than 49 years (p<0.001), having a partner (aOR=1.19; 95%CI=1.06-1.35, being locked down in a more confined space (per one m2/person decrease: aOR=1.02; 95%CI=1.01-1.03), being locked down alone (aOR=1.29; 95%CI=1.11-1.49), and reporting a current (aOR=1.94; 95%CI=1.62-2.31) or past (aOR=1.27; 95%CI=1.09-1.47) psychiatric treatment. The main specific factors of increase in screen use (n=11,267) were female gender (aOR=1.31; 95%CI=1.21-1.43), being aged less than 29 years (p<0.001), having no partner (aOR=1.18; 95%CI=1.06-1.32), being professionally active (p<0.001), an intermediate/high education level (p<0.001), being locked down with no access to an outdoor space (aOR=1.16; 95%CI=1.05-1.29), being locked down alone (aOR=1.15; 95%CI=1.01-1.32), in an urban environment (p<0.01), and not working (p<0.001). The main specific factors of increase in tobacco use (n=2,787) were female gender (aOR=1.31; 95%CI=1.11-1.55), having no partner (aOR=1.30; 95%CI=1.06-1.59), having and intermediate/low education level (p<0.01), and still working at workplace (aOR=1.47; 95%CI=1.17-1.86). The main specific factors of increase in alcohol use (n= 7,108) were being aged 30-49 years (p<0.05), a high level of education (p<0.001), or a current psychiatric treatment (aOR=1.44; 95%CI=1.10-1.88). The main specific factor of increase in cannabis use (n=620) was an intermediate/low level of education (p<0.001).

Conclusions:

The early phase of the COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits. Clinical Trial: NA