To our knowledge, this is the first longitudinal survey that studies the changes of alcohol, cannabis, and tobacco consumption during the COVID-19 lockdown period in a cohort of teenagers from Central Catalonia. Our findings showed a general trend of reduction of binge drinking, hazardous drinking, hazardous consumption of cannabis, and daily tobacco smoking, among 14- to 18-year-old high-school students during the COVID-19 lockdown period. Despite decreasing, we must not belittle the prevalence of consumption and risky consumption. The results of this project allowed us to establish relationships between individual and contextual factors and the changes in the use of risky substance in adolescents, due to the COVID-19 confinement. It is noteworthy that the dependent variable “worsening the risky consumption” includes both increasing and maintaining the use of substances in a risky pattern.
Indeed, we considered worrying continuing to engage in risky consumption during the extreme situation of confinement, despite the stay-at-home measures and difficulties that adolescents might have faced to get some substances and consume them inside or outside home. One limitation of this study could be that our questionnaires excluded the population out of formal educative system; therefore, the sample is representative of most students aged 14–18, but not all. Besides, in this sample we have seen that girls engage in a higher risky consumption of some substances compared to boys. These results contradict the literature, which affirms a higher risky consumption in boys. Despite this, the differences are not statistically significant, and in the analysis of the evolution of substance use during confinement, the conclusions on consumption continue to show that this pattern does not change by sex. In addition, the self-reported variables of the DESK questionnaires could have generated information biased results. However, the evidence affirms that the use of self-reported questionnaires is a reliable method to detect the alcohol and cannabis consumption in adolescents .
Another limitation might be the way the questionnaires were distributed, as those were sent by mail and WhatsApp, and these channels often have a high prevalence of no response. As already mentioned, the COVID-19 lockdown period modified the patterns of binge drinking, the hazardous drinking, hazardous consumption of cannabis, and smoking tobacco among schooled adolescents. The lack of statistically significant differences could be due to the sample size. Despite this, a tendency of changes in substance use was found in some variables, which suggests that there are sectors of the population that have been less affected by the confinement due to the COVID-19 pandemic. Indeed, our results showed a higher prevalence and probability of engage in binge drinking, hazardous drinking, hazardous consumption of cannabis, and more daily use of tobacco in older adolescents attending advanced courses , compared to the rest of the participants of lower courses.During adolescence, socialization with peers provides and facilitates opportunities for consumption; therefore, the social contact constraint and isolation due to COVID-19 made the access to risky substances more challenging.
Nevertheless, some studies suggest that situations of social distancing during the pandemic could have negative consequences on psychological and mental health ; therefore, some adolescents could have engaged in substance use as a way to cope or deal with all the psychological discomfort and negative feelings related to the COVID-19 situation . Despite most adolescents live with their parents or family members, the maintenance or increase in substance use could be explained by the fact that some adolescents stayed alone at home while parents went to work because they could not do telework. So, maybe the adolescents seized the lack of parental control to use substance at home. In this case, legality and accessibility of some substances seem to play an important role in the atypical situation of confinement. The binge drinking and the hazardous drinking take place specially in social occasions with peers, so the social distancing and the limitationof the leisure could explain the observed reduction in alcohol consumption.As for cannabis, we observed a more considerable reduction and it might be because the situation of confifinement could have made it difficult to obtain this illicit substance, reducing the availability and accessibility . The decrease in tobacco smoking was less accentuated than the decrease in the consumption of other substances during the COVID-19 lockdown period. This might be because tobacco is a legal substance, easily accessible even at home and tobacco retailers did continue their activity during lockdown.