Will changes in alcohol and tobacco use be seen during the COVID-19 lockdown?/?Se observaran cambios en el consumo de alcohol y tabaco durante el confinamiento por COVID-19?

Introduction

The coronavirus pandemic (COVID-19) of recent months has triggered a global emergency. Reactions of anxiety, worry or fear are estimated to be frequent across general population given the unknown and novel nature of the disease, and the social distancing measures resulting from the state of alarm. However, the potential psychological impact, not only of coronavirus per se but also of lockdown, is still unknown, as we are facing an exceptional and unprecedented situation.

Some studies focusing on the impact of Severe Acute Respiratory Syndrome (SARS), the first massive outbreak of an infectious disease in the 21st century, have shown significant repercussions on people's mental health and their level of well-being (Ko, Yen, Yen & Yang, 2006), even four years after the epidemic (Lam et al., 2009). People talk about "bio-disasters" capable of generating psychological impacts comparable to those of other catastrophes such as terrorist attacks, earthquakes, etc. (Chong et al., 2004; Wu et al., 2008). In the case of exposure to SARS, post-traumatic stress disorder and depressive disorders have been shown to be the most prevalent mental disorders during long-term follow-up (Mak, Chu, Pan, Yiu & Chan, 2009). However, during SARS, neither the measures implemented nor the level of global impact were as extreme as on this occasion, so the effects of the COVID-19 pandemic can be expected to be even greater.

During the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak in 2015, which caused the confinement of almost 17,000 people exposed to it, an increased risk of post-traumatic stress symptoms was observed in health workers who had treated infected patients (Lee, Kang, Cho, Kim & Park, 2018), as well as symptoms of anxiety (7.6%), anger (16.6%) and depression (19.3%), even among those under isolation measures without having become infected themselves (Yoon, Kim, Ko & Lee, 2016); in many cases, these symptoms continued during the 4-6 month period after confinement (Jeong et al., 2016).

Studies published on the psychological impact of COVID-19 in China have observed emotional distress, with severe anxiety responses present in one third of the general population (Lima et al., 2020; Wang et al., 2020). However, a study carried out with a large general population sample in Spain showed how during the first weeks of lockdown (from March 19 to 26) the most frequently observed pathological psychological responses were depressive symptoms (46.7%), followed by avoidance behaviour (44.3%). Furthermore, contrary to expectations, anxiety responses were the least frequent, affecting 6.1% of the population (Garcia-Alvarez et al., 2020). Likewise, the psychological effects of lockdown seem to increase as the days go by (Garcia-Alvarez et al., 2020) and in certain vulnerable groups of the population, such as healthcare workers (Bai et al., 2004; Maunder et al., 2003), people with past somatic disease or those with or current mental disorder, more specifically, depression, anxiety or bipolar disorder (Garcia-Alvarez et al., 2020). Similarly, people with substance use disorders could represent at-risk groups (Pfefferbaum & North, 2020).

At issue is how this public health emergency may generate not only negative dysfunctional responses...