Did self‐reported tobacco smoking, alcohol consumption, and physical activity change during the COVID-19 restrictions in Germany in spring 2020? Findings from a population survey (the DEBRA study)

Background: Broad nationwide restrictions of social life and contacts were implemented in Germany on March 22nd, 2020, to reduce the spread of the severe acute respiratory syndrome coronavirus type 2 (SARS‑CoV‑2). It is unclear how these restrictions affected peoples’ health behaviour. Objective To: i) examine changes in self-reported health behaviour of the German population regarding tobacco smoking, alcohol consumption, and physical activity during the restrictions compared with the time prior to these restrictions; ii) explore associations between potential changes and socioeconomic and sociodemographic characteristics. Methods We used data from two waves (June-August 2020) of the German Study on Tobacco Use (DEBRA): a cross-sectional, representative, face-to‐face household survey in people aged ≥ 14 years (N = 4078). Associations between socioeconomic and sociodemographic characteristics and changes in each health behaviour were analysed using multinomial logistic regression analyses (categories of the dependent variable: increase, no change, decrease). Results People reported changes in their health behaviour: smoking increase = 24.0% (95% confidence interval (CI) = 21.5–26.7), decrease = 12.2% (95%CI = 10.4–14.4); alcohol consumption increase = 12.9% (95%CI = 11.7–14.1), decrease = 19.9% (95%CI = 18.4–21.3); physical activity increase = 18.5% (95%CI = 17.3–19.7); decrease = 29.4% (95%CI = 28.0–31.0). People with a lower level of education and younger age were more likely to report a harmful change in health behaviour. Conclusion The majority of people in Germany did not change their health behaviour during the 2020 corona restrictions. Among those who changed, relatively more increased their smoking and decreased their alcohol consumption and physical activity. Public health interventions in this context should particularly target people with lower socioeconomic status and younger age e.g., by offering more online courses.