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Adolescents’ Substance Use and Physical Activity Before and During the COVID-19 Pandemic (JAMA Pediatrics)

Publication Topics

2020 California Health Interview Survey (CHIS 2020); COVID-19; Adolescents/Children; Health Behaviors; Physical Activity; Tobacco/Smoking; Child Development

Publication Type

CHIS Journal Article

Publication Date


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<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=1922\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=1922&amp;RootFolder=*">Benjamin W. Chaffee</a>

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Summary: To compare adolescents’ substance use and physical activity behaviors before and after stay-at-home restrictions.

Ongoing prospective cohort study of tobacco use behaviors among ninth- and tenth-grade students enrolled at eight public high schools in Northern California from March 2019 to February 2020 and followed up from September 2019 to September 2020. Race/ethnicity was self-classified from investigator-provided categories and collected owing to racial/ethnic differences in tobacco and substance use. In California, a COVID-19 statewide stay-at-home order was imposed March 19, 2020. In this study, 521 six-month follow-up responses were completed before the order and 485 were completed after the order.

The prevalence of substance use (ie, past 30-day use of e-cigarettes, other tobacco, cannabis, and alcohol) and physical activity (active ≥5 days/week) was compared at baseline and follow-up. A difference-in-difference approach was used to assess whether changes from baseline to 6-month follow-up varied if follow-up occurred after the stay-at-home order, adjusting for baseline behaviors and characteristics.

Findings: Of 1,423 adolescents enrolled at baseline, 1,006 completed 6-month follow-up. E-cigarette use declined from baseline to 6-month follow-up completed before the stay-at-home order and 6-month follow-up completed after the stay-at-home order, but the extent of decline did not differ statistically between groups responding before versus after the stay-at-home order.

In contrast, being physically active was unchanged from baseline if follow-up was before the order but declined sharply from baseline if follow-up was after the order, indicating a pronounced difference in change from baseline after the stay-at-home order. Overall in the cohort, reported use of other tobacco, cannabis, and alcohol did not differ meaningfully before and after the order.

In this cohort, a reduction in e-cigarette use occurred independently of COVID-19 stay-at-home restrictions, but persistent cannabis and alcohol use suggest continued need for youth substance use prevention and cessation support. Declining physical activity during the pandemic is a health concern.

This study uses 2020 California Health Interview Survey (CHIS) data.


Article 1

Journal Article: Adolescents’ Substance Use and Physical Activity Before and During the COVID-19 Pandemic

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Press Release

Related Link 1

California Health Interview Survey (CHIS)

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Created at 6/21/2021 2:22 PM by i:0#.f|uclachissqlmembershipprovider|celeste
Last modified at 8/2/2021 8:59 AM by i:0#.f|uclachissqlmembershipprovider|venetia