As COVID-19 infections continue to rise, with countries facing a fifth wave spurred by the omicron variant, alcohol consumption and smoking are also increasing.

A study published in the journal Addiction in August found that, during England's first lockdown, 4.5 million more adults would have been classed as high-risk drinkers compared with before the pandemic — that's an increase of 40%. 

"This trend was particularly worrying in women (up 55%) as well as people from lower socioeconomic groups (up 64%)," the authors said in a press release.

More than 652,000 young adults became smokers during the first lockdown, according to the study.

A study published in the European Journal of Public Health in October 2021, found that among current smokers in France nearly 27% reported an increase in tobacco use since the country's first lockdown in March 2020, and about 19% reported a decrease.

An increase in tobacco consumption was associated with people aged 18-34 who experienced anxiety and had a high level of education.

Nearly 11% of drinkers reported an increase in their alcohol consumption since lockdown, and 24.4% reported a decrease. The increase in alcohol consumption was associated with an age of 18-49 years.

In Germany, where some cigarette advertising is still allowed, 31% of people older than 14 currently smoke, compared with 27% at the end of 2019, according to the long-term German Study on Smoking Behavior.

Smoking kills up to 120,000 people per year in Germany. That's about the same number of people killed by COVID-19 in the country since the pandemic started almost two years ago.

The impact of alcohol

Alcohol consumption contributes to 3 million deaths every year globally, according to the World Health Organization, and alcohol use is responsible for 5.1% of the global burden of disease.

The negative health impacts of alcohol are far-reaching. Over time, excessive alcohol intake can lead to the development of chronic diseases and health problems including high blood pressure, heart disease, stroke and liver disease, according to the US national public health agency, the Centers for Disease Control and Prevention. It can also lead to a weakened immune system, mental health problems and cancer.

Tobacco has an ever greater death toll, killing 8 million people each year, including 1.2 million nonsmokers who had been exposed to secondhand smoke. More than 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries, according to the WHO.

Fueled by stress and boredom

Despite fewer opportunities to drink socially, alcohol consumption increased among some groups in Germany.

Falk Kiefer, a doctor and president of the German Society for Addiction Research & Addiction Therapy, told the German news agency DPA that about 25% of adults drank more than they did before the pandemic.

"People who already drank alcohol regularly at home, for example to make the evening nice — to drive away loneliness, boredom or worries — they now drink more," Kiefer said.

Sarah Jackson, a behavioral scientist at University College London and lead author of the Addiction study, said that, though many smokers took the first lockdown as an opportunity to quit, stress contributed to others' smoking and drinking more.

"The first lockdown was also a period of great stress for many people, and we saw rates of smoking and risky drinking increase among groups hardest hit by the pandemic," Jackson said in a press release.

How much alcohol is safe?

Though some studies have found that there are possible health benefits of moderate alcohol consumption, recent studies have found that no amount of alcohol is safe.

Studies have shown that moderate alcohol intake is associated with reduced cardiovascular risk compared with heavy drinking or abstinence.

Researchers from Oxford University, Peking University and the Chinese Academy of Medical Sciences wanted to see if there was a causal link.

In a study published in The Lancet in April 2019, the scientists interviewed and followed 500,000 people in East Asian populations for 10 years.

In East Asian populations, there are common genetic variants that greatly reduce alcohol tolerance, which means that consumption is reduced. But the genetic variants are unrelated to other lifestyle factors such as smoking.

The scientists found that the people with the genetic variants had decreased alcohol intake, and also had decreased blood pressure and stroke risk. The researchers concluded that alcohol increases the risk of having a stroke by about 35% for every four additional drinks per day and that there are no protective effects from light or moderate drinking.

"There's no 'safe' level of smoking or drinking, and stopping smoking or cutting down drinking will help to reduce your risk of cancer," said Michelle Mitchell, chief executive of Cancer Research UK, which funded the UK-based Addiction study.

Excessive alcohol consumption is also a risk factor for domestic violence, which increased in some homes as countries went into lockdown. Emergency calls about domestic violence increased by 60% in EU countries, according to the Organisation for Economic Co-operation and Development (OECD).

Editor: Fabian Schmidt