Substance and Internet use during the COVID-19 pandemic in China

Qiuping Huang,Yi Cai,Shuhong Lin,Xinxin Chen,Hongxian Shen,Tianli Shao,Shucai Huang,Yifan Li,Zhenjiang Liao,Jing Qi

doi:10.1038/s41398-021-01614-1

Abstract

The coronavirus disease 2019 (COVID-19) has adversely influenced human physical and mental health, including emotional disorders and addictions. This study examined substance and Internet use behavior and their associations with anxiety and depression during the COVID-19 pandemic. An online self-report questionnaire was administered to 2196 Chinese adults between February 17 and 29, 2020. The questionnaire contained the seven-item Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9), questions on demographic information, and items about substance and Internet use characteristics. Our results revealed that males consumed less alcohol (p < 0.001) and areca-nut (p = 0.012) during the pandemic than before the pandemic. Age, gender, education status, and occupation significantly differed among increased substance users, regular substance users, and nonsubstance users. Time spent on the Internet was significantly longer during the pandemic (p < 0.001) and 72% of participants reported increased dependence on the Internet. Compared to regular Internet users, increased users were more likely to be younger and female. Multiple logistic regression analysis revealed that age <33 years (OR = 2.034, p < 0.001), increased substance use (OR = 3.439, p < 0.001), and increased Internet use (OR = 1.914, p < 0.001) were significantly associated with depression. Moreover, anxiety was significantly related to female gender (OR = 2.065, p < 0.001), “unmarried” status (OR = 1.480, p = 0.017), nonstudents (OR = 1.946–3.030, p = 0.001), and increased substance use (OR = 4.291, p < 0.001). Although there was a significant decrease in social substance use during the pandemic, more attention should be paid to increased Internet use. Increased Internet use was significantly associated with both anxiety and depression, and increased substance use was related to depression. Professional support should be provided to vulnerable individuals to prevent addiction.

Highlights

Since December 2019, COVID-19 has emerged and spread rapidly across the globe
Due to concerns about infection and stigma toward infected individuals and their families, as well as occupational factors, economy, isolation, loneliness, and other factors [2, 3], the prevalence of various psychological disorders—such as anxiety, depression, stress, and insomnia— has increased [4,5,6]. To cope with these altered circumstances, people are more likely to indulge in addictive behaviors and/or relapse from abstinence [7,8,9]
This study examined substance and Internet use behavior and their associations with anxiety and depression during the COVID-19 pandemic

Summary

Introduction

Since December 2019, COVID-19 has emerged and spread rapidly across the globe. The World Health Organization declared COVID19 a pandemic on March 11, 2020 [1]. Due to concerns about infection and stigma toward infected individuals and their families, as well as occupational factors, economy, isolation, loneliness, and other factors [2, 3], the prevalence of various psychological disorders—such as anxiety, depression, stress, and insomnia— has increased [4,5,6]. To cope with these altered circumstances, people are more likely to indulge in addictive behaviors (including substance use and behavioral addictions) and/or relapse from abstinence [7,8,9]. It remains unclear whether there has been a change in substance use in China, and how the change occurs, if there has

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