Table 2.
Description of studies included in the review and summary of findings
| Author(s) | Age | Sample size | Sample type | Sample recruitment time/data collection* | Cross-sectional (C) or longitudinal (L) | Type(s) of substance use | Substance use measurement | Main findings of relevance |
|---|---|---|---|---|---|---|---|---|
| Albrecht et al. [38] | 15–17 | 8,972 | Voluntary response | May 2017–July 2017 & May 2020–June 2020 | C | Alcohol and smoking (not specified) | Weekly alcohol consumption & smoker or non-smoker (only for participants 16 +) | Less alcohol consumption was reported during school closures |
| Ayran et al. [59] | 19–24 | 503 | Non-probabilistic: Purposive | May 2020 & June 2020 | C | Nicotine | Fagerström Test for Nicotine Dependence | Higher levels of anxiety led to higher reporting of nicotine dependence in university students |
| Benschop et al. [39] | 16–24 | 6,070 | Convenience | May 2020 & October 2020 | C | Tobacco, alcohol, cannabis, and other drugs (ecstasy (XTC/MDMA), amphetamines, cocaine, nitrous oxide, ketamine, LSD, psychedelic mushrooms/truffles, GHB, 2C-B, 3-MMC/4-MMC and/or any other drug) | Alcohol, tobacco and cannabis use in the last week, other drug use in the last month | There was an overall decrease or cessation in current use of substances, especially in drugs like ecstasy and nitrous oxide |
| Berki and Piko [40] | 14–19 | 705 | Voluntary response | December 2020 | C | Tobacco, alcohol use, and drug abuse | International Health Behavior in School-aged Children (HBSC) survey | Although COVID caused mandatory isolation, many young people still engaged in substance use |
| Bourion-Bédès et al. [41] | 17–25 | 3,764 | Voluntary response | May 2020–May 2020 | C | Alcohol, tobacco | Substance use reported during the pandemic (none, no change, increased consumption, reduced consumption) | Increased alcohol and tobacco consumption were identified as risk factors for high perceived stress |
| Branquinho et al. [69] | 16–24 | 617 | Convenience | April 2020–May 2020 | C | Substance use (general) | No information provided other than the survey was designed for the study | An increase in substance use was reported |
| Branquinho et al. [70] | 16–24 | 592 | Convenience | February 2021–March 2021 | C | Substance use (general) | No information provided other than the survey was designed for the study | Compared to girls, boys reported more negative consequences due to substance use |
| Chaffee et al. [24] | 14–16 | 1,006 | Non-probabilistic: Purposive | March–May 2019, August–February 2019, & September 2020 | L | Alcohol, cigarettes, cigars, e-cigarettes, hookah, cannabis, and conventional smokeless tobacco | Ever used (yes/no) and number of days used (0–30) in the past | There was no significant change in the prevalence of e-cigarette, cannabis, or alcohol use |
| Chaiton et al. [25] | 15–29 | 1,404 | Voluntary response | November 2020–March 2021 | C | Alcohol, cigarettes, cannabis, e-cigarettes, illicit drugs | Frequency of use in the past year | Participants in the study faced barriers to accessing mental health and addiction services as well as expressed need for additional supports |
| Chaiton et al. [26] | 16–25 | 6,721 | Voluntary response | August 2020–March 2021 | C | Cigarettes, e-cigarettes, cannabis, alcohol | Rating of how the pandemic influenced the use of cigarettes, e-cigarettes, cannabis, and alcohol and their current use of each | An increase in the use of one or more substances during the pandemic was observed |
| Cho et al. [27] | 14–21 | 2,120 | Cluster sample | Fall 2013 (wave 1), Fall 2016 (wave 2), & May–August 2020 (wave 3) | L | Alcohol, combustible cigarettes, e-cigarettes, cigars/cigarillos, hookah, blunts, combustible cannabis, e-marijuana, marijuana edibles, dabbing, prescription stimulants, prescription pain-killers | Youth risk behavior surveillance survey (past 30-day substance use) | An escalation in substance use in young adults with prior emotional disturbances during the pandemic was observed |
| Clare et al. [51] | 19–23 | 443 | Voluntary response | September 2017–July 2018, September 2018–May 2019, August 2019–January 2020, & May2020–June 2020 | L | Alcohol | Australian Parental Supply of Alcohol Longitudinal Study (APSALS) | A small reduction in alcohol use was observed during pandemic-related restrictions compared to before the restrictions were noted. There was also a large decline in alcohol-related harms during this same time |
| Clendennen et al. [54] | 16–24 | 709 | Voluntary response | Spring 2020 | C | Marijuana, e-cigarettes, and cigarettes | National Survey on Drug Use and Health, the 10-item Hooked on Nicotine Checklist (HONC) | An increase or the same levels of current marijuana, e-cigarette, and cigarette use were reported during the pandemic |
| Dumas et al. [28] | 14–18 | 1,054 | Voluntary response | April 2020 | L | Alcohol, vaping, cannabis, and binge drinking | 2018 National Survey on Drug Use and Health | The percentage of young people binge drinking, vaping, and using cannabis (girls only) significantly decreased when comparing the pre-covid and post-covid social distancing orders; however, there was no significant change in the percentage of alcohol use |
| Dvorsky et al. [29] | 15–17 | 238 | Non-probabilistic: Purposive | May–June 2020, July–August 2020, & October–November 2020 | L | Alcohol, vaping, and cigarettes | Substance use was rated on a five-point scale (1 = not at all; 5 = regularly), with higher scores indicating higher frequency of use of each type of substance | Adolescents with ADHD were at greater risk for experiencing increases in mental health symptoms and substance use throughout the pandemic, relative to adolescents without ADHD |
| Fruehwirth et al. [52] | 18–20 | 439 | Voluntary response | October 2019–February 2020 & June 2020–July 2020 | L | Alcohol | Youth Risk Behavior Surveillance System | Alcohol use and binge drinking decreased |
| Gaiha et al. [62] | 13–24 | 4,351 | Voluntary response | May 2020 | C | E-cigarette | National cross-sectional survey to assess e-cigarette use | Data showed that participants who have smoked cigarettes and do not believe that e-cigarette use increases their risk of contracting the COVID-19 virus were more likely to report using e-cigarettes in the past month |
| Gaiha et al. [63] | 13–24 | 2,167 | Voluntary response | May 2020 | C | E-cigarette | Change in e-cigarette use, access to e-cigarettes before and after the COVID-19 pandemic began, reasons for change, number of times e-cigarettes were used, and nicotine dependence | Over half of the participants reported reducing e-cigarette use or quitting |
| Gesualdo et al. [49] | 18–24 | 212 | Voluntary response | November 2020–December 2020 | C | Alcohol | Alcohol Use Disorders Identification Test | College students who moved away from home consumed more alcohol than college students who did not leave their home |
| Gilic et al. [30] | 15–18 | 661 | n/a | January 2020 & April 2020 | L | Cigarette smoking, alcohol consumption, and drug consumption | Alcohol Use Disorders Identification Test | No change in smoking, alcohol consumption or drug use was observed during the pandemic |
| Hawke et al. [66] | 14–28 | 622 | Convenience | April 2020 | C | Substance use in general | GAIN-Short Screener (GAIN-SS) | Substance use declined during the pandemic |
| Hawke et al. [31] | 14–28 | 619 | Convenience | April 2020, June 2020, August 2020, & October 2020 | L | Substance use in general | GAIN-Short Screener (GAIN-SS) | Substance use remained stable during the pandemic |
| Hermosillo-de-la-Torre et al. [42] | 14–21 | 8,033 | Voluntary response | November 2020–December 2020 | L | Alcohol, cannabis, tobacco, cocaine, inhalants, and methamphetamine | Problem-Oriented Screening Instrument for Teenagers (POSIT) | Alcohol and tobacco use indicated higher odds of suicidal behavior |
| Ho et al. [60] | 15–25 | 201 | Snowball | April 2020–May 2020 | C | Smoking | Standardized and structured questionnaire covering smoking behavior, readiness to quit, and risk perceptions of smoking during the pandemic | The bulk of participants reduced their daily cigarette use and almost half of participants were motivated to quit |
| Hopkins and Al-Hamdani [64] | 16–24 | 540 | Non-probabilistic: purposive | April 2020–May 2020 | C | E-cigarette | The 2020 Youth and Young Adult Survey | A decrease in the frequency of vaping and in puff per single vaping period was reported |
| Kerekes et al. [37] | 15–19 | 5,114 | Non-probabilistic: purposive | September 2020–February 2021 | C | Cigarettes, alcohol | Changes concerning substance use | A significant decrease in alcohol use and intoxication during the pandemic compared to before was noted. There was no significant change in smoking |
| Kreslake et al. [65] | 15–24 | 5,752 | Convenience | January 2020–June 2020 | C | E-cigarette | Self-reported change in the amount of e-cigarette use reported by current vape users during the COVID-19 pandemic | Due to stay-at-home orders, both difficulties in accessing e-cigarettes and a decrease in their use were noted during the pandemic |
| Kuitunen [67] | 10–17 | 10,000 | Convenience | January 2020–December 2020 | L | Substance use (not specified) | Emergency Dept. nurse assessment (poisoning not included), breathalyzer (alcohol) | Overall incidence rates of intoxication among youth were higher during the pandemic than in the three previous years |
| Lansford et al. [43] | 15–20 | 1,330 | Non-probabilistic: purposive | 2015–2016 & March 2020–January 2021 | L | Cigarettes, alcohol, and illicit drugs | A 5-point scale rating from ‘decreased a lot’ to ‘increased a lot’ during the pandemic | Adolescents that reported poorer well-being before the pandemic were more likely to report an increase in substance use during the pandemic |
| Lazaro-Perez et al. [44] | 18 + | 310 | Non-probabilistic: purposive | June 2020 | C | Tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives or sleeping pills, hallucinogens, opiates, and other drugs | ASSIST questionnaire | A third of the university student participants had a high risk of tobacco and alcohol consumption |
| Leatherdale et al. [55•] | 13–17 | 1,937 | Non-probabilistic: purposive | 2018, 2019, & May–July 2020 | L | Cannabis | Past 12-month marijuana or cannabis use | No significant effect on young people’s cannabis use during the earlier stages of the pandemic was observed |
| Li et al. [45] | 18–23 | 1,010 | Voluntary response | December 2020–January 2021 | C | Alcohol, cigarettes, other drugs | Frequency of substance abuse (0 to > 7 times a week) | Both male and female participants with anxiety problems were more likely to use drugs and alcohol |
| Martinez-Fernandez et al. [56] | 14–16 | 21 | Non-probabilistic: purposive | May 2020 | C | Cannabis | The Spanish Survey on Drug Use in Secondary Education (ESTUDES) was used to measure cannabis use | During stay-at-home orders and other restrictions during the pandemic, young people commonly relied on their immediate network of friends to gain access to cannabis substances |
| Maurino et al. [46] | 12–20 | 1,535 | Voluntary response | August 2020–September 2020 | C | Alcohol, tobacco, marihuana, other drugs | A semi-structured questionnaire with close-ended and open questions designed for the study | A decrease in substance use in all categories was reported |
| Merianos et al. [58] | 18–24 | 756 | Voluntary response | October 2020–December 2020 | C | Exclusive, dual, and polytobacco e-cigarette | Self-report of substance use in the past 30 days | Participants who used two or more types of tobacco products were the most likely to report experiencing COVID-19 symptoms and they were at the highest risk to be diagnosed with COVID-19 |
| Miech et al. [32•] | 17–20 | 582 | Simple random sampling | February–March 2020 & July–August 2020 | L | Cannabis, alcohol, vaping | Monitoring the Future (MTF) | Despite no significant change of marijuana, alcohol, and vape use, perceived availability of these substances declined dramatically during the pandemic |
| Naguib et al. [33] | 18–24 | 2,380 | Cluster Sample | July 2020–October 2020 | C | Cigarettes, alcohol, Tramadol, Heroin, Hashish, Bhang, Strox, Voodoo | Addiction Severity Index | During the pandemic, illicit substance users increased use by almost 80% |
| Pelham et al. [34••] | 10–14 | 7,842 | Simple random sampling | May 2021, June 2021, August 2021 | L | Alcohol, cigarettes, e-cigarette, cigar/hookah/pipe, smokeless tobacco/chew/snus; cannabis (flower/concentrate/edible); prescription drugs not prescribed; used inhalants; any other drugs | Adolescent Brain Cognitive Development (ABCD) Study (past month use of each listed substance) | During the pandemic, a decrease in alcohol use was reported but an increase was reported in the use of nicotine and unprescribed prescription drugs |
| Pigeaud et al. [50] | < 18 (no range given; mean = 16) | 482 | Non-probabilistic: purposive | January 2019–December 2020 | L | Alcohol | Acute Alcohol Intoxication diagnosis | A decrease in acute alcohol intoxication was reported |
| Roges et al. (2021) [35] | 14–8 | 303 | Convenience | October 2019–February 2020 & June–July 2020 | L | Alcohol, cannabis, tobacco | DESK-COVID-Cohort survey, AUDIT-C test, CAST validated test (Cannabis Abuse Screening Test) | A general reduction in substance use during the pandemic was reported with the exception of vocational and educational training students who were at a higher risk of substance use than other students |
| Romm et al. [36] | M = 24.76 (no range given) | 1,084 | Convenience | September–December 2019 & March–May 2020 | L | Cigarette, e-cigarette, marijuana, and alcohol | Past 30-day substance use frequency | Participants who reported increases in e-cigarette use and alcohol use were more likely to report adverse childhood experiences and depressive symptoms |
| Sen et al. [22] | 10–20 | 2,932 | Voluntary response | April–June 2020 | C | Cigarettes, alcohol, illicit drugs | Alcohol Use Disorders Identification Test (AUDIT), Cigarette Dependence Scale 12 (CDS-12) | Over half of those who reported drinking alcohol reported increased drinking and over a third reported harmful or dependence-like drinking behavior. Adolescents who smoked reported decreased cigarette use. Over a third of adolescents who reported using drugs reported an increase in use |
| Singh et al. [68] | 13–60 | 1,027 | Voluntary response | December 1–31 2020 | C | Alcohol, tobacco, and self-medication | Brief COPE | Significantly higher substance use was reported among young males compared to girls during the pandemic |
| Skumlien et al. [57] | 16–30 | 798 | Voluntary response | June–August 2020 | C | Alcohol, cannabis, illicit drugs | Severity of Dependence Scale (Cannabis dependence) | An increase in alcohol use was reported during the lockdown among adolescents with a history of alcohol use. A decrease in the use of illicit drug use was noted among both adolescents with and without a history of such use. An increase in cannabis use was noted. No differences were noted in cigarette use |
| Thorisdottir et al. [23••] | 13–18 | 59,701 | Cluster sample | October or February in 2016 and 2018 & October, 2020 | L | Cigarette, e-cigarette, and alcohol | Frequency of cigarette, e-cigarette, and alcohol use in the past 30 days | In the 15–18-year-old age group, substance use decreased with no differences by gender |
| Vera et al. [53] | 18–25 | 305 | Voluntary response | November 2019–February 2020 & March 2021 | L | Alcohol | Daily Drinking Questionnaire (DDQ) | Alcohol use decreased during the pandemic, compared to before the pandemic |
| von Soest et al. [47] | 13–18 | 227,258 | Random sampling | Each Spring from 2014–2019, January–March 2020, January–March 2021 | L | Tobacco, alcohol, cannabis | Nationwide Norwegian Survey | Alcohol and cannabis use decreased |
| Yu and Choe [48] | 12–18 | 108,038 | Stratified cluster | June to August in 2019 and August to November in 2020 | C | Drinking, smoking | Korea Youth Risk Behavior Surveys (KYRBS) | A decrease in drinking and smoking was noted, with a larger decrease among adolescent boys than girls |
*Month of administration reported when available. If not, the time of year or solely the year in some cases, as reported by the authors