Traditional smoking associated with alcohol and psychotropic substance use in post-lockdown in a representative sample of the Italian population

Introduction: Vulnerable population subgroups, such as drug users or alcoholics, have been most impacted by the pandemic. The objective of the present work is to assess which variables are associated with the concomitant consumption of smoking, alcohol and psychotropic substances after the lockdown in Italy and to estimate a possible association between the consumption of these substances and the level of mental health. Methods: The data used come from the Lost in Tuscany 2023 survey, a project carried out with the aim of assessing the impact of the COVID-19 pandemic on the lifestyles and mental health of the Italian population aged 18 to 74. Results: The concomitance of smoking, alcohol use and psychotropic substances appears to be especially prevalent among younger people. College graduates accompany traditional smoking more with both risk behaviors; those with low degrees, on the other hand, make greater use of exclusive smoking. Regarding the psychological component: the concomitant use of alcohol and psychotropic substances is higher among the most frail individuals, who present symptoms of anxiety and depression; in addition, the proportion of smokers who accompany smoking with both risk behaviors is higher among those who use psychoactive drugs. Conclusion: Even before the lockdown anxiety and depression were known risk factors for smoking, alcohol and psychotropic substance use. The restrictive measures implemented following the pandemic worsened the mental health of citizens, increasing the use of these substances. After the lockdown in Italy, younger individuals and those with worse mental health are at greater risk for consuming smoking, alcohol and other psychotropic substances.