Prevention of alcohol, drugs and tobacco during the COVID-19-pandemic – consequences and inequalities in Swedish municipalities

Abstract Background and objectives The COVID-19 pandemic and measures to prevent the spread of the virus challenged public health practice at the local and regional level in Sweden. The objective of this study was to follow-up how local preventive ADT prevention (alcohol, drugs, and tobacco) in Sweden was affected during 2020-2021. Methods All Swedish municipalities (N = 290) were included in surveys on how the pandemic affected local ADT prevention. Response rates ranged between 82 and 91 percent. Quantitative data were analysed with reference to socioeconomic and demographic conditions. Qualitative data were analysed thematically. Results A majority of the municipalities reported a decrease in ADT prevention, especially aimed at groups such as parents, children, and young people. There was no correlation between the decrease in municipal ADT prevention and socio-demographic conditions. A majority of the municipalities reported that activities were adapted, often with a digital approach. Adaptation of ADT prevention was less common in smaller municipalities and municipalities where residents had lower levels of education and lower incomes. An increase in activities, as a consequence of measures to prevent the spread of the virus, was more common in larger municipalities and municipalities with a greater proportion of residents with higher educational backgrounds and higher incomes. Conclusions ADT prevention carried out by municipalities in Sweden was initially deeply affected by the COVID-19 pandemic and by measures to prevent the spread of the virus. However, activities were adapted over time, mainly with a digital approach. The ability to adapt differed depending on the sociodemographic conditions of the municipalities. Follow-up studies on ADT prevention and the consequences of the digital approach during 2021 will be presented at the conference.


Background and objectives:
The COVID-19 pandemic and measures to prevent the spread of the virus challenged public health practice at the local and regional level in Sweden. The objective of this study was to follow-up how local preventive ADT prevention (alcohol, drugs, and tobacco) in Sweden was affected during 2020-2021. Methods: All Swedish municipalities (N = 290) were included in surveys on how the pandemic affected local ADT prevention. Response rates ranged between 82 and 91 percent. Quantitative data were analysed with reference to socioeconomic and demographic conditions. Qualitative data were analysed thematically.

Results:
A majority of the municipalities reported a decrease in ADT prevention, especially aimed at groups such as parents, children, and young people. There was no correlation between the decrease in municipal ADT prevention and sociodemographic conditions. A majority of the municipalities reported that activities were adapted, often with a digital approach. Adaptation of ADT prevention was less common in smaller municipalities and municipalities where residents had lower levels of education and lower incomes. An increase in activities, as a consequence of measures to prevent the spread of the virus, was more common in larger municipalities and municipalities with a greater proportion of residents with higher educational backgrounds and higher incomes. Conclusions: ADT prevention carried out by municipalities in Sweden was initially deeply affected by the COVID-19 pandemic and by measures to prevent the spread of the virus. However, activities were adapted over time, mainly with a digital approach. The ability to adapt differed depending on the sociodemographic conditions of the municipalities. Follow-up studies on ADT prevention and the consequences of the digital approach during 2021 will be presented at the conference.

Background and objectives:
The COVID-19 pandemic has posed challenges for traditional public health practice. In the area of alcohol, drugs, and tobacco, local and regional actors have largely moved from physical to digital solutions to handle the barriers imposed by the pandemic. To strengthen the knowledge base in the area, this project aimed to explore how the local transition to, and management of, digital solutions within alcohol, drugs, and tobacco prevention might support the policy drive in Sweden towards equity in health.

Methods:
This was a qualitative study where 13 local coordinators from 7 municipalities participated. Data were collected through 9 individual and 2 group interviews (semi-structured). The analysis was inductive and followed a thematic analysis approach to identify, analyse, and present patterns (themes) in the data. Results: Three themes were developed illustrating how the local implementation of digital solutions in the area of alcohol, drugs, doping, and tobacco prevention might support the transition towards equity in health by 'making time and resources available for development and innovation', 'improving the ability to reach and engage with vulnerable groups', and '(re)shape initiatives to act inclusively'.

Conclusions:
As illustrated by experiences of the local coordinators, the municipalities seemed to have managed the challenges of the pandemic in a good way. To a large extent, they appeared to have adapted their work to remain operational by transitioning into digital solutions. Considering that the pandemic has been challenging in various ways, the finding of ensuring operations were running should not be underestimated. However, besides being able to largely maintain a ''status quo'' in a time when traditional modes of working were inadequate or inappropriate, the results illustrated how the municipalities have added numerous (digital) tools to their toolbox for use in the continuing drive towards good and equitable health.
iii8 European Journal of Public Health, Volume 32 Supplement 3, 2022