Modifiable lifestyles and health-related behaviors are leading causes of morbidity and mortality worldwide.^1-3 Smoking, poor diet, physical inactivity, and alcohol consumption have been identified as particularly important risk factors, accounting for over a third of all deaths in the United States in 2000.² Risk can be reduced by adopting healthier lifestyles,^4-11 but many people find it difficult to make lasting changes.^12-14

Aim: To examine changes in smoking, drinking and quitting/reduction behaviour following the COVID‐19 lockdown in England.Design/setting: Monthly cross‐sectional surveys representative of the adult population in England, aggregated before (April 2019–February 2020) versus after (April 2020) lockdown.Participants: A total of 20 558 adults (≥ 16 years).Measurements: The independent variable was the timing of the COVID‐19 lockdown (before versus after March 2020). Dependent variables were: prevalence of smoking and high‐risk drinking, past‐year cessation and quit attempts (among past‐year smokers), past‐year attempts to reduce alcohol consumption (among high‐risk drinkers) and use of evidence‐based (e.g. prescription medication/face‐to‐face behavioural support) and remote support [telephone support/websites/applications (apps)] for smoking cessation and alcohol reduction (among smokers/high‐risk drinkers who made a quit/reduction attempt). Covariates included age, sex, social grade, region and level of nicotine and alcohol dependence (as relevant).Findings: The COVID‐19 lockdown was not associated with a significant change in smoking prevalence [17.0% (after) versus 15.9% (before), odds ratio (OR) = 1.09, 95% CI = 0.95–1.24], but was associated with increases in quit attempts [39.6 versus 29.1%, adjusted odds ratio (OR_adj) = 1.56, 95% CI = 1.23–1.98], quit success (21.3 versus 13.9%, OR_adj = 2.01, 95% CI = 1.22–3.33) and cessation (8.8 versus 4.1%, OR_adj = 2.63, 95% CI = 1.69–4.09) among past‐year smokers. Among smokers who tried to quit, there was no significant change in use of evidence‐based support (50.0 versus 51.5%, OR_adj = 1.10, 95% CI = 0.72–1.68) but use of remote support increased (10.9 versus 2.7%, OR_adj = 3.59, 95% CI = 1.56–8.23). Lockdown was associated with increases in high‐risk drinking (38.3 versus 25.1%, OR = 1.85, CI = 1.67–2.06), but also alcohol reduction attempts by high‐risk drinkers (28.5 versus 15.3%, OR_adj = 2.16, 95% CI = 1.77–2.64). Among high‐risk drinkers who made a reduction attempt, use of evidence‐based support decreased (1.2 versus 4.0%, OR_adj = 0.23, 95% CI = 0.05–0.97) and there was no significant change in use of remote support (6.9 versus 6.1%, OR_adj = 1.32, 95% CI = 0.64–2.75).Conclusions: Following the March 2020 COVID‐19 lockdown, smokers and high‐risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high‐risk drinking prevalence increased post‐lockdown and use of evidence‐based support for alcohol reduction by high‐risk drinkers decreased with no compensatory increase in use of remote support.

Background: Relationships among sexual activity, problems and concerns, and well-being among older adults have not been fully explored. Aim: To investigate associations among sexual activity, problems and concerns, and experienced well-being in a representative sample of older adults. Methods: In this cross-sectional analysis from the English Longitudinal Study of Ageing, sexual behavior, problems, and concerns were assessed via a self-completed questionnaire. Covariates included age, partnership status, socioeconomic status, smoking status, alcohol intake, limiting long-standing illness, and depressive symptoms. Data were analyzed using 1-way independent analysis of variance. Main Outcome Measure: Enjoyment of life was assessed with the pleasure subscale of the CASP-19 (Control, Autonomy, Self-realization, and Pleasure), a validated measure of quality of life specific to older age. Results: Data on sexual activity and enjoyment of life were available for a total of 3,045 men and 3,834 women (mean age 64.4 years in men and 65.3 years in women). Men and women who reported any sexual activity in the past year had significantly higher mean enjoyment of life scores compared with those who were not sexually active (men, 9.75 vs 9.44 [P < .001]; women, 9.86 vs 9.67 [P = .003]). Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life. Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101). Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women. Conclusion: This is among the first studies to show that well-being is higher among older adults when they are sexually active. Preferences regarding the expression of sexual activity differed between the sexes. Further longitudinal research is needed to confirm a causal association between sexual activity and well-being.

Age discrimination (or ageism) is pervasive in society. Other forms of discrimination (such as racism) have been linked with adverse health outcomes, but age discrimination has not been well studied in public health. We aimed to examine associations between perceived age discrimination and health and wellbeing in England. We did a longitudinal observational population study with data from the English Longitudinal Study of Ageing, a nationally representative sample of older men and women. Participants were aged 50 years or older and reported experiences of age discrimination via a face-to-face computer-assisted personal interview and a self-completed questionnaire between July, 2010, and June, 2011. Self-rated health, chronic health conditions, and depressive symptoms were assessed between July, 2010, and June, 2011, and between May, 2016, and June, 2017. We used logistic regression to test cross-sectional associations between perceived age discrimination and baseline health status and prospective associations between perceived age discrimination and incident ill health over 6 years. Analyses were adjusted for age, sex, and wealth. Our sample for cross-sectional analyses of 2010-11 data comprised 7731 people who took part in the face-to-face interview, returned the self-completion questionnaire, and had available data for age discrimination. Perceived age discrimination was reported by 1943 (25·1%) participants. Patients who perceived age discrimination were more likely to self-report fair or poor health (odds ratio [OR] 1·32 [95% CI 1·17-1·48]) and to have coronary heart disease (1·33 [1·14-1·54]), chronic lung disease (1·37 [1·11-1·69]), arthritis (1·27 [1·14-1·41]), limiting long-standing illness (1·35 [1·21-1·51]), and depressive symptoms (1·81 [1·57-2·08]) than those who did not perceive age discrimination. Follow-up data collected 6 years after the baseline assessment were available for 5595 participants. Longitudinally, perceived age discrimination was associated with the deterioration of self-rated health (OR 1·32 [95% CI 1·10-1·58]) and incident coronary heart disease (1·66 [1·18-2·35]), stroke (1·48 [1·08-2·10]), diabetes (1·33 [1·01-1·75]), chronic lung disease (1·50 [1·10-2·04]), limiting long-standing illness (1·32 [1·10-1·57]), and depressive symptoms (1·47 [1·16-1·86]) over 6 years. Among older adults living in England, perceived age discrimination was associated with increased odds of poor self-rated health and risk of incident serious health problems over a 6-year period. These findings underscore the need for effective interventions at the population level to combat age stigma and discrimination. UK Economic and Social Research Council.

Objective To examine associations between perceived weight discrimination and changes in weight, waist circumference, and weight status. Methods Data were from 2944 men and women aged ≥50 years participating in the English Longitudinal Study of Ageing. Experiences of weight discrimination were reported in 2010-2011 and weight and waist circumference were objectively measured in 2008-2009 and 2012-2013. ANCOVAs were used to test associations between perceived weight discrimination and changes in weight and waist circumference. Logistic regression was used to test associations with changes in weight status. All analyses adjusted for baseline BMI, age, sex, and wealth. Results Perceived weight discrimination was associated with relative increases in weight (+1.66 kg, P < 0.001) and waist circumference (+1.12 cm, P = 0.046). There was also a significant association with odds of becoming obese over the follow-up period (OR = 6.67, 95% CI 1.85-24.04) but odds of remaining obese did not differ according to experiences of weight discrimination (OR = 1.09, 95% CI 0.46-2.59). Conclusions Our results indicate that rather than encouraging people to lose weight, weight discrimination promotes weight gain and the onset of obesity. Implementing effective interventions to combat weight stigma and discrimination at the population level could reduce the burden of obesity.