Stress and Substance Use During the COVID-19 Pandemic Lockdown among College Students in the United States

The high prevalence of substance use among U.S. college students has been a long-term health problem that was likely intensified by the COVID-19 pandemic. In this study, we investigated the associations between pandemic-specific stress and current use of alcohol, (non-medical) cannabis, and tobacco, and estimated the unique impact of pandemic-specific stress on substance use while controlling for general stress. Current substance use was defined as daily or occasional use in the past three months. Data were collected online at one large, southeastern university in March of 2021 as part of the American College Health Association—National College Health Assessment III. Results indicated that while the two pandemic-specific stress measures were highly interrelated, stress due to a worsened financial situation (as a result of the COVID-19 pandemic) was more strongly associated with current use of alcohol and cannabis than was pandemic-specific overall stress. After controlling for students’ sociodemographic characteristics, college-related factors, and an indicator of whether the student ever had COVID-19, the odds of reporting current use of alcohol and cannabis were significantly higher among students who reported that the pandemic made their financial situation a lot more stressful relative to students who reported otherwise. The latter finding was also observed after controlling for the level of overall stress, pointing to a unique impact of pandemic-specific stress on substance use. The study documents a robust association between pandemic-specific stress and college students’ substance use and underscores the importance of providing wellness programs to help students deal with pandemic-specific and general stressors. Moreover, the study highlights the need for future research addressing the impact of pandemic-specific stress on substance use on other U.S. college campuses.