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Exposure to health misinformation about COVID-19 and increased tobacco and alcohol use: a population-based survey in Hong Kong
  1. Tzu Tsun Luk1,
  2. Shengzhi Zhao1,
  3. Xue Weng1,
  4. Janet Yuen-Ha Wong1,
  5. Yongda Socrates Wu1,
  6. Sai Yin Ho2,
  7. Tai Hing Lam2,
  8. Man Ping Wang1
  1. 1School of Nursing, The University of Hong Kong, Hong Kong, China
  2. 2School of Public Health, The University of Hong Kong, Hong Kong, China
  1. Correspondence to Dr Man Ping Wang, School of Nursing, The University of Hong Kong, Hong Kong, China; mpwang{at}


Introduction Health information about COVID-19 has been circulating in social networking sites, including unproven claims that smoking and alcohol drinking could protect against COVID-19. We examined if exposure to such claims was associated with changes in tobacco and alcohol consumption.

Methods We conducted a population-based, landline and mobile phone survey of 1501 randomly sampled adults aged 18 years or older (47.5% male) in Hong Kong in April 2020. Respondents reported if they had ever seen claims that ‘smoking/alcohol drinking can protect against COVID-19’ from popular social networking platforms. Current tobacco and alcohol users reported if they had increased or reduced their consumption since the outbreak. Prevalence data were weighted by sex, age and education of the general adult population.

Results 19.0% (95% CI 16.8% to 21.4%) of all respondents reported having seen claims that ‘smoking/alcohol drinking can protect against COVID-19’ from social networking sites. Multinomial logistic regression showed that exposure to the claims was significantly associated with increased tobacco use (OR 2.37, 95% CI 1.08 to 5.20) in current tobacco users (N=280) and increased alcohol use (OR 4.16, 95% CI 2.00 to 8.67) in current drinkers (N=722), adjusting for sex, age, education level, alcohol/tobacco use status, home isolation, anxiety and depressive symptoms, and survey method.

Conclusion Our results first showed that exposure to health misinformation that smoking/alcohol drinking can protect against COVID-19 was associated with self-reported increases in tobacco and alcohol consumption in Chinese during the pandemic.

  • prevention
  • advertising and promotion
  • media
  • surveillance and monitoring

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  • Twitter @TT_Luk, @KelvinW95143430

  • Contributors SZ, JY-HW and MPW conceptualised the study. SZ implemented the study. TTL conducted statistical analyses and drafted the first version of the manuscript. All authors reviewed the manuscript, interpreted the data and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was granted by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 20-238).

  • Provenance and peer review Not commissioned; externally peer reviewed.