2.2.1. Lifestyle Behavioral Change Variables

Self-reported changes in healthy (i.e., eating healthy foods and PA) and addictive (i.e., alcohol use, tobacco smoking, and vaping) lifestyle behaviors were assessed and are described as follows:

Healthy Eating. Respondents indicated a degree of agreement with the question, "Since COVID-19, I am eating more healthy foods". Response options were on a 5-point Likert-type scale from 1 = "strongly disagree" to 5 = "strongly agree".

Physical Activity. PA was assessed with the item, "Since COVID-19, I am exercising more." Response options were on a 5-point Likert-type scale from 1 = "strongly disagree" to 5 = "strongly agree".

Alcohol Use. Individuals were first asked if they drink alcohol (yes/no), and if so, whether their alcohol consumption had "increased", "decreased", or "stayed the same" since the pandemic.

Tobacco Smoking. Items were taken from the Global Adult Tobacco Survey [31]. Individuals were first asked if they currently smoke tobacco "on a daily basis", "less than daily", or "not at all". Then, they were asked if their smoking had "increased", "decreased", or "stayed the same" since the pandemic.

Vaping. Participants were first asked if they use e-cigarettes "on a daily basis", "less than daily", or "not at all". Then, they were asked if their vaping had "increased", "decreased", or "stayed the same" since the pandemic.

Lifestyle behavioral change indices.

Healthy lifestyle behavior change index. The two healthy lifestyle behavioral change variables (i.e., healthy eating and PA) were re-coded by assigning a value of +1 for affirmative responses (i.e., agree or strongly agree), −1 for negative responses (i.e., disagree or strongly disagree), and 0 for neutral responses. Then, scores for the re-coded variables were summed to yield a healthy behavioral change index with a range from −2 to +2.

Addictive lifestyle behavior index. The three addictive lifestyle behavioral change variables (i.e., alcohol use, tobacco smoking, and vaping) were re-coded as −1 = decrease in behavior, 0 = no change, or +1 = increase in behavior. Then, scores for the re-coded variables were summed to yield an addictive behavioral change index with a range from −3 to +3.
