The COVID-19 outbreak in December 2019 and the following restrictions have had detrimental effects on the lives of people all over the globe [1]. The pandemic has cost the lives of over 4.5 million people so far [2], and governments have implemented lockdown measures and social distancing policies to slow the further spread of the disease. In Austria, a first lockdown was implemented from 16 March 2020 to 30 April 2020, which was followed by further strict lockdown measures from 3 November 2020 to 8 February 2021, due to rising COVID-19 cases.

These measures have rapidly affected all areas of everyday life including healthcare, as well as in the economic and social domain, and has led to a major decrease in mental health and well-being all over the world [3,4]. As a consequence of these policies, many people have experienced disruptions to their daily routines, including changes in health behaviors such as exercise or dietary habits [5]. Participants in a US-based study, for instance, primarily reported a decrease in physical activity during the early stages of the COVID-19 pandemic [6]. A multi-country study during the first weeks of COVID restrictions revealed that individuals who adapted to restriction measures with a positive change in exercise behavior showed better mental health and well-being than individuals who reported a negative change in exercise behavior, in comparison to before the pandemic [7]. Young adults (18–29 years old) reported more negative changes in exercise behavior, suggesting their health behaviors may have been more negatively impacted by the pandemic.

Furthermore, a general population survey conducted by the Austrian Ministry for Social Affairs, Health, Care, and Consumer Protection during the first lockdown in March 2020 suggested that especially younger people have changed their consumption habits of psychoactive substances during lockdown, with around 40% of 15–34-year-olds having reported an increase in their smoking and drinking behaviors [8]. For adolescents and young people, the pandemic has come at a time of crucial social development and educational and career milestones, and as such they constitute a group that has been especially affected by the pandemic-related measures and restrictions. In Austria, school students were restricted to home schooling, with classes taking place online, from October 2020 to February 2021. Indeed, many studies showed that the mental health of young people has particularly suffered since the emergence of COVID-19 [9].

Some health behaviors, such as exercise, not only improve physical health, but also have protective effects on mental health. For example, a longitudinal study conducted with Chinese college students during the COVID-19 outbreak revealed a mitigating effect of physical activity on mental health [10]. Additionally, a recent cross-sectional study revealed that mental well-being during a COVID-19 lockdown could be improved by maintaining health behaviors such as physical activity and a balanced diet [11]. Adverse health behaviors, however, can negatively affect mental health. For example, alcohol and cigarette consumption as a coping strategy during COVID-19 lockdowns was shown to negatively predict quality of life and well-being, and positively predict perceived stress, depression, anxiety, and insomnia [12]. Therefore, monitoring the health behaviors of young people during the pandemic is important not only for understanding physical health, but also for identifying risk behaviors for mental health. This study aimed to assess the following health behaviors of young people in Austria during the COVID-19 pandemic: smoking, alcohol consumption, cannabis consumption, exercise, and perceived general health status.

Another group that was identified to be at greater risk for decreased mental health during COVID-19 lockdown were women, with more women than men reporting symptoms of depression, anxiety, and insomnia [13]. Moreover, more women than men reported an increase in substance, alcohol, and cigarette consumption during the first lockdown in Austria [8], whereas more men than women reported a decrease in their consumption. However, girls tend to generally exhibit more positive health behaviors than boys [14]. Gender is therefore an important aspect to consider when analyzing health behaviors during the COVID-19 pandemic. In the manuscript at hand, we therefore analyzed if gender had an effect on the health behaviors of Austrian youth. We predicted that health behaviors would differ between genders and explored the assessed health behaviors in each gender separately.

Another hugely important determinant of health behaviors is education level [15]. While the predictive nature of education on positive health behaviors was identified many years ago [16], the reasons for this relationship are not completely clear yet. On the one hand, opportunity costs may affect the relationship between education level and health behaviors [17], on the other hand, education background is also the most important factor for health literacy, which in turn affects health behaviors [18]. In Germany, education was even found to have a causal effect on reducing smoking behavior [19]. We therefore wanted to investigate this in our sample by analyzing whether two different education groups, high school students and apprentices, differed in their health behaviors during the COVID-19 pandemic. We chose to compare these two education groups as apprentices in Austria are typically in the same age group as high school students. Apprenticeship is usually started around the age of 15, after compulsory school has been completed. However, apprenticeship constitutes a different form of dual vocational education, including both vocational school and practical job training, compared to full time high school education. We hypothesized that apprentices would show poorer health behaviors than high school students.

Lastly, vaccinations against COVID-19 are a critical step to ending the pandemic [20]. As health behaviors tend to co-occur [21], it is worth examining the factors that influence adolescents’ willingness to receive a COVID-19 vaccination in order to better inform to whom vaccination campaigns are directed. Results of a recent study, for example, suggest an association between heavy lifetime cannabis use and reduced vaccination willingness; although, no difference in vaccination willingness was found between light and heavy cannabis users [22]. Therefore, we also investigated whether vaccine willingness is affected by other health behaviors in young people and predicted that those with poorer health behaviors would show a lower willingness to receive the COVID-19 vaccine. Overall, we aimed to build a picture of health behaviors in two groups of young people in Austria with differing education types during the COVID-19 pandemic.