Parents Who First Allowed Adolescents to Drink Alcohol in a Family Context During Spring 2020 COVID-19 Emergency Shutdowns

Self-perceived impact of COVID-19 and risk behaviors among adolescents: Results from the HBSC 2021/22 study in 21 European countries

AIMS

To investigate adolescents' perception of the impact of the COVID-19 pandemic on several aspects of their lives (mental health, well-being, family situation, peers, school, dieting, and physical activity) in relation to risk behaviors such as smoking, alcohol use, drunkenness, and cannabis use.

METHODS

Data were used from the Health Behaviour in School-aged Children (HBSC) study conducted in 2021/2022, comprising 106,221 adolescents aged 11-15 (50.9% females) from 21 European countries. The data analysis plan involved Multilevel Generalized Latent Class Analysis (GLCA) models, latent class membership, and substance use behaviors, with alcohol consumption, smoking, drunkenness, and cannabis use as distal outcomes.

FINDINGS

GLCA identified 14 % of the adolescents as negatively or very negatively impacted by the pandemic and 42 % with a positive or very positive impact. The remaining 44 % of adolescents were not attributed with either a negative or positive impact. In the first group, girls, older adolescents, and adolescents from less affluent families were overrepresented. The negatively impacted group was particularly prevalent (>25 %) in countries such as Hungary, Cyprus, Greece, and Poland. Negatively impacted adolescents exhibited a higher risk of smoking, drunkenness, and cannabis use compared to their peers in the positively impacted group after adjusting for sex, age, and family wealth.

CONCLUSIONS

Results of the 2021/22 HBSC study highlighted an elevated level of substance use among adolescents who perceived a stronger negative impact of the COVID-19 pandemic on their lives. These findings indicate that the pandemic has put a particular strain on girls, older and less wealthy adolescents. They highlight the need for special attention and tailor-made interventions to deal with stressful future events that may impact on the life and mental health of these adolescents.

The role of family relationships on adolescents' development and adjustment during the COVID-19 pandemic: A systematic review

In typical times, adolescents' relationships with family members influence changing cognitive, social, and physical aspects of their development. The COVID-19 pandemic, however, impacted the full family system in ways that were unprecedented. Scholars of adolescence worldwide were driven to understand how adolescents' relationships with family members changed due to these dramatic societal shifts and the influence these relationships had on adolescents' well-being. This systematic review examined two research questions with 189 articles published from 2020-2022: (1) How has the COVID-19 pandemic impacted families with adolescents, including broader family functioning, family relationship qualities, and parenting? and (2) How has the pandemic or pandemic-related stressors interacted with family functioning, family relationships, and parenting of adolescents to impact adolescent well-being and adjustment? Additionally, examination of the relevant studies were divided into sub-themes of pandemic influence: (a) family environment and routines, (b) family difficulties, (c) parenting and parent-adolescent relationships, and (d) sibling relationships.

Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth

BACKGROUND

Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth.

METHODS

The study included baseline and five follow-up surveys, collected every 6 months, from California adolescents (ages 12-16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow-up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past-6-month alcohol frequency, alcohol quantity, and number of alcohol-related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences.

RESULTS

For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity.

CONCLUSIONS

Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity.

Method of accessing alcohol and binge drinking status in youth and young adults

AIMS

The study investigated relationships between how youth and young adults access alcohol and their binge drinking behaviors.

METHODS

Data from the Rhode Island Student Survey (11- to 18-year-olds) and the Mobile Screen Time project (18- to 24-year-old) were included. Participants were asked whether they access alcohol through several different methods (e.g. gifts, purchase, theft), and a latent class analysis was conducted to identify patterns of behavior. Logistic regression models were used to determine if class assignment was associated with binge drinking, after adjusting for age, sexual/gender status, and identification as a Black, Indigenous, and other Person of Color.

RESULTS

Among youth, participants who primarily accessed alcohol through friends had 6 times the odds of binge drinking (OR[95%CI] = 6.22 [4.08,9.49]), and those who accessed alcohol through all available sources had 23 times the odds (OR[95%CI] = 23.1 [9.08,58.6]). In young adults, participants who actively purchased alcohol had 3.7 times the odds of binge drinking (OR [95%CI] = 3.69 [1.62,8.37]).

CONCLUSIONS

Distinct means of accessing alcohol in youth and young adult populations can be identified, and different methods of access may be associated with increased binge drinking. Strong availability and ID checking policies are needed for on- and off-premise locations, and the implementation of parent-centered programs should be considered.

Parental Patterns of Alcohol Consumption During the COVID-19 Pandemic: Scoping Review

BACKGROUND

The declaration of the COVID-19 pandemic led to public health restrictions that impacted the lives of people across the globe. Parents were particularly burdened with balancing multiple responsibilities, such as working from home while caring for and educating their children. Alcohol use among parents is an area that warrants further exploration.

OBJECTIVE

This study aimed to investigate patterns of parental alcohol consumption during the COVID-19 pandemic, focusing on relative changes in the frequency and quantity of alcohol use compared to prepandemic use, nonparent adult samples, or both.

METHODS

A scoping review informed by the methodology of Arksey and O'Malley explored patterns of parental alcohol consumption during the COVID-19 pandemic. Searches were conducted in CINAHL, Ovid MEDLINE, PsycINFO, and Web of Science. Search terms were created using the Joanna Briggs Institute framework of Population, Concept, and Context, with the population being parents and the concept being alcohol consumption during the COVID-19 pandemic.

RESULTS

The database search yielded 3568 articles, which were screened for eligibility. Of the 3568 articles, 40 (1.12%) met the inclusion criteria and were included in the scoping review. Findings indicated the following: (1) having children at home was a factor associated with parental patterns of alcohol use; (2) mixed findings regarding gender-related patterns of alcohol consumption; and (3) linkages between parental patterns of alcohol use and mental health symptoms of stress, depression, and anxiety.

CONCLUSIONS

This scoping review revealed heterogeneous patterns in parental alcohol use across sociocultural contexts during the COVID-19 pandemic. Given the known harms of alcohol use, it is worthwhile for clinicians to assess parental drinking patterns and initiate conversations regarding moderation in alcohol use.

Impact of the COVID-19 Pandemic on Youth Substance Use and Substance-Related Risk Factors and Outcomes: Implications for Prevention, Treatment, and Policy

Youth substance use and substance use disorders (SUD) are major public health issues associated with significant societal cost. The coronavirus SARS-CoV-2 (COVID-19) pandemic and pandemic-related lockdowns, school closures, and social distancing dramatically impacted the daily lives of young people worldwide, resulting in major disruptions to normal developmental trajectories and complex (and at times opposing effects) on different SUD risk and protective factors, which contributed to inconsistent outcomes. During the COVID-19 pandemic, substance use prevalence rates decreased in the general population of US youth, but increased for certain vulnerable subgroups. Additionally, overdose deaths related to fentanyl rose significantly among US youth.

"An escape from the isolation": Youth thoughts about the impact of COVID-19 on adolescent sexual behavior and alcohol use

INTRODUCTION

The COVID-19 pandemic likely affected adolescent sexual behaviors and alcohol use, although how is not well understood.

METHOD

Youth were sampled from the national, online longitudinal Growing up with Media study. They responded via text messaging to open-ended questions about how the COVID-19 pandemic may have impacted the sexual behavior and alcohol use of adolescents. Conventional content analysis summarized open-ended responses.

RESULTS

416 responses were analyzed from 335 participants (aged 15-30, US residents), 81 of whom provided data for both topics. Participants suggested that the pandemic affected some youths' sexual health precautions (increased and varying) and attitudes about sex (positive and negative). They discussed how adolescents met partners during the pandemic, including increased use of online platforms. Participants also suggested researchers investigate sexual risk in the realm of COVID-19 transmission and the practice of "safe sex." Many participants believed adolescents were drinking alcohol more as a result of the pandemic, both alone and with friends; however, others perceived adolescents were drinking less. Participants proposed researchers investigate adolescent drinking habits during the pandemic, as well as how this compares to before the pandemic and the type and quantity of alcohol consumed.

CONCLUSIONS

Young people believe adolescent sexual relationships and drinking behaviors changed due to the pandemic, though how varied. Future research could examine the contexts and individual differences that shape these varying behaviors. Overall, this study highlights the importance of directly asking youth about their pandemic experiences and the diversity of views on how the pandemic has influenced adolescent behavior.

Alcohol consumption among adolescents during the COVID-19 pandemic, ConVid Adolescents - Behavior Research

OBJECTIVE

To describe the prevalence of alcohol consumption before and during the COVID-19 pandemic and to analyze the factors associated with this behavior during the period of social distancing among Brazilian adolescents.

METHODS

Cross-sectional study using data from the ConVid Adolescents survey, carried out via the Internet between June and September 2020. The prevalence of alcohol consumption before and during the pandemic, as well as association with sociodemographic variables, mental health, and lifestyle were estimated. A logistic regression model was used to assess associated factors.

RESULTS

9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI 16.64-18.85) before the pandemic to 12.80% (95%CI 11.85-13.76) during the pandemic. Alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9; 95%CI 1.08-1.53), place of residence in the South (OR=1.82; 95%CI 1.46-2.27) and Southeast regions (OR=1.33; 95%CI 1.05-1.69), having three or more close friends (OR=1.78; 95%CI 1.25-2.53), reporting worsening sleep problems during the pandemic (OR=1.59; 95%CI 1.20-2.11), feeling sad sometimes (OR=1,83; 95%CI 1,40-2,38) and always (OR=2.27; 95%CI 1.70-3.05), feeling always irritated (OR=1,60; 95%CI 1,14-2,25), being a smoker (OR=13,74; 95%CI 8.63-21.87) and a passive smoker (OR=1.76; 95%CI 1.42-2.19). Strict adherence to social distancing was associated with lower alcohol consumption (OR=0.40; 95%CI 0.32-0.49).

CONCLUSIONS

The COVID-19 pandemic led to a decrease in consumption of alcoholic beverages by Brazilian adolescents, which was influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle in this period. Managers, educators, family and the society must be involved in the articulation of Public Policies to prevent alcohol consumption.

Problematic social media use and alcohol expectancies in early adolescents

BACKGROUND

Alcohol expectancies are beliefs regarding positive (e.g., tension reduction) or negative (e.g., loss of motor coordination) effects of alcohol. Based on Social Learning Theory, social media can influence alcohol expectancies in adolescents. In particular, problematic social media use - which can reflect elements of addiction, including mood modification, tolerance, withdrawal, conflict, and relapse - could be linked to alcohol expectancies. We aimed to determine the associations between problematic social media use and alcohol expectancies in a national (U.S.) cohort of 10-14-year-old early adolescents.

METHODS

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 9,008) at the Year 2 assessment (2018-2020). Unadjusted and adjusted linear regression analyses were conducted to examine the associations between problematic social media use and alcohol expectancies (positive and negative), adjusting for race/ethnicity, sex, household income, parent education, sexual orientation, parental marital status, and study site. Furthermore, we computed marginal predicted probabilities to aid in interpreting findings.

RESULTS

The sample was 48.7% female and racially and ethnically diverse (43.0% non-White), with a mean age of 12.02 ± 0.66 years old. In models adjusted for confounders including both time spent on social media and problematic social media use, time spent on social media was not associated with positive or negative alcohol expectancies, but higher problematic social media use score was associated with higher positive (B = 0.045, 95% confidence interval [CI] 0.020-0.069) and negative (B = 0.072, 95% CI 0.043-0.101) alcohol expectancies scores.

CONCLUSION

Problematic social media use was associated with both positive and negative alcohol expectancies in a demographically diverse national sample of early adolescents in the U.S. Given the small effect sizes of the current study, future studies should further examine these relationships prospectively, as well as the mechanisms linking problematic social media use to alcohol expectancies and alcohol consumption. Because alcohol expectancies are modifiable and linked with alcohol initiation, they could be a target for future prevention efforts.

College students' virtual and in-person drinking contexts during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has resulted in pronounced changes for college students, including shifts in living situations and engagement in virtual environments. Although college drinking decreased at the onset of the pandemic, a nuanced understanding of pandemic-related changes in drinking contexts and the risks conferred by each context on alcohol use and related consequences have yet to be assessed.

METHODS

Secondary data analyses were conducted on screening data from a large parent clinical trial assessing a college student drinking intervention (N = 1669). Participants across six cohorts (from Spring 2020 to Summer 2021) reported on the frequency of drinking in each context (i.e., outside the home, home alone, home with others in-person, and home with others virtually), typical amount of drinking, and seven alcohol-related consequence subscales.

RESULTS

Descriptive statistics and negative binomial regressions indicated that the proportion and frequency of drinking at home virtually with others decreased, while drinking outside the home increased from Spring 2020 to Summer 2021. Limited differences were observed in the proportion or frequency of individuals drinking at home alone or at home with others in-person. Negative binomial and logistic regressions indicated that the frequency of drinking outside the home was most consistently associated with more alcohol-related consequences (i.e., six of the seven subscales). However, drinking at home was not without risks; drinking home alone was associated with abuse/dependence, personal, social, hangover, and social media consequences; drinking home with others virtually was associated with abuse/dependence and social consequences; drinking home with others in-person was associated with drunk texting/dialing.

CONCLUSION

The proportion and frequency of drinking in certain contexts changed during the COVID-19 pandemic, although drinking outside the home represented the highest risk drinking context across the pandemic. Future prevention and intervention efforts may benefit from considering approaches specific to different drinking contexts.

Retrospective Self-Reports of How Adolescent Substance Use Changed with the COVID-19 Pandemic

The final year of high school is a challenging phase of adolescents' lives and substance use can play an important role. We examined changes in the frequency and quantity of alcohol and cannabis use, and demographic correlates among Grade 12 students of 2020. Students (N = 844) from nine schools retrospectively self-reported changes in substance use after the easing of COVID-19 lockdowns (back to school), compared to before the pandemic. Changes in use were examined with age, gender, Aboriginal or Torres Islander, parental and family characteristics, and truancy. Thirty-one percent of students reported that they used alcohol less frequently, and 24% reported that they used it more frequently compared to pre-COVID-19. Most students (46%) reported that they used cannabis less, while a subset reported using more frequently (22%). A history of truancy was associated with an increased frequency (OR = 2.13 [1.18-3.83]) of cannabis use. A substantial minority of adolescents used more alcohol and cannabis after the initial COVID-19 lockdown period. Students in their final year who reported increased use may benefit from increased support to manage their substance use.

The Impact of the COVID-19 Pandemic on Adolescent Mental Health and Substance Use

PURPOSE

The aim of this study is to determine whether COVID-19-induced financial impact, stress, loneliness, and isolation were related to perceived changes in adolescent mental health and substance use.

METHODS

Data were from Baseline (2018) and Wave 3 (2020; mean age = 14.8; 50% female) of 1,188 adolescents recruited from 12 Texas public middle schools as part of a randomized controlled trial. Participants were primarily Black (23%), Latinx (41%), Asian (11%), and White (9%). We assessed mental health and substance use (Baseline and Wave 3) and pandemic-related physical interaction, loneliness, stress, family conflict, and economic situation (Wave 3).

RESULTS

COVID-19-induced stress and loneliness were linked to depression (beta = 0.074, p ≤ .001; beta = 0.132, p ≤ .001) and anxiety (beta = 0.061, p = .001; beta = 0.088, p ≤ .001) among ethnically diverse adolescents. Adolescents who did not limit their physical interactions due to COVID-19 had fewer symptoms of depression (beta = -0.036, p = .03); additionally, adolescents who did not restrict their socializing were substantially more likely to report using a variety of substances (e.g., for episodic heavy drinking; odds ratio = 1.81, p = .001). Increased use of a food bank was linked to depression (beta = 0.063, p ≤ .001) and a negative change in financial situation was linked to increased alcohol use (odds ratio = 0.70, p = .04) among adolescents.

DISCUSSION

After controlling for prepandemic psychopathology and race/ethnicity, COVID-19 induced isolation, loneliness, stress, and economic challenges were linked to poor mental health and substance misuse. Substantial structural, community, school, and individual level resources are needed to mitigate the impact of the COVID-19 pandemic on adolescent psychosocial health.

35-Year-Old Parents Do Not Approve of 17-Year-Olds' Cigarette, Marijuana, or Alcohol Use: U.S. National Data 1993-2018

PURPOSE

Parents' attitudes about adolescent substance use likely guide their parenting behaviors. This study documents prevalence of parents' disapproval of adolescent substance use and characteristics associated with disapproval.

METHODS

Survey data from national samples of 35-year-old parents from the U.S. Monitoring the Future study were collected 1993-2018. Multivariable logistic regression examined predictors of disapproving attitudes about substance use by a hypothetical 17-year-old child, including occasional marijuana use or drunkenness, and regular cigarette, marijuana, or alcohol use.

RESULTS

Across all cohorts, rates of disapproving attitudes ranged from 93.7% disapproving of getting drunk occasionally to 97.2% disapproving of regular cigarette use, with some erosion in disapproval for some substances across cohorts. Parents' own recent abstinence from substance use predicted greater odds of disapproval.

CONCLUSIONS

The overwhelming majority of 35-year-old parents disapprove of adolescent substance use. Prevention and public health messaging can support parenting by sharing this important information.

The Impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Substance Use in the United States

The SARS-CoV-2 pandemic has been associated with dramatic increases in substance use, as marked by increased alcohol, nicotine, and cannabis sales. Lethal opioid overdoses also increased dramatically, especially during the initial phases of the epidemic when lockdowns and social isolation combined with increasing fentanyl contamination of the illicit drug supply resulted in more overdoses and fewer opportunities for rescue. Substance use, and especially inhalational drug use, increases the likelihood of both transmission and severe infection. Youth are especially vulnerable to substance use and have increased risk of long-term problems. These outcomes highlight the need for greater access to substance use treatment. Virtual treatment, which emerged as a promising format during the pandemic, may reduce access barriers. This article reviews trends in substance use during the pandemic, explores root causes of increased use and overdose, and examines the potential to increase treatment through virtual care, especially during future periods of disruption.

Use of Tobacco Products, Alcohol, and Other Substances Among High School Students During the COVID-19 Pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021

The COVID-19 pandemic has been associated with established risk factors for adolescent substance use, including social isolation, boredom, grief, trauma, and stress. However, little is known about adolescent substance use patterns during the pandemic. CDC analyzed data from the Adolescent Behaviors and Experiences Survey, an online survey of a probability-based, nationally representative sample of public- and private-school students in grades 9–12 (N = 7,705), to examine the prevalence of current use of tobacco products, alcohol, and other substances among U.S. high school students. Prevalence was examined by demographic characteristics and instructional models of the students’ schools (in-person, virtual, or hybrid). During January–June 2021, 31.6% of high school students reported current use of any tobacco product, alcohol, or marijuana or current misuse of prescription opioids. Current alcohol use (19.5%), electronic vapor product (EVP) use (15.4%), and marijuana use (12.8%) were more prevalent than prescription opioid misuse (4.3%), current cigarette smoking (3.3%), cigar smoking (2.3%), and smokeless tobacco use (1.9%). Approximately one third of students who used EVPs did so daily, and 22.4% of students who drank alcohol did so ≥6 times per month. Approximately one in three students who ever used alcohol or other drugs reported using these substances more during the pandemic. The prevalence of substance use was typically higher among non-Hispanic American Indian or Alaska Native students, older students, and gay, lesbian, or bisexual students than among students of other racial or ethnic groups, younger students, and heterosexual students. The prevalence of alcohol use also was higher among non-Hispanic White students than those of other racial or ethnic groups. Students only attending school virtually had a lower prevalence of using most of the substances examined than did students attending schools with in-person or hybrid models. These findings characterizing youth substance use during the pandemic can help inform public health interventions and messaging to address these health risks during and after the COVID-19 pandemic.

Use of Tobacco Products, Alcohol, and Other Substances Among High School Students During the COVID-19 Pandemic - Adolescent Behaviors and Experiences Survey, United States, January-June 2021

The COVID-19 pandemic has been associated with established risk factors for adolescent substance use, including social isolation, boredom, grief, trauma, and stress. However, little is known about adolescent substance use patterns during the pandemic. CDC analyzed data from the Adolescent Behaviors and Experiences Survey, an online survey of a probability-based, nationally representative sample of public- and private-school students in grades 9-12 (N = 7,705), to examine the prevalence of current use of tobacco products, alcohol, and other substances among U.S. high school students. Prevalence was examined by demographic characteristics and instructional models of the students' schools (in-person, virtual, or hybrid). During January-June 2021, 31.6% of high school students reported current use of any tobacco product, alcohol, or marijuana or current misuse of prescription opioids. Current alcohol use (19.5%), electronic vapor product (EVP) use (15.4%), and marijuana use (12.8%) were more prevalent than prescription opioid misuse (4.3%), current cigarette smoking (3.3%), cigar smoking (2.3%), and smokeless tobacco use (1.9%). Approximately one third of students who used EVPs did so daily, and 22.4% of students who drank alcohol did so ≥6 times per month. Approximately one in three students who ever used alcohol or other drugs reported using these substances more during the pandemic. The prevalence of substance use was typically higher among non-Hispanic American Indian or Alaska Native students, older students, and gay, lesbian, or bisexual students than among students of other racial or ethnic groups, younger students, and heterosexual students. The prevalence of alcohol use also was higher among non-Hispanic White students than those of other racial or ethnic groups. Students only attending school virtually had a lower prevalence of using most of the substances examined than did students attending schools with in-person or hybrid models. These findings characterizing youth substance use during the pandemic can help inform public health interventions and messaging to address these health risks during and after the COVID-19 pandemic.

Adolescents' Alcohol Use and Related Expectancies before and during the Early COVID-19 Pandemic: Evidence from the Nationwide MyLife Study

INTRODUCTION

We examined a range of alcohol use indicators among Norwegian adolescents before and during the early COVID-19 pandemic.

METHODS

We examined two cohorts of Norwegian 16-year-olds from the nationwide MyLife study who entered high school in fall 2020 (i.e., COVID-19 pandemic cohort; n = 915) and fall 2019/18 (i.e., prepandemic cohort; n = 1,621). Through e-surveys, adolescents reported their past year drinking frequencies and quantities (generating the Alcohol Use Disorders Identification Test-Concise; AUDIT-C scores) and completed Social Facilitation (SF) and Tension Reduction (TR) subscales of the Alcohol Outcome Expectancies Scale. Cohort differences across these outcomes were examined with linear and modified Poisson regression models.

RESULTS

There were no cohort differences in the proportion of adolescents who reported drinking in the past year or in drinking/binge drinking frequencies. However, alcohol quantities consumed on a typical drinking day were 1/3 of a drink greater in the COVID-19 cohort than in the prepandemic cohort; aIRR (95% CI) = 1.13 (1.02-1.25). These consumption differences compounded into significantly greater AUDIT-C scores (aIRR [95% CI] = 1.16 [1.02-1.32]) and positive AUDIT-C screens (31.2% vs. 26.4%; aRR [95% CI] = 1.21 [1.07-1.36]) in the COVID-19 cohort. In terms of alcohol-related expectancies, there were no SF differences, but the COVID-19 cohort reported significantly greater TR expectancies; b (95% CI) = 0.11 (0.02-0.20).

CONCLUSION

Despite the 2020 lockdown, Norwegian adolescents who started high school during the first pandemic year did not differ from their prepandemic peers in terms of how many of them drank, how often they drank, or in prosocial expectations they had of alcohol use. However, they consumed greater alcohol quantities per drinking day, had greater AUDIT-C scores, and reported greater tension reduction expectations of alcohol use. These results underscore the value of examining adolescents' alcohol-related behaviors during the COVID-19 pandemic above and beyond the basic drinking prevalence and frequencies.

Lockdown and licensed premises: COVID-19 lessons for alcohol policy

Introduction

The COVID‐19 pandemic necessitated unprecedented changes in alcohol availability, including closures, curfews and restrictions. We draw on new data from three UK studies exploring these issues to identify implications for premises licensing and wider policy.

Methods

(i) Semi‐structured interviews (n = 17) with licensing stakeholders in Scotland and England reporting how COVID‐19 has reshaped local licensing and alcohol‐related harms; (ii) semi‐structured interviews (n = 15) with ambulance clinicians reporting experiences with alcohol during the pandemic; and (iii) descriptive and time series analyses of alcohol‐related ambulance callouts in Scotland before and during the first UK lockdown (1 January 2019 to 30 June 2020).

Results

COVID‐19 restrictions (closures, curfews) affected on‐trade premises only and licensing stakeholders highlighted the relaxation of some laws (e.g. on takeaway alcohol) and a rise in home drinking as having long‐term risks for public health. Ambulance clinicians described a welcome break from pre‐pandemic mass public intoxication and huge reductions in alcohol‐related callouts at night‐time. They also highlighted potential long‐term risks of increased home drinking. The national lockdown was associated with an absolute fall of 2.14 percentage points [95% confidence interval (CI) −3.54, −0.74; P = 0.003] in alcohol‐related callouts as a percentage of total callouts, followed by a daily increase of +0.03% (95% CI 0.010, 0.05; P = 0.004).

Discussion and Conclusions

COVID‐19 gave rise to both restrictions on premises and relaxations of licensing, with initial reductions in alcohol‐related ambulance callouts, a rise in home drinking and diverse impacts on businesses. Policies which may protect on‐trade businesses, while reshaping the night‐time economy away from alcohol‐related harms, could offer a ‘win–win’ for policymakers and health advocates.