Alcohol narrows physical distance between strangers

Concurrent decline in teenage fertility rate and binge drinking? An observational study across 45 nations

INTRODUCTION

Alcohol consumption is associated with unintended pregnancies among teenagers. Its role as a broader determinant of teenage fertility rates remains unclear. We investigate whether adolescent binge drinking affects the number of teenage births.

METHODS

Binge drinking data from 137,898 females aged 15-16 were collected in the HBSC study (2002-2018, 43 countries/regions) and 267,359 in the ESPAD study (1995-2019, 41 countries/regions). Age-specific fertility rates were from the Human Fertility Database and the World Health Organization. We examined changes over time in countries' average levels of binge drinking among female pupils aged 15-16 and population-level fertility rates for the same cohorts when aged 16-19 years.

RESULTS

Controlling for differences between countries and survey waves, we found an association between binge drinking and fertility rate, B = 0.019, 95% confidence interval [0.004, 0.034]. When accounting for the countries' time trends, the association was substantially reduced, B = 0.006, 95% confidence interval [-0.0062, 0.0174]. The relationship was not moderated by abortion rates and controlling for contraceptive use had no impact on the findings.

DISCUSSION AND CONCLUSIONS

The association between adolescent binge drinking and fertility rates diminishes when accounting for country-specific time trends. Given the lack of clear mechanisms linking binge drinking to trends in fertility rates rather than shorter-term changes, the association likely reflects broader secular trends. Binge drinking may be involved in teen pregnancy and childbirth in individual cases but it does not explain recent developments in teenage fertility rates.

The impact of alcohol on affiliative verbal behavior: A systematic review and meta-analysis

BACKGROUND

Language is a fundamental aspect of human social behavior that is linked to many rewarding social experiences, such as social bonding. Potential effects of alcohol on affiliative language may therefore be an essential feature of alcohol reward and may elucidate pathways through which alcohol is linked to social facilitation. Examinations of alcohol's impact on language content, however, are sparse. Accordingly, this investigation represents the first systematic review and meta-analysis of alcohol's effects on affiliative language. We test the hypothesis that alcohol increases affiliative verbal approach behaviors and discuss future research directions.

METHODS

PsycInfo and Web of Science were systematically searched in March 2023 according to our preregistered plan. Eligible studies included social alcohol administration experiments in which affiliative verbal language was assessed. We present a random-effects meta-analysis that examines the effect of alcohol compared to control on measures of affiliative verbal behavior.

RESULTS

Our search identified 16 distinct investigations (comprising 961 participants) that examined the effect of alcohol on affiliative verbal behavior. Studies varied greatly in methods and measures. Meta-analytic results demonstrated that alcohol is modestly associated with increases in affiliative verbal behavior (Hedges' g = 0.164, 95% CI [0.027, 0.301], p = 0.019). Study quality was rated using an adapted version of the Quality Assessment Tool for Quantitative Studies and did not significantly moderate alcohol's effects.

CONCLUSIONS

This study provides preliminary evidence that alcohol can increase affiliative verbal behaviors. This effect may be an important feature of alcohol reward. Given heterogeneity in study features, low study quality ratings, and limited reporting of effect size data, results simultaneously highlight the promise of this research area and the need for more work. Advances in language processing methodologies that could allow future work to systematically expand upon this finding are discussed.

Alcohol and common ground: The effects of intoxication on linguistic markers of shared understanding during social exchange

OBJECTIVE

Most alcohol consumption takes place in social contexts, and the belief that alcohol enhances social interactions has been identified as among the more robust predictors of alcohol use disorder (AUD) development. Yet, we know little of how alcohol affects mental representations of others-what we share and do not share-nor the extent to which intoxication might impact the development of shared understanding (i.e., common ground) between interaction partners. Employing a randomized experimental design and objective linguistic outcome measures, we present two studies examining the impact of alcohol consumption on the development and use of common ground.

METHOD

In Study 1, groups of strangers or friends were administered either alcohol (target Breath Alcohol Content = .08%) or a control beverage, following which they completed a task requiring them to develop a shared language to describe ambiguous images and then describe those images to either a knowledgeable or a naïve partner. The same procedures were completed in Study 2 using a within-subjects alcohol administration design and all-stranger groups.

RESULTS

Study 1 findings did not reach significance but suggested that alcohol may facilitate common ground development selectively among stranger groups. This effect emerged as significant in the context of the within-subjects design of Study 2, b = -0.19, p = .007, with participants demonstrating greater facility in establishing common ground during alcohol versus control sessions.

CONCLUSIONS

Results suggest that alcohol facilitates the development of shared linguistic understanding in novel social spaces, indicating common ground as one potential mechanism to consider in our broader examination of alcohol reinforcement and AUD etiology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol policy framing in South Africa during the early stages of COVID-19: using extraordinary times to make an argument for a new normal

INTRODUCTION

Public health and alcohol industry actors compete to frame alcohol policy problems and solutions. Little is known about how sudden shifts in the political context provide moments for policy actors to re-frame alcohol-related issues. South Africa's temporary bans on alcohol sales during the COVID-19 pandemic offered an opportunity to study this phenomenon.

METHODS

We identified Professor Charles Parry from the South African Medical Research Council as a key policy actor. Parry uses a Twitter account primarily to comment on alcohol-related issues in South Africa. We harvested his tweets posted from March 18 to August 31, 2020, coinciding with the first two alcohol sales bans. We conducted a thematic analysis of the tweets to understand how Parry framed alcohol policy evidence and issues during these 'extraordinary times.'

RESULTS

Parry underlined the extent of alcohol-related harm during 'normal times' with scientific evidence and contested industry actors' efforts to re-frame relevant evidence in a coherent and well-constructed argument. Parry used the temporary sales restrictions to highlight the magnitude of the health and social harms resulting from alcohol consumption, particularly trauma, rather than the COVID-19 transmission risks. Parry portrayed the sales ban as a policy learning opportunity (or 'experiment') for South Africa and beyond.

CONCLUSIONS

Crisis conditions can provide new openings for public health (and industry) actors to make salient particular features of alcohol and alcohol policy evidence.

Associations between mental health challenges, sexual activity, alcohol consumption, use of other psychoactive substances and use of COVID-19 preventive measures during the first wave of the COVID-19 pandemic by adults in Nigeria

BACKGROUND

The aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances.

METHODS

This was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables.

RESULTS

Increased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59).

CONCLUSION

There was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

Where to Look? Alcohol, Affect, and Gaze Behavior During a Virtual Social Interaction

COVID-19 forced social interactions to move online. Yet researchers have little understanding of the mental health consequences of this shift. Given pandemic-related surges in emotional disorders and problematic drinking, it becomes imperative to understand the cognitive and affective processes involved in virtual interactions and the impact of alcohol in virtual social spaces. Participants (N=246) engaged in an online video call while their gaze behavior was tracked. Prior to the interaction, participants were randomly assigned to receive an alcoholic or control beverage. Participants' affect was repeatedly assessed. Results indicated that a proportionally larger amount of time spent gazing at oneself (vs. one's interaction partner) predicted significantly higher negative affect after the exchange. Further, alcohol independently increased self-directed attention, failing to demonstrate its typically potent social-affective enhancement in this virtual context. Results carry potential implications for understanding factors that increase risk for hazardous drinking and negative affect in our increasingly virtual world.

Impact of alcohol consumption on coronavirus disease 2019 severity: A systematic review and meta-analysis

Fear and misinformation lead to widespread myths in the coronavirus disease 2019 (COVID-19) pandemic, such as "consuming high-strength alcohol kills the virus in the inhaled air." However, whether alcohol consumption can affect COVID-19 has not been clarified yet. This study aims to investigate the impact of alcohol consumption on COVID-19 severity. PubMed, Embase, Cochrane Library, Central, CINAHL, ClinicalTrials.gov, and WHO-International Clinical Trials Registry Platform were searched until November 25, 2022. Forty studies (1,697,683 COVID-19 individuals) were analyzed. Brown (patients numbers: 1317, risk ratios [RR] = 1.58, 95% [confidence interval] CI = 1.31 to 1.90, I2  = 0.0%, p < 0.001), American (patients numbers: 3721, RR = 1.51, 95% CI = 1.30 to 1.75, I2  = 0.0%, p < 0.001), and European (patients numbers: 261,437, RR = 2.04, 95% CI = 1.96 to 2.13, I2  = 0.0%, p < 0.001) drinkers were at high risk of severe COVID-19, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV), respectively. Consistently, individuals with a drinking history were at high risk of severe COVID-19 (patients numbers: 5399, RR = 1.23, 95% CI = 1.02 to 1.48, I2  = 38.4%, p = 0.03) and ICU admission (patients numbers: 6995, RR = 1.32, 95% CI = 1.08 to 1.60, I2  = 46.6%, p = 0.01). In addition, current drinkers had an increased risk of symptomatic COVID-19. However, excessive drinkers were at high risk of COVID-19 hospitalization. Alcohol consumption intensifies COVID-19 severity and deteriorates its clinical outcomes. Here, we strongly propose that people do not drink alcohol during the COVID-19 pandemic.

Lapses in the Person Radar: ADHD Symptoms Predict Difficulty in Interpersonal Distancing

OBJECTIVE

Across contexts, from social cognition to the COVID-19 pandemic response, individual variation in the regulation of interpersonal distance has typically been viewed as a voluntary choice. Here we examine the frequency of unintentional lapses in interpersonal distancing, and their relationship with childhood ADHD symptoms.

METHOD

We administered a novel measure of difficulty with interpersonal distancing across three undergraduate samples (total N = 1,225), in addition to measures of recalled childhood ADHD symptoms, mind wandering, and hyperfocus.

RESULTS

Almost all (>97%) participants reported unintentional lapses in maintaining interpersonal distance, with 16% experiencing such lapses frequently. Thirty percent of the variance in these reports was accounted for by attentional traits: Inattentive and hyperactive/impulsive ADHD symptoms jointly predicted difficulties with interpersonal distancing, with the former relationship fully mediated by hyperfocus and spontaneous mind wandering.

CONCLUSION

Both inattentive and hyperactive/impulsive ADHD symptoms confer vulnerability to frequent unintentional lapses in interpersonal distancing.

Spatial-temporal differences of COVID-19 vaccinations in the U.S

Although the disparities in COVID-19 outcomes have been proved, they have not been explicitly associated with COVID-19 full vaccinations. This paper examines the spatial and temporal patterns of the county-level COVID-19 case rates, fatality rates, and full vaccination rates in the United States from December 24, 2020 through September 30, 2021. Statistical and geospatial analyses show clear temporal and spatial patterns of the progression of COVID-19 outcomes and vaccinations. In the relationship between two time series, the fatality rates series was positively related to past lags of the case rates series. At the same time, case rates series and fatality rates series were negatively related to past lags of the full vaccination rates series. The lag level varies across urban and rural areas. The results of partial correlation, ordinary least squares (OLS) and Geographically Weighted Regression (GWR) also confirmed that the existing COVID-19 infections and different sets of socioeconomic, healthcare access, health conditions, and environmental characteristics were independently associated with COVID-19 vaccinations over time and space. These results empirically identify the geographic health disparities with COVID-19 vaccinations and outcomes and provide the evidentiary basis for targeting pandemic recovery and public health mitigation actions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44212-022-00019-9.

A social contextual review of the effects of alcohol on emotion

Drinking and drinking problems are complex phenomena. Understanding the etiology of alcohol use disorder requires consideration of biological, psychological, and social processes. It is our view that the last of these dimensions is just beginning to receive adequate scrutiny. In this selective review, we discuss the concept of a biopsychosocial analysis of the effects of alcohol. After briefly addressing biological and psychological research on alcohol's emotional effects, we bid to make a case for the vital role that social processes play in understanding why people drink. The bulk of the paper describes research illustrating the contributions that a social psychological perspective can make to advance understanding of the rewarding effects of alcohol. Overall, studies incorporating social contexts have revealed reliable evidence that alcohol enhances emotional experience in many social environments and have identified socio-contextual variables that moderate responses to alcohol. Further, these studies have broadened the scope of constructs thought to be socially rewarding, including social bonding, relationship functioning, and humor enjoyment. Our analysis concludes by identifying research areas we believe would profit from additional research.

Alcohol sales in Canadian liquor outlets as a predictor of subsequent COVID-19 infection rates: a time-series analysis

AIMS

Government alcohol sales data were used to examine whether age 15+ per-capita alcohol consumption (PCAC) (i) changed during COVID-19 and (ii) predicted COVID-19 infections 2-5 weeks later.

DESIGN

Interrupted time-series analyses were applied to panels of data before and after COVID-19 restrictions were introduced in Canada.

SETTING AND PARTICIPANTS

The populations, aged 15+, of the provinces of Ontario (ON), British Columbia (BC) and Nova Scotia (NS), Canada.

INTERVENTION

Expansion of home delivery options and hours of trading for liquor stores while restrictions on travel, social and economic activities were imposed by governments during COVID-19 from 17 March 2020 until 29 March 2021.

MEASUREMENTS

Weekly estimates of (i) age 15+ PCAC using sales data supplied by provincial government alcohol distributors for liquor stores, bars and restaurants, (ii) stringency of public health measures assessed by the Public Health Agency of Canada (PHAC) and (iii) new COVID-19 infections reported by PHAC.

FINDINGS

PCAC increased by 7.10% (P = 0.013) during the pandemic versus previous years, with increased private liquor store sales partly offset by reduced bar/restaurant sales. Consumption was positively associated with stringency of public health measures. Weekly PCAC was positively associated with new COVID-19 infections 2 weeks later (+6.34% for a one drink/week increase, P < 0.001). Lagged associations with COVID-19 infections 2 or 3 weeks later were observed for PCAC from all sales channels, with larger effect sizes per standard drink/person/week increase for on-premise outlets (+77.27% week 2, P = 0.009) than government liquor stores (+6.49%, week 2, P < 0.001) or private liquor stores (+7.13%, week 4, P < 0.001).

CONCLUSIONS

Alcohol consumption increased in three Canadian provinces during COVID-19 to degrees corresponding to the extent of the strictness of measures imposed to prevent viral spread. Increased consumption of alcohol was associated with increased COVID-19 infection rates 2 weeks later.

To what extent is alcohol consumption in social gatherings associated with observance of COVID-19 restrictions? A rapid review

Background

Pre-pandemic research found a connection between alcohol consumption and reduced physical distancing among strangers. Understanding the association between alcohol consumption at social gatherings and observance of COVID-19 restrictions can help inform policy related to the safe operation of public spaces where alcohol is typically consumed, as well as guidance related to the safe conduct of social events in private spaces.

Methods

We conducted a rapid review using adapted systematic review methods to explore the association between alcohol consumption in social gatherings and compliance with COVID-19 public health measures and produced a narrative synthesis of our findings. We ran searches in eleven health-related databases (MEDLINE, PubMed, CINAHL, Scopus, Embase (Ovid), ProQuest Public Health, ProQuest Coronavirus, Global Health (Ovid), WHO COVID-19 literature database, PsycInfo (Ovid) and ASSIA) between July 9, 2021, and July 31, 2021. We assessed methodological quality using the relevant Joanna Briggs Institute (JBI) checklists. This review was conducted and reported in accordance with PRISMA-P guidelines.

Results

We identified 7936 studies from the searches. After title, abstract and full-text review, three cross-sectional studies were eligible for inclusion. One study found that people who adhered strongly to physical distancing rules were engaged in about 40% fewer weekly drinks and 60% fewer heavy episodic drinking occasions in a week than people who adhered poorly to physical distancing rules (P < 0.01). One study found that people who reported low-risk alcohol consumption patterns had a higher chance of adhering to hand hygiene measures than those who reported high-risk alcohol consumption (odds ratio (OR) = 4.24, 95% confidence interval (CI) = 1.08-16.64). No other statistically significant results on patterns of alcohol consumption and compliance with individual public health measures or with non-pharmaceutical interventions (NPIs) were found. The direction of effect between alcohol consumption and non-adherence to NPIs and the effect of confounding factors has not been established. The quality of studies found was low to moderate, with risk of recall bias and selection bias due to study design; and the extent to which those studies can be generalised beyond their original settings may be limited.

Conclusions

Despite existing evidence suggesting an association between alcohol consumption, reduced physical distancing, and increased social interaction, we found few studies of variable quality exploring the relationship between alcohol consumption and compliance with public health measures. A possible association between higher-risk alcohol behaviours and lower compliance with certain NPIs was suggested, but the direction of effect is unknown, and further studies are required to confirm this finding.

Relationship between high-risk alcohol consumption and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion: a prospective sero-epidemiological cohort study among American college students

AIMS

To estimate the associations between high-risk alcohol consumption and (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion, (2) self-reported new SARS-CoV-2 infection and (3) symptomatic COVID-19.

DESIGN

Prospective cohort study.

SETTING

Indiana University Bloomington (IUB), IN, USA.

PARTICIPANTS

A total of 1027 IUB undergraduate students (64% female), aged 18 years or older, residing in Monroe County, Indiana, seronegative for SARS-CoV-2 at study baseline.

MEASUREMENTS

Primary exposure was high-risk alcohol consumption measured with an Alcohol Use Disorders Identification Test (AUDIT) questionnaire score of 8 or more. Primary outcome was SARS-CoV-2 seroconversion since baseline, assessed with two SARS-CoV-2 antibody tests, at baseline (September 2020) and end-line (November 2020). Secondary outcomes were (a) self-reported new SARS-CoV-2 infection at the study end-line and (b) self-reported symptomatic COVID-19 at baseline.

FINDINGS

Prevalence of high-risk alcohol consumption was 32 %. In models adjusted for demographics, students with high-risk alcohol consumption status had 2.44 [95% confidence interval (CI) = 1.35, 4.25] times the risk of SARS-CoV-2 seroconversion and 1.84 (95% CI = 1.04, 3.28) times the risk of self-reporting a positive SARS-CoV-2 infection, compared with students with no such risk. We did not identify any association between high-risk alcohol consumption and symptomatic COVID-19 (prevalence ratio = 1.17, 95% CI = 0.93, 1.47). Findings from sensitivity analyses corroborated these results and suggested potential for a dose-response relationship.

CONCLUSIONS

Among American college students, high-risk alcohol consumption appears to be associated with higher risk for severe acute respiratory syndrome coronavirus 2 seroconversion/infection.

Relationship Between Anxiety, Depression, and Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Proof of Concept

BACKGROUND

Psychological factors can influence susceptibility to viral infections. We examined whether such influences are evident in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

METHODS

Participants (n = 102) completed measures of anxiety, depression, positive mood, and loneliness and provided a blood sample for the measurement of antibodies to the SARS-CoV-2 spike and nucleocapsid proteins.

RESULTS

SARS-CoV-2 was significantly negatively associated with anxiety and depression. The model remained significant after adjustment for age and gender, although anxiety and depression were no longer significant independent predictors.

CONCLUSIONS

These findings offer early support for the hypothesis that psychological factors may influence susceptibility to SARS-CoV-2 infection.

Increased transmission of SARS-CoV-2 in Denmark during UEFA European championships

Denmark hosted four games during the 2020 UEFA European championships (EC2020). After declining positive SARS-CoV-2 test rates in Denmark, a rise occurred during and after the tournament, concomitant with the replacement of the dominant Alpha lineage (B.1.1.7) by the Delta lineage (B.1.617.2), increasing vaccination rates and cessation of several restrictions. A cohort study including 33 227 cases was conducted from 30 May to 25 July 2021, 14 days before and after the EC2020. Included was a nested cohort with event information from big-screen events and matches at the Danish national stadium, Parken (DNSP) in Copenhagen, held from 12 June to 28 June 2021. Information from whole-genome sequencing, contact tracing and Danish registries was collected. Case–case connections were used to establish transmission trees. Cases infected on match days were compared to cases not infected on match days as a reference. The crude incidence rate ratio (IRR) of transmissions was 1.55, corresponding to 584 (1.76%) cases attributable to EC2020 celebrations. The IRR adjusted for covariates was lower (IRR 1.41) but still significant, and also pointed to a reduced number of transmissions from fully vaccinated cases (IRR 0.59). These data support the hypothesis that the EC2020 celebrations contributed to the rise of cases in Denmark in the early summer of 2021.

Societal activities associated with SARS-CoV-2 infection: a case-control study in Denmark, November 2020

Identification of societal activities associated with SARS-CoV-2 infection may provide an evidence base for implementing preventive measures. Here, we investigated potential determinants for infection in Denmark in a situation where society was only partially open. We conducted a national matched case-control study. Cases were recent RT-PCR test-positives, while controls, individually matched on age, sex and residence, had not previously tested positive for SARS-CoV-2. Questions concerned person contact and community exposures. Telephone interviews were performed over a 7-day period in December 2020. We included 300 cases and 317 controls and determined odds ratios (ORs) and 95% confidence intervals (95% CI) by conditional logistical regression with adjustment for household size and country of origin. Contact (OR 4.9, 95% CI 2.4-10) and close contact (OR 13, 95% CI 6.7-25) with a person with a known SARS-CoV-2 infection were main determinants. Contact most often took place in the household or work place. Community determinants included events with singing (OR 2.1, 95% CI 1.1-4.1), attending fitness centres (OR 1.8, 95% CI 1.1-2.8) and consumption of alcohol in a bar (OR 10, 95% CI 1.5-65). Other community exposures appeared not to be associated with infection, these included shopping at supermarkets, travel by public transport, dining at restaurants and private social events with few participants. Overall, the restrictions in place at the time of the study appeared to be sufficient to reduce transmission of disease in the public space, which instead largely took place following direct exposures to people with known SARS-CoV-2 infections.

Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample.

Alcohol Use and the Risk of Communicable Diseases

The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol's role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date-Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia-as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.