Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic

Diverging trends in alcohol-related harms: The role of comorbid mental health, suicide and self-harm behaviors in ambulance attendances for alcohol intoxication during the COVID-19 pandemic in Victoria, Australia

BACKGROUND

Alcohol harms changed significantly during COVID-19, but did not affect the population equally. Vulnerable groups including people with pre-existing mental health or suicidal behaviors may be at greater risk of alcohol-related harms, yet limited public health data are able to assess these.

METHODS

The present study utilised a novel, statewide surveillance system to examine ambulance attendances for alcohol intoxication over a four-year period prior to, and during the strictest lockdowns in Victoria, Australia.

RESULTS

While there was an overall reduction in alcohol-related attendances during lockdown (n = 15,064) compared to the 2018-19 period (n = 16,989), alcohol- intoxication attendances involving mental health symptoms increased by 40 % in Melbourne (IRR: 1.40 [1.30-1.51], p < 0.001), and by 25 % in regional Victoria (IRR: 1.25 [1.07-1.44], p = 0.005).There was also a 7 % increase in alcohol-intoxication attendances with co-morbid suicidal behaviors in Melbourne (IRR: 1.07 95%CI [1.02-1.13], p = 0.006), and a 21 % increase in regional Victoria (IRR: 1.21 [1.08-1.35], p = 0.001).

CONCLUSIONS

These findings suggest that extra services and supports for individuals with co-morbid alcohol-related harms are required to ensure their clinical care needs are being met.

The extent and diversity of harm from the drinking of unknown others in Australia: An analysis of data from during the COVID-19 pandemic

INTRODUCTION

This paper aims to produce a comprehensive estimate of alcohol's harm to others (AHTO) from strangers among Australia adults in 2021. This survey was undertaken during COVID-19 and aims to compare AHTO results with those from 12 years before and identify differences across socio-demographics.

METHODS

Cross-sectional data of 2574 Australian adults were collected in November 2021 via two survey modes: random digit dialling and the Life in Australia™ panel. Questions pertained to harms from the drinking of known and unknown others ('strangers') in the previous 12 months. Multivariable logistic regression is used to analyse differences in the experience of AHTO from strangers across age, gender and other socio-demographics.

RESULTS

Under half of Australian adults reported experiencing AHTO from a stranger (42.2%) during the period of COVID-19. Women were at significantly higher odds of reporting harm than men. Significantly higher percentages of participants aged 18-49 reported harm than those 65 and over. Rates of experience of harm from strangers' drinking varied between different Australian regions. Adults engaging in less frequent risky drinking (less than 4 days a month) reported significantly greater experiences of harm than those not engaging in risky drinking in the past year.

DISCUSSION AND CONCLUSIONS

The current study provides a national estimate of AHTO from strangers in Australia during the COVID-19 pandemic. Finding greater risk of experiencing AHTO from strangers among women than men differs from previous AHTO literature, and further research is required to determine if this is an emerging trend.

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.

Harm from the drinking of people you know: A range of effects from different relationships

AIMS

To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co-workers.

DESIGN, SETTING AND PARTICIPANTS

Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey.

MEASUREMENTS

Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio-economic status.

FINDINGS

Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%-62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%-23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13-1.95), younger people, rural, Australian-born (vs. respondents born overseas in non-English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model.

CONCLUSIONS

Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives.

Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research

Purpose: This study aimed to measure the frequency of high-quality and transparent sexual orientation and gender identity (SOGI) data collection and reporting in highly cited current alcohol use research, using the extant literature to identify community-informed priorities for the measurement of these variables. Methods: A single search to identify alcohol use literature was conducted on PubMed with results restricted to primary research articles published between 2015 and 2022. The 200 most highly cited studies from each year were identified and their titles and abstracts reviewed against inclusion criteria after deduplication. After full-text review, study characteristics and data indicating quality of SOGI reporting were extracted. The fidelity of the results was verified with a random sample before analyses. Results: The final sample comprised 580 records. Few studies reported gender identity (n = 194; 33.4%) and, of these, 7.2% reported the associated gender identity measure. A two-stage approach to measure gender was adopted in 3 studies, one study used an open-ended question with a free-text response option, and 13 studies recorded nonbinary gender identities (reported by 0.9% of the whole sample). Nineteen (3.3%) studies reported sexual orientation and more than half of these provided the sexual orientation measure. Eight of the 20 studies that reported sexual orientation and/or gender identity measures were classified as sexual and gender minority specialist research. Conclusions: Culturally competent SOGI reporting is lacking in highly cited current alcohol research. SOGI measures should be disclosed in future research and should provide free-text response options.

Population Subgroups at Risk of Unhealthy Changes in Food and Beverage Consumption During COVID-19 Lockdowns

BACKGROUND

Understanding health behaviour changes during the COVID-19 pandemic can assist in developing strategies to promote healthy lifestyles at such times. The aim of this exploratory study was to examine whether the frequency of consuming unhealthy foods and beverages changed during lockdown and whether certain population subgroups were more likely to make such changes.

METHOD

An online survey was administered to a national sample of 4022 Australian adults (51% female, mean age 48 years). Generalised linear models with generalised estimating equations were used to identify whether demographic characteristics (age, gender, education, presence of children in the household, number of people in the household) and beliefs related to COVID-19 were associated with changes in the frequency of consuming alcohol, sweet snacks, salty snacks, and sugary beverages from pre to during lockdown.

RESULTS

Overall, the frequency of consuming the four assessed unhealthy products did not change during lockdown. However, being male and having children at home were consistently associated with unhealthy changes, whereas believing that alcohol or unhealthy diets would exacerbate COVID-19 severity was linked to a decreased frequency of consuming these products respectively. Age, education, and living with more people were also associated with changes in the frequency of consuming some product categories.

CONCLUSION

During lockdown, certain population subgroups appeared to be at increased risk of more frequent consumption of unhealthy foods and beverages. Believing certain consumption habits are linked to adverse health impacts of COVID was found to reduce frequency of consumption of related products, presenting a potential focus for future public health actions.

A cross-sectional study of Australian teachers' health: are work-related factors associated with lifestyle behaviours?

Teacher's lifestyle behaviours are important because they lead to positive health outcomes for teachers themselves and because teachers model behaviour to their students. This cross-sectional study examined the lifestyle behaviours of a large sample of teachers in New South Wales (NSW), Australia and assessed the association between work-related factors and lifestyle behaviours. From February to October 2021, data were collected on the lifestyle behaviours, work-related factors and socio-demographics of primary and secondary school teachers in NSW, via an online survey. Associations between individual work-related factors and lifestyle behaviours were modelled using logistic regression and adjusted for sex, age, number of children and geographic location. Most of our survey sample (n = 1136) were women (75%) and 53% were reported as having overweight or obesity. Only 23% of teachers met the recommended physical activity guidelines, 39% met fruit intake guidelines, 9% met vegetable intake guidelines and 58% met healthy sleep guidelines. Most teachers (78%) met the recommendation of sugar-sweetened beverage consumption, 89% were not current smokers, but only 46% met the recommended alcohol consumption guidelines. Hours worked, teaching load, school sector and teacher role were associated with one or more lifestyle behaviours after adjusting for the demographic variables. This study highlights the need for additional support to improve the health-related behaviours of teachers in NSW. Policymakers should recognize the negative impact of high workloads on teachers' health-related behaviours, increasing their risk of chronic disease.

A review of the impact of social disruptions on food security and food choice

At times of severe social disruption, be that war, conflict, pandemic, or economic downturn, both the availability and consumption of healthy dietary patterns can be adversely affected with any effects often outlasting the initial social disruption. For instance, when the COVID-19 pandemic hit and lockdown restrictions followed, households were reported to consume unhealthy diets. In some cases, this seemed to be a response to the situation and a coping mechanism. In contrast, in other cases, it was a consequence of limited food availability or access, with some communities finding that fresh foods became difficult to source due to the disruption in global supply chains. The example presented by the impact of conflict in Ukraine, which has also disrupted global food supply chains, at a macrolevel, food systems and at a microlevel, individual and community shows that food choices may respond to different global events in similar ways. Therefore, in this review, a range of events/disruptions are considered, beyond pandemics and wars, including climate disasters (e.g., fire, famine, and floods) that have been shown to impact food supply and consequently, food security. The importance of this can be seen as inadequate and nutritionally poor diets have a concomitant effect on health, which extends beyond the initial period of societal stress and disruption of food supply chains. Hence, the impact of such disruptions on consumer behavior which includes food choice needs to be corroborated. Therefore, this review aims to discuss the impact of such disruptions on consumer behavior and food choices. Additionally, this review provides some practical strategies that can be used to ensure the availability of healthy diets.

Alcohol use disorder treatment via video conferencing compared with in-person therapy during COVID-19 social distancing : A non-inferiority comparison of three cohorts

BACKGROUND

Social distancing measures during the COVID-19 pandemic forced an abrupt transformation of treatment delivery for mental health care. In mid-March 2020, nearly all in-person contact was replaced with video conferencing. The pandemic thus offered a natural experiment and a unique opportunity to conduct an observational study of whether alcohol use disorder treatment through video conferencing is non-inferior to in-person treatment.

METHODS

In a large urban substance use disorder treatment center in the Netherlands, treatment evaluation is routine practice. Outcome data are regularly collected to support shared decision making and monitor patient progress. For this study, pre-test and post-test data on alcohol use (Measurements in the Addictions for Triage and Evaluation), psychopathology (Depression Anxiety Stress Scales), and quality of life (Manchester Short Assessment of Quality of Life) were used to compare outcomes of cognitive behavioral therapy treatment for three cohorts: patients who received treatment for a primary alcohol use disorder performed prior to (n = 628), partially during (n = 557), and entirely during (n = 653) the COVID-19 lockdown.

RESULTS

Outcome was similar across the three cohorts: No inferior outcomes were found for treatments that were conducted predominantly through video conferencing during lockdown or treatments that started in-person, but were continued through video conferencing, compared to in-person treatments that were conducted prior to COVID-19. The number of drop-outs were also similar between cohorts. However, there was a difference in average treatment intensity between cohorts, with treatment partially or fully conducted during the COVID-19 pandemic lasting longer.

CONCLUSIONS

Treatment for a primary alcohol use disorder, provided partially or predominantly through video conferencing during the COVID-19 pandemic resulted in abstinence rates and secondary outcomes similar to traditional in-person care, in spite of the potentially negative effects of the COVID-related lockdown measures themselves. These results from everyday clinical practice corroborate findings of randomized controlled studies and meta-analyses in which video conferencing appeared non-inferior to in-person care in clinical effectiveness.

Alcohol's harm to others in 2021: Who bears the burden?

BACKGROUND AND AIMS

Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS

Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross-sectional survey modes: a random-digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey. In 2021 participants were asked about harms they had experienced from the drinking of family, friends, co-workers and the public in the past year. Applying combined sample weights from each mode, bivariable and adjusted multivariable logistic regressions were used to analyse differences in rates of AHTO by participant gender, age, residence in rural or metropolitan regions, country of birth, education and employment.

FINDINGS

In 2021, 23.6% reported being negatively affected by strangers' drinking and 21.3% by the drinking of someone they knew, with 34.3% reporting being negatively affected a lot or a little by either; 42.4% of respondents reported specific harms from strangers' drinking. Thus, 48.1% of respondents reported any harm (negative effects or specific harms) from others' drinking. Women, younger people, Australian-born and heavier episodic drinkers reported significantly higher rates of AHTO compared with other respondents. Smaller percentages (7.5%) of participants reported being harmed substantially by others' drinking, including by people they knew (5.8%) or strangers (2.3%). Stratified analyses showed that heavier drinking, furloughed, younger men who were born overseas in English-speaking countries were affected by others' drinking, whereas women were affected regardless of these factors (apart from age).

CONCLUSIONS

More than one-third of Australian adults appear to have been negatively affected by others' drinking in 2021, with women, younger people and heavier drinkers at greater risk. Substantial harm appears to be more likely to arise from the drinking of people Australians know than from strangers' drinking.

Qualitative study of states' capacity to support alcohol prevention policies during the COVID-19 pandemic in the USA

INTRODUCTION

The onset of the COVID-19 pandemic accelerated rates of alcohol purchasing and related harms in the USA. The increases followed governors' emergency orders that increased alcohol availability, including the allowance of alcohol home delivery, alcohol to-go from restaurants and bars, and curbside pickup from retailers.

METHODS

Semi-structured interviews were conducted with 53 participants involved in state-level alcohol prevention policy across 48 states. Interviewees' perspectives on changes to alcohol prevention policies during the COVID-19 pandemic, including capacity to respond to alcohol-focused executive and legislative changes to alcohol availability, were explored. Initial codes were developed collectively and refined through successive readings of transcripts using a phenomenological, action-oriented research approach. Themes were identified semantically after all transcripts were coded and reviewed.

RESULTS

Four themes were developed including: (i) alcohol prevention policies and capacity during COVID-19; (ii) industry-related challenges during COVID-19; (iii) limited pre-COVID-19 alcohol prevention capacity; and (iv) needs to strengthen alcohol prevention capacity.

DISCUSSION AND CONCLUSIONS

The pandemic exacerbated states' capacity limitations for alcohol prevention efforts and created additional impediments to public health messaging about alcohol health risks related to greater alcohol availability. Participants offered a myriad of strategies to improve alcohol prevention and to reduce alcohol-related harms. Recommendations included dedicated federal and state prioritisation, more funding for community organisations, greater coordination, consistent high-quality trainings, stronger surveillance and widespread prevention messaging. States' alcohol prevention efforts require dedicated leadership, additional funding and support to strengthen population-based strategies to reduce sustained alcohol-related harms associated with increases in alcohol availability.

The impact of COVID-19 on alcohol sales and consumption in the United States: A retrospective, observational analysis

Understanding the COVID-19 pandemic's effect on alcohol sales and consumption is critical in mitigating alcohol abuse and morbidity. We sought to determine how the onset of the COVID-19 pandemic and changes in viral incidence affected alcohol sales and consumption in the United States. We conducted a retrospective observational analysis regressing National Institute on Alcohol Abuse and Alcoholism (NIAAA) alcohol sales data and Behavioral Risk Factor Surveillance System (BRFSS) survey data for 14 states for 2017 to 2020 with COVID-19 incidence in 2020 in the United States. The onset of the pandemic was associated with higher monthly alcohol sales per capita of 1.99 standard drinks (95% Confidence Interval: 0.63 to 3.34, p = 0.007). Increases of one COVID-19 case per 100 were associated with lower monthly alcohol sales per capita of 2.98 standard drinks (95% CI: -4.47 to -1.48, p = 0.001) as well as broad decreases in alcohol consumption, notably 0.17 fewer days per month with alcohol use (95% CI: -0.31 to -0.23, p = 0.008) and 0.14 fewer days per month of binge drinking (95% CI: -0.23 to -0.052, p < 0.001). The COVID-19 pandemic is associated with increased monthly average alcohol purchases, but higher viral incidence is linked to lower alcohol purchases and consumption. Continued monitoring is needed to mitigate the effects of higher population alcohol use during the pandemic.

Have COVID-19 Stimulus Packages Mitigated the Negative Health Impacts of Pandemic-Related Job Losses? A Systematic Review of Global Evidence from the First Year of the Pandemic

Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.

The Impact of (COVID)-19 on Beverage Purchasing Behaviors in Korea

Objective: In this study, we examined changes in purchase behavior of alcoholic beverages (ie, soju, beer, wine, traditional Korean liquor, and liquor) and non-alcoholic beverages (ie, fruit and vegetable juices, coffee, tea, bottled water, milk, yogurt, and plant-based milk) before and after the COVID-19 pandemic. Methods: Monthly beverage expenditure data, based on Korean household demographic information, was used for 3 years and 6 months. The 2-part model was used for analysis. To examine the effect of COVID-19, beverage expenditure was analyzed after dividing it into short-term and long-term effects. Results: Our results show that the probability of purchasing alcoholic beverages increased owing to the long-term effect of the COVID-19 pandemic. The amounts of beer, wine, and traditional Korean liquor purchased increased in the long-term. The purchase of sweet drinks decreased (ie, fruit and vegetable juices and yogurt) in the long-term because of the effect of the pandemic. On the other hand, tea, water, and plant-based milk expenditures increased. Conclusion: This beverage consumption pattern reflects both unhealthy (ie, an increase in alcoholic beverage purchases) and healthy drinking behaviors (ie, a decrease in sweet beverage purchases and an increase in tea, water, and plant-based milk purchases).

The association between psychological distress and alcohol consumption and physical activity: a population-based cohort study

Introduction

The COVID-19 pandemic and infection control measures caused changes to daily life for most people. Heavy alcohol consumption and physical inactivity are two important behavioral risk factors for noncommunicable diseases worldwide. The COVID-19 pandemic, with its social distancing measures, home office policies, isolation, and quarantine requirements may have an impact on these factors. This three-wave longitudinal study aims to investigate if psychological distress and worries related to health and economy were associated with levels and changes in alcohol consumption and physical activity during the two first years of the COVID-19 pandemic in Norway.

Methods

We used data collected in April 2020, January 2021, and January 2022 from an online longitudinal population-based survey. Alcohol consumption and physical activity status were assessed at all three measuring points via the Alcohol Use Disorder Identification Test (AUDIT-C) and the International Physical Activity Questionnaire (IPAQ-SF). COVID-19-related worries, home office/study, occupational situation, age, gender, children below 18 years living at home, and psychological distress (measured with the Symptom Checklist (SCL-10)) were included as independent variables in the model. A mixed model regression was used and presented with coefficients with 95% confidence intervals (CI).

Results

Analysis of data from 25,708 participants demonstrates that participants with substantial symptoms of psychological distress more often reported higher alcohol consumption (1.86 units/week, CI 1.48-2.24) and lower levels of physical activity [-1,043 Metabolic Equivalents of Task (METs) per week, CI -1,257;-828] at baseline. Working/studying from home (0.37 units/week, CI 0.24-0.50) and being male (1.57 units/week, CI 1.45-1.69) were associated with higher alcohol consumption. Working/studying from home (-536 METs/week, CI -609;-463), and being older than 70 years (-503 METs/week, CI -650;-355) were related to lower levels of physical activity. The differences in activity levels between those with the highest and lowest levels of psychological distress reduced over time (239 METs/week, CI 67;412), and similarly the differences in alcohol intake reduced over time among those having and not having children < 18 years (0.10 units/week, CI 0.01-0.19).

Conclusion

These findings highlight the substantial increases in risks related to inactivity and alcohol consumption among those with high levels of psychological distress symptoms, and particularly during the COVID-19 pandemic, and increase the understanding of factors associated with worries and health behavior.

Perceived discrimination enhances the association between distress and impact related to the murder of George Floyd and unhealthy alcohol use in a survey sample of U.S. Veterans who report drinking

Introduction

On May 25, 2020, George Floyd was murdered by a Minneapolis police officer leading to increased social justice and antiracism movements (SJARM) across the United States. Vicarious exposure to racism and perceived discrimination are salient sources of distress which may lead to increased alcohol use as means of coping. The primary aim of the current study was to examine how perceived discrimination and the subjective impact and personal distress related to the SJARM following the George Floyd murder interact and relate to unhealthy alcohol use among U.S. Veterans.

Methods

286 Veterans were assessed for unhealthy alcohol use (AUDIT-10), perceived discrimination (EDS), and subjective impact and personal distress related to the SJARM. Two moderation analyses were performed to examine whether subjective impact and personal distress moderated relations between perceived discrimination and alcohol use. In-depth follow-up analyses were conducted to examine differences and relationships among variables.

Results

In two different moderation models, perceived discrimination moderated the association between both subjective impact (p <.001) and personal distress (p <.001) felt by the SJARM and unhealthy alcohol use. In planned exploratory analyses, Veterans who reported perceived discrimination reported higher levels of unhealthy alcohol use (M = 14.71, SD = 9.39) than those who did not t(2 8 4) = 5.61, p <.001. In post-hoc analyses, racial/ethnic minorities were significantly more likely to report perceived racial discrimination (p <.001) while non-Hispanic Whites were more likely to report perceived discrimination based on education or income level (p <.01).

Conclusions

In the context of a socially unjust event amidst a global pandemic, perceived discrimination contributes to unhealthy alcohol use and subjective impact and personal distress associated with the SJARM following the murder of George Floyd. Results highlight the importance of addressing discrimination experiences in Veterans who seek alcohol treatment, particularly as rates of unhealthy alcohol use are on the rise.

Changes in secondary substance use after the onset of the COVID-19 pandemic among people who use cannabis: Findings from a web-based sample of adults in the United States

The coronavirus disease 2019 (COVID-19) pandemic has had widespread impacts on mental health and substance use. Increases in cannabis use have been documented in the United States, but little is known about how other substance use has changed among people who use cannabis. We sought to examine changes in alcohol, tobacco, opioid, and stimulant use during COVID-19 and explore how these changes relate to patterns of cannabis use. Data were obtained from a web-based survey of adults in the United States who use cannabis (n = 1,471) administered in September 2020. Using data reported in retrospective (prepandemic) and time-of-survey assessment periods, we explored changes in the prevalence of regular (≥ weekly) alcohol, tobacco, opioid, and stimulant use during COVID-19 among respondents who used medical and nonmedical cannabis. We used modified Poisson regression to examine cannabis-related correlates of increasing or decreasing secondary substance use during the pandemic. There was a slight but significant increase in ≥weekly alcohol use in the medical use group only (41.4%-47.0%, p = .034). ≥ Weekly tobacco, opioid, and stimulant use did not change significantly. Pandemic-concurrent shifts in secondary substance use depended on interacting cannabis-related factors including medical cannabis use, prepandemic cannabis frequency, and pandemic-concurrent frequency changes. For example, ≥ weekly prepandemic cannabis use was significantly and positively associated with decreasing opioid use frequency among the medical cannabis use group only. Assessments of the pandemic's effects on substance use should consider relationships between cannabis and other substances, which may differ according to cannabis-specific behaviors, motives, and contexts of use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Changing trends and characteristics of one punch deaths in Australia (2012-2018)

One-punch assaults also known as 'coward punches', are characterised by a single severe blow to the head causing the victim to lose consciousness, resulting in a secondary impact between the head and surrounding environment. Such impacts may result in brain injury leading to fatality or permanent neurological impairment. In a previous publication, there were 90 one punch deaths around Australia between 2000 and 2012, mostly involving young men drinking alcohol at a licensed venue at the weekend. This prompted a surge of public education and awareness campaigns around Australia, in addition to regulatory and legislative changes aimed at curbing social violence. This retrospective descriptive study aimed to examine one punch deaths since 2012 in Australia to determine if there has been a decrease in deaths, and whether the demographics and circumstances of these deaths have changed. A search of the National Coronial Information System was undertaken for all closed coronial cases between 1 January 2012 and 31 December 2018. Additional information was collected from medicolegal reports including toxicology, pathology and coronial findings. There were 80 one punch fatalities in Australia, almost exclusively involving males. The median age was 43.5 (range 18-71) years and there was a decreasing trend in the number of deaths annually. Most fatal assaults occurred in the state of New South Wales (28.8%) followed by Queensland (23.8%), and in metropolitan locations (64.6%) rather than regional areas (35.4%). Alcohol was the most commonly detected drug, found in 47 cases of the 71 cases where toxicology results were available (66%), with a median concentration of 0.14 and 0.19 g/100 mL in antemortem and postmortem samples, respectively (range 0.005-0.32 g/100 mL). Five deaths reported methylamphetamine, with THC detected in 21.1% of cases. Assaults more commonly occurred on a footpath or roadside (41.3%), followed by a home or dwelling (32.5%). 8.8% of assaults occurred inside hotels, bars or other licenced venues. Most transpired on a weekday, which differed from the pre-2012 period when these assaults occurred mainly on the weekend. While some trends are positive, there has been a shift in the victim demographic as well as the typical environment for fatal one punch assaults, highlighting the importance of public health surveillance in providing a current evidence base to inform policy and practice.

A mixed methods exploration of a pilot photo-reflection intervention for enhancing coping and well-being during COVID-19

Restrictions enforced during the COVID-19 pandemic are associated with negative impacts on mental health and well-being. There is a need to support individuals to cope with these challenging circumstances. An embedded design mixed methods approach was employed to explore challenges experienced during the pandemic, the effectiveness of a photo-reflection intervention for enhancing coping, wellbeing, and resilience, and how this intervention functioned to impact on these outcomes. 108 participants were randomised to one of three photo-taking conditions; challenges experienced, coping strategies, or experiences and were assessed with measures of wellbeing, coping and resilience. In addition, open-ended survey questions were used to assess perceptions of experiences and of the effects of the intervention. There were no significant differences across the groups, however subjective psychological well-being, and emotional and functional well-being improved post-intervention regardless of intervention type. There was also an increase in planning and self-distraction coping for those whom the intervention elicited reflection. Qualitative data highlighted a range of challenges experienced and examples of both adaptive and maladaptive coping approaches. Photo-reflection intervention approaches may improve well-being and enhance coping during these challenging circumstances through providing opportunity to review and reflect on life experiences.

Temporal Trends in the Disease Burden of Colorectal Cancer with Its Risk Factors at the Global and National Level from 1990 to 2019, and Projections Until 2044

Background

This study aimed to evaluate the global colorectal cancer(CRC) trend and the relevant risk factors from 1990 to 2019 and for better policymaking and resource allocation.

Methods

Data on CRC, including incidence, mortality and disability adjusted life year (DALY) rates, were extracted from the 2019 Global Burden of Disease (GBD) study. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trend of incidence, mortality and DALYs. The Bayesian age-period-cohort model(BAPC) was used to predict the future burden of CRC.

Results

In 2019, a total of 2.17 million CRC cases were reported worldwide, a 157% increase from 1990. In high-social demographic index (SDI) regions, the trend of age-standardized incidence rate(ASIR) tended to decrease, while the proportion of people under 50 years of age tended to increase. Although the number of deaths and DALYs increased, the age-standardized death rate (ASDR) and age-standardized DALY rate decreased. The CRC burden was growing fastest in middle-SDI regions, especially in East Asia, followed by low SDI regions. In addition, the milk intake, High-BMI and high fasting plasma glucose play a more important role in on CRC. The predicted cases and deaths in global continued to increase to 2044. And there is an upward trend in ASIR for both men and women.

Conclusion

In developed regions, the CRC burden continues to decrease, while the CRC burden become more and more severe in developing regions. Overall, the burden of CRC will rising in the near future. Therefore, reasonable resource allocation and prevention policies should be implemented. Developing countries needs more attention.

The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melbourne, Australia

PURPOSE

To compare the incidence, aetiology, and patterns of maxillofacial fracture presentations during the various stages of the 2020 Melbourne COVID-19 lockdown restrictions to periods outside lockdown in 2019 and 2020.

METHODS

This is a retrospective study of 344 subjects. The patterns of facial trauma presentations to a tertiary hospital in metropolitan Melbourne during the 2020 COVID-19 restrictions were compared to periods with no restrictions over 22 months from March 2019 to December 2020.

RESULTS

The incidence of maxillofacial fractures decreased by 28% during lockdown (0.41 vs. 0.57 injuries/day, P = 0.0003). Falls overtook interpersonal violence as the leading cause of fractures (44% of lockdown presentations vs. 25.7% of presentations outside lockdown, P = 0.002), while sporting injuries dropped drastically (4% vs. 17.1%, P = 0.005). Lockdowns saw an increase in the proportion of female patients (40% vs. 26.8%, P = 0.03) and a fivefold increase in proportion of domestic violence-related fractures (6.7% vs. 1.1%, P = 0.006). Alcohol-related injuries decreased significantly (11% vs. 21%, P = 0.03).

CONCLUSIONS

While restrictions reduced rates of interpersonal violence and alcohol-related maxillofacial trauma, there was a higher proportion of injuries to females, increased falls, and domestic violence-related injuries.

Changes in Diet, Physical Activity, Alcohol Consumption, and Tobacco Use in Adults During the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic changed various lifestyle habits worldwide due to the prevention measures implemented in each country, these changes may affect or benefit people's health. We aimed to systematically review changes in diet, physical activity (PA), alcohol consumption, and tobacco use habits during the COVID-19 pandemic in adults. Two databases: PubMed and ScienceDirect, were used for this systematic review. The research was limited to open-access, peer-reviewed original articles published in English, French, or Spanish from January 2020 to December 2022 and investigated diet, PA, alcohol consumption, and tobacco use habits before and during the COVID-19 pandemic in adults. Excluded studies were review studies, intervention studies with a sample size of fewer than 30 participants, and poor-quality articles. This review followed PRISMA 2020 guidelines (PROSPERO: CRD42023406524), whereas to assess the quality of the studies, we used the quality assessment tools developed by the BSA Medical Sociology Group for cross-sectional studies and the QATSO for the longitudinal studies. Thirty-two studies were included. Some studies reported changes to promote healthy lifestyles; 13 out of 15 articles reported an increase in healthy diet consumption habits, 5 out of 7 studies reported a decrease in alcohol consumption, and 2 out of 3 studies reported a decrease in tobacco use. On the other hand, the other studies reported changes to promote unhealthy lifestyles: 9 out of 15, and 2 out of 7 studies reported an increase in unhealthy diet and alcohol consumption habits respectively, 25 out of 25 reported a decrease in physical activity, and 13 out of 13 reported an increase in sedentary behavior. During the COVID-19 pandemic, there have been changes to promote a healthy and unhealthy lifestyle; the latter can affect people's health. Therefore, effective responses are needed to mitigate the consequences.

Psychological Distress, Fear and Coping Strategies among Hong Kong People During the COVID-19 Pandemic

The COVID-19 pandemic contributed to potential adverse effects on the mental health status of a wide range of people. This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Hong Kong. A cross-sectional online survey was conducted among general population in Hong Kong. Psychological distress was assessed using the Kessler Psychological Distress Scale; level of fear was evaluated using the Fear of COVID-19 scale; and coping strategies were assessed using the Brief Resilient Coping Scale. Multivariable logistic regression was used to identify key factors associated with these mental health variables. Of the 555 participants, 53.9% experienced moderate to very high levels of psychological distress, 31.2% experienced a high level of fear of COVID-19, and 58.6% showed moderate to high resilient coping. Multivariable logistic regression indicated that living with family members, current alcohol consumption, and higher level of fear were associated with higher levels of psychological distress; perceived stress due to a change in employment condition, being a frontline worker, experiencing 'moderate to very high' distress, and healthcare service use to overcome the COVID-19 related stress in past 6 months were associated with a higher level of fear; and perceived better mental health status was associated with a moderate to high resilient coping. This study identified key factors associated with distress, fear and coping strategies during the pandemic in Hong Kong. Mental health support strategies should be provided continuously to prevent the mental impact of the pandemic from turning into long-term illness.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-021-02338-7.

COVID 19—impact on substance use treatment utilization and provision in South Africa

Background

The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide. The aim of this study was to explore, changes in the number of SUD treatment episodes provided during the height of the pandemic and, SUD treatment providers’ perceptions of the impact of COVID-19-related restrictions on people with SUDs and the delivery of SUD treatment services in South Africa.

Methods

We used administrative data collected as part of the South African Community Epidemiology Network on Drug Use (SACENDU) project to assess whether the number of treatment episodes changed during the height of COVID-19 restrictions. We used data from an online survey of SUD treatment providers to assess providers’ perceptions of the impact of COVID-19 on SUD treatment delivery. Eight seven SUD facilities were recruited to participate in the online survey.

Results

Sixty-three organisations (out of a total of 86) participated in the survey, yielding a 73.2% response rate. About half (n = 30; 47.6%) of the sample thought the need for SUD treatment had remained the same or had increased during the COVID-19 lockdown. Half the sample (n = 32; 50.7%) reported decreased availability of SUD services during COVID-19 lockdowns. Participants believed that the lack of services during COVID-19 lockdown impacted negatively on patients that were enrolled in their programmes and on individuals who wished to access the service. Furthermore, changes in service provision seemed to increase patients’ anxiety, exacerbate pre-existing mental health problems and in some cases were thought to precipitate relapse. In addition, patient disengagement and attrition from treatment were thought to have increased during this period. Whilst 47.6% (n = 30) of providers agreed with the value of the alcohol ban, 23.8% (n = 15) of providers thought it had unintended negative consequences.

Conclusion

Based on the findings it is evident that SUD treatment services in South Africa have been significantly affected during the COVID-19 pandemic and more severely during the onset of the pandemic. Together with service providers, more effective ways should be sought on how to feasibly expand access to SUD treatment for all South Africans and enhance the country’s preparedness for future health emergencies.

Changes in Alcohol Consumption after 1 Year of the COVID-19 Pandemic: A Cross-Sectional Study in a Region of France

BACKGROUND

There is conflicting evidence on how the COVID-19 pandemic changed patterns of alcohol consumption. While some studies have suggested that alcohol consumption decreased at the beginning of the pandemic, there are limited data for a longer period. The objective of this study was to investigate changes in alcohol consumption 1 year after the onset of the COVID-19 pandemic in France, and to identify vulnerable subgroups in a French adult population.

METHODS

This was a single-center, cross-sectional, descriptive study. Self-reported changes in alcohol consumption were collected from 2491 respondents in a survey carried out in western Brittany from 18 January to 9 March 2021.

RESULTS

Of respondents, 27.64% reported that they had increased their alcohol consumption, 14.7% had decreased, 3.94% had ceased, and 53.72% reported no change in their alcohol consumption. Increased alcohol use was associated with male gender, age 26 to 44 years, living with a family, not being a health professional, having had a physical or psychological health problem during lockdowns, smoking tobacco, and using cannabis. Reduced alcohol use or cessation was associated with male gender, age 18 to 25 years, living in Brest, living alone, and using cannabis.

CONCLUSIONS

Our study suggests that during the COVID-19 pandemic, a significant number of people increased their alcohol consumption in France, even outside lockdowns. These results should encourage health professionals and public authorities to implement more specific prevention measures to limit the risks associated with alcohol consumption.

Harmful Drinking Phenotype in a Large Dutch Community Sample

AIMS

Harmful drinking patterns are shaped by a broad complex interaction of factors, societal and individual, psychological and behavioral. Although previous studies have focused on a few variables at a time, the current study simultaneously examines a large number of variables in order to create a comprehensive view (i.e. phenotype) of harmful drinking, and to rank the main predictors of harmful and non-harmful drinking by order of importance.

METHODS

We surveyed a large sample of Dutch adults about their habitual drinking characteristics and attitudes, perceptions and motives for drinking. We fed 45 variables into a random forest machine learning model to identify predictors for (1) drinking within and in excess of Dutch guideline recommendations and (2) harmful and non-harmful drinking.

RESULTS

In both models, respondents' subjective perceptions of 'responsible drinking', both per occasion and per week, showed the strongest predictive potential for different drinking phenotypes. The next strongest factors were respondents' reason for drinking, motives for drinking and age. Other variables, such as drinking location, knowledge about alcohol-related health risks and consumption of different beverage types, were not strong predictors of drinking phenotypes.

CONCLUSIONS

Although the direction of the relationship is unclear from the findings, they suggest that interventions and policy measures aimed at individuals and social norms around drinking may offer promise for reducing harmful drinking. Messaging and promotion of drinking guidelines should be tailored with this in mind.

Association between Dietary Habits, Food Attitudes, and Food Security Status of US Adults since March 2020: A Cross-Sectional Online Study

Since COVID-19, global reports indicate changes in dietary habits and food security status of the population. As a follow-up to an earlier study conducted in 2020, the purpose of this online cross-sectional study was to examine food security and food attitudes and their subsequent impact on dietary habits since March 2020 and potential associations with demographics, health characteristics and lifestyle habits on dietary habits. Participants (n = 2036) responded to a 71-item online survey conducted between February−March 2022. Frequency counts and percentages were tabulated, and multivariate linear regressions were conducted to examine associations. Results showed that most participants indicated no change in dietary habits (45.9−88.8%) for the listed food and beverage items. A significant positive association for food attitudes scores (1.11, 95% CI 0.93 to 1.29; p < 0.001) and food security scores (0.53, 95% CI 0.35 to 0.71; p < 0.001) on total dietary habits was found. Further, significant positive associations were seen with various health characteristics such as medical conditions (p = 0.01) and lifestyle habits such as preparing meals at home (p < 0.001). A negative association was observed with females on total dietary habits (p < 0.001). It is necessary to encourage adults in the US to maintain the positive dietary and lifestyle habits they acquired since March 2020 in their daily living. Future studies should investigate the impact these habits have on their health long-term and sustained positive dietary and lifestyle habits.

Impacts of the COVID-19 public health restrictions on substance use, mental health, and psychosocial functioning among individuals with alcohol use disorder

Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders.Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use.Methods: Participants were 125 AUD+ individuals (% males: 57.60; M_age = 49.11, SD = 12.13) reporting on substance use from January 1^st-24^th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24^th March-June 28^th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic.Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days (p = .02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression (ps < .001).Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health.

Changes in Alcohol Consumption among Different Population Groups during the SARS-CoV-2 Pandemic: Outcomes of the Slovenian Cross-Sectional National Survey (SI-PANDA)

BACKGROUND

Slovenia ranks amongst the countries with the highest recorded alcohol consumption. The mortality rate attributed to alcohol-related causes of death in Slovenia also exceeds the EU average. The aim of our research was to confirm the changes in alcohol consumption in Slovenia during the SARS-CoV-2 virus pandemic on a representative sample and to identify vulnerable groups at higher risk of increasing alcohol consumption.

METHODS

Two consecutive data collections of the National Survey on the Impact of the Pandemic on Life, each in different epidemiological situations, were conducted. A structured questionnaire was used to monitor the number of alcoholic beverages consumed during the pandemic, compared to the time before the pandemic.

RESULTS

The majority of the population did not change the number of alcoholic beverages consumed, and among those with changes, there were significantly more of those who drank less than those who drank more. Among respondents who drank a greater number of alcoholic beverages, statistically significantly higher proportions were found in younger age groups, people with post-secondary vocational education or higher, and people with a higher probability of mental health problems.

CONCLUSIONS

During the pandemic crisis, we need to pay special attention to vulnerable groups that are at higher risk of increasing alcohol use.

MM, Villanueva-Silvestre V, Vázquez-Martínez A. Relationship Between Depression and Risky Alcohol Consumption in Women: the Mediating Role of Coping Styles and Age

Women are more likely to use alcohol as a coping strategy for psychological distress, with higher rates of comorbidity with depression being found in those with an alcohol use disorder. The objective of this study was to analyze changes in problematic alcohol consumption and depression during the COVID-19 lockdown, and to establish a predictive model based on age. A total of 1889 women aged 18-64 years (M = 36.14) participated. The Patient Health Questionnaire was applied for depression, the Alcohol Use Disorders Identification Test-Short Version for alcohol, and active and avoidant coping were considered. In the period prior to the pandemic, depression and avoidant coping were good predictors of alcohol consumption in women, regardless of age. During lockdown, this predictive capacity was only maintained in women aged 35-64 years. In the mediational models, differences were observed according to age. For women aged 18-34 years, depression was the predictor variable of problematic alcohol consumption, but for women aged 35-64 years it was the avoidant coping style, which is the predominant style in women of this age with clinical depression. The relevance of age in the combined treatments of depression and problematic alcohol consumption is highlighted, and training in active coping strategies is suggested.

Factors associated with changing alcohol consumption during the first UK lockdown

Background

In response to COVID-19 there have been lockdowns and restrictions to hospitality services. Drinking behaviours often change in response to traumatic events and changes in the drinking environment, and this is influenced by a range of factors. This study explores self-reported changes in alcohol consumption in the third month of the UK lockdown, associations with socio-demographics factors and with COVID-19-related concerns, and mental health and wellbeing.

Methods

The COVID-19 Psychological Wellbeing Study was a longitudinal, online, three-wave survey of 1958 UK adults. Data were collected during the first UK lockdown; wave 1 launched 23 March 2020, wave 2 was 1 month after and wave 3 2 months after completion of wave 1A hierarchical multinomial regression model was estimated to investigate factors associated with changes in perceived alcohol consumption in the third month of the lockdown.

Results

The majority of participants reported changes in drinking (62%) with over one-third indicating increased consumption. Student status and worries about the financial implications of COVID-19 were associated with lower odds of decreased alcohol consumption. Those with above average income and those with children in the household had lower odds of increased alcohol consumption, while younger adults had higher odds of increased alcohol consumption.

Conclusions

This study adds to the growing body of research showing changes in alcohol consumption behaviours during the COVID-19 lockdown restrictions, and identifies risk and protective factors which can aid in targeting intervention at those most in need of support.

How did the COVID-19 pandemic influence health-related behaviour? An online survey on food choice, physical activity and changes in body weight among Swiss adults

The COVID-19 pandemic has affected all aspects of our everyday lives. To investigate these behaviour changes, an online survey was conducted with 1'028 individuals (51% female) in Switzerland between June and July 2020. The questions referred in particular to the lockdown in spring 2020. We put specific focus on the pandemic's impact on health-related behaviour, which includes food choice, physical activity and body weight management. For instance, participants reported whether and how their consumption of different foods changed during the lockdown. As a measure of healthy food choice, we chose consumption of vegetables and salad and in contrast, sweet snacks and alcohol consumption was used as a measure for unhealthy food choice. For physical activity and body weight, participants indicated whether it decreased, increased or did not change during the lockdown as compared before. In a next step, we investigated the influence of various predictors on health-related behaviour using multinomial logistic regression models. We find that the possibility to work remotely led to healthier food choices, that is, a reported increase in vegetable consumption and decrease in sweet snack consumption, but also to more unhealthy food choices and lifestyles, that is, a reported increase in alcohol consumption as well as an increase in sweet snack consumption. For weight change, the data indicated that individuals who worked remotely were more likely to gain or lose weight than individuals working from the office. Our findings demonstrate how individuals are affected differently by the pandemic and how complex the whole picture is. Further, these results are crucial in developing health recommendations for possible future lockdowns or health crises in general.

Treatment seeking for alcohol-related issues during the COVID-19 pandemic: An analysis of an addiction-specialized psychiatric treatment facility

The COVID-19 pandemic and its societal impact may cause long-term behavioral changes in alcohol use due to increased psychological distress, unemployment, and time spent home. The purpose of this study was to determine whether or not the COVID-19 pandemic had a significant impact on treatment seeking for alcohol use disorders and related problems in a Swedish psychiatric treatment facility. Using an interrupted-time-series design on data derived from an addiction-specific psychiatric treatment facility located in Malmö, Sweden, we hypothesized that treatment seeking would decrease during the pandemic based on previous research identifying limited alcohol availability and affordability, as well as accessibility to treatment centers as influential factors. In addition, we assessed the predictive power of alcohol sales and number of active cases in the region using simple linear regressions. Results indicated that the pandemic had little to no effect on the number of people needing care, however a significant step change was found in treatment seeking patterns for unique female patients during the second wave (October 2020). Regression analyses indicated that alcohol sales and the number of active cases in the region did not significantly predict treatment seeking. A causal relationship between the onset of the pandemic and variation in treatment seeking for alcohol use could not be established. More research is needed to fully understand the pandemic's impact on alcohol use behavior change.

The impact of changes in COVID-19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020: an interrupted time-series analysis

BACKGROUND AND AIMS

Early evidence suggests that COVID-19 lockdown restrictions affect alcohol consumption. However, existing studies lack data on how drinking practices changed as restrictions disrupted people's work, family life and socializing routines. We examined changes in consumption and drinking occasion characteristics during three periods of changing restrictions in Scotland/England.

DESIGN

Interrupted time-series analysis of repeat cross-sectional market research data (assessing step-level changes).

SETTING

Scotland/England, January 2009-December 2020.

PARTICIPANTS

Scotland: 41 507 adult drinkers; England: 253 148 adult drinkers.

MEASUREMENTS

Three intervention points: March 2020 lockdown, July 2020 easing of restrictions and October 2020 re-introduction of some restrictions.

PRIMARY OUTCOME

mean units consumed per week (total/off-trade/on-trade; 1 unit = 8 g ethanol).

SECONDARY OUTCOMES

drinking > 14 units per week, heavy drinking, drinking days per week, solitary drinking, drinking with family/partners, drinking with friends/colleagues, own-home drinking, drinking in someone else's home and drinking start times.

FINDINGS

In Scotland, March 2020's lockdown was associated with a 2.32 [95% confidence interval (CI) = 0.61, 4.02] increase in off-trade (i.e. shop-bought) units per week, a -2.84 (95% CI = -3.63, -2.06) decrease in on-trade (i.e. licensed venues) units per week, but no statistically significant change in total units per week. July 2020's easing of restrictions was associated with a 1.33 (95% CI = 0.05, 2.62) increase in on-trade units per week, but no statistically significant total/off-trade consumption changes. October 2020's re-introduction of some restrictions was not associated with statistically significant consumption changes. Results for England were broadly similar. Lockdown restrictions were also associated with later drinking start times, fewer occasions in someone else's home and with friends/colleagues, more own-home drinking and (in Scotland only) more solitary drinking.

CONCLUSIONS

Reductions in on-trade alcohol consumption following COVID-19 lockdown restrictions in Scotland/England in 2020 were mainly offset by increased own-home drinking. This largely persisted in periods of greater/lesser restrictions. The shift towards off-trade drinking involved significant changes in the characteristics of drinking occasions.

Alcohol use and the COVID-19 pandemic: Historical trends in drinking, contexts, and reasons for use among U.S. adults

OBJECTIVE

The current study used U.S. national data to examine drinking trends prior to and during the COVID-19 pandemic in 2020, focusing on changes in U.S. young- and middle-adult alcohol prevalence, frequency, and drinking contexts and reasons, and whether they differed by age and college status.

METHODS

Data from 2015 to 2020 from 16,987 young adults (ages 19-30) and 23,584 middle adults (ages 35-55) in the national Monitoring the Future study were used to model historical trends and potential 2020 shifts (data collection April 1 to November 30, 2020) in prevalence (30-day, daily, binge drinking) and frequency (30-day, binge drinking). For young adults, data on drinking contexts and negative affect reasons for drinking were examined. Moderation by age and college status was also tested.

RESULTS

2020 was associated with (1) downward deviation in 30-day (young and middle adults) and binge drinking (young adults) prevalence; (2) upward deviation in daily drinking prevalence (middle adults); (3) among drinkers, upward deviation in frequency of 30-day (young and middle adults) and binge drinking (young adults); and (4) changes in drinking contexts and reasons among drinkers. Among college students, in particular, 2020 was associated with a downward deviation from expected historical trends in drinking prevalence. Upward deviations in daily prevalence and both binge and 30-day drinking frequency were stronger at ages 25-30 (vs. 19-24) and 35-45 (vs. 50-55).

CONCLUSIONS

Among U.S. young and middle adults, deviations from expected historical trends in population alcohol use that occurred during the pandemic included decreases in alcohol use prevalence, increases in alcohol use frequency, and increases in the use of alcohol to relax/relieve tension and because of boredom. These shifts were likely due, in part, to drinking while alone and at home-which increased during the pandemic.

Patterns of Alcohol Use Among Italian Young Adults Before and During a COVID-19 Lockdown: A Latent Class Analysis Study

Two not mutually exclusive theories explain the effects of the COVID-19 pandemic on alcohol use. The Availability hypothesis contends that reduced opportunities to drink due to the closure of outlets and consumption sites should lead to decreases in alcohol use, whereas the Stress and Coping hypothesis argues that those exposed to stressful situations may increase drinking. The primary aim of this study was to examine changes—separately by gender—in the prevalence of drinking patterns among Italian young adults (18–34 years) before and during a COVID-19 lockdown. Study design was a repeated cross-sectional study, whereby data collected in 2015 and 2020 from nationally representative samples were analyzed. Latent class analysis identified five, fully invariant for women and partially invariant for men, drinking pattern classes among both cohorts: current non-drinkers (CND), weekend risky (WRD) and weekend non-risky drinkers (WnRD), daily non-risky (DnRD) and daily risky drinkers (DRD). In support of the Availability hypothesis, increases in abstaining and moderate drinking women and men were observed from 2015 to 2020. Concomitantly, among men only there were also increases in the prevalence of patterns characterized by risky drinking, coping drinking motives and related harm (Stress and Coping hypothesis). The pandemic and the three-tier lockdown imposed by the Italian government likely reduced overall alcohol use in the general population who drink moderately. However, there was a substantial increase in the prevalence of a small but significant group of men who drank daily and heavily to cope. Outreach and prevention efforts should target primarily this group, but also consider the opportunities that the exceptional circumstances of a quarantine offer to any individuals to reshape their lifestyle and health-related behaviors.

Substance, use in relation to COVID-19: A scoping review

BACKGROUND

We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates.

METHODS

A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15, 2020 and again in April 15, 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only.

RESULTS

Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use.

CONCLUSIONS

Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where appropriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic.

FUNDING

Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.

Consumption practices during the COVID-19 crisis

This research draws on protection motivation theory, temporal construal theory, and self-determination theory to understand consumption practices during a pandemic crisis by looking at the narratives of British consumers during the COVID-19 crisis. A two-stage design is adopted: the first stage adopts an exploratory strategy to identify consumption-related themes using netnography, while the second stage explores these themes further to gain a deeper insight through 13 semi-structured interviews. Three themes emerge relating to different aspects of consumption practices. These themes are found to link to the self-control research area and include consumers' self-control changing their shopping behaviour, having less self-control over unhealthy snack consumption and having less self-control concerning alcohol. These lead to changes in other consumption practices, including store format and type of shopping. Different initiatives are discussed to help retailers retain their new lockdown customers to help manufacturers provide healthier options and to help weight management businesses and the National Health Service reduce unhealthy consumption habits.

Changes in alcohol use during the COVID ‐19 pandemic in Europe: A meta‐analysis of observational studies

Issues

Numerous studies have examined the impact of the COVID‐19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms.

Approach

We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self‐reported changes in alcohol use associated with COVID‐19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations. We identified 646 reports, of which 56 general population studies were suitable for random‐effects meta‐analyses of proportional differences in alcohol use changes. Variations by time, sub‐region and study quality were assessed in subsequent meta‐regressions. Additional 16 reports identified were summarised narratively.

Key Findings

Compiling reports measuring changes in overall alcohol use, slightly more individuals indicated a decrease than an increase in their alcohol use during the pandemic [3.8%, 95% confidence interval (CI) 0.00–7.6%]. Decreases were also reported more often than increases in drinking frequency (8.0%, 95% CI 2.7–13.2%), quantity consumed (12.2%, 95% CI 8.3–16.2%) and heavy episodic drinking (17.7%, 95% CI 13.6–21.8%). Among people with pre‐existing high drinking levels/alcohol use disorder, high‐level drinking patterns appear to have solidified or intensified.

Implications

Pandemic‐related changes in alcohol use may be associated with pre‐pandemic drinking levels. Increases among high‐risk alcohol users are concerning, suggesting a need for ongoing monitoring and support from relevant health‐care services.

Conclusion

Our findings suggest that more people reduced their alcohol use in Europe than increased it since the onset of the pandemic. However high‐quality studies examining specific change mechanisms at the population level are lacking.

Divergent changes: abstinence and higher-frequency substance use increase among racial/ethnic minority young adults during the COVID-19 global pandemic

BACKGROUND

Identifying factors influencing substance use among racial/ethnic minorities (REM) is important given the disproportionate impact of the COVID-19 pandemic on this population.

OBJECTIVES

We examined factors in four domains and hypothesized that poor mental health, negative coping behaviors, negative environmental aspects, and belonging to more vulnerable social groups would be associated with increased substance use during the pandemic.

METHODS

Multiple regression was applied to longitudinal data from a college sample assessed prior (fall 2017 to spring 2019) and during (spring 2020) the pandemic (n= 323; 81.5% cisgender women; 34.5% African-American, 36.1% Asian-American, 15.5% Hispanic/Latinx, 11.8% multi-racial) to identify factors predicting current alcohol, cannabis, and nicotine use frequency (spring 2020) and change in frequency of use between springs 2019 and 2020.

RESULTS

While infrequent substance use (monthly or less) decreased during the pandemic, abstinence rates increased (alcohol 39%; cannabis 18%; nicotine 18%) and higher-frequency alcohol use increased (207%-1600% 2-3 times+/week) compared to spring 2019. The strongest protective factor was change in living situation during the pandemic, associated with lower current alcohol and cannabis use. Risk factors included a history of trouble with police and impulsivity since the pandemic, both associated with higher current and increased alcohol and cannabis use. REM did not differ on most factors and the outcomes. However, a higher percentage of Asian-Americans than other REM reported living situation changes.

CONCLUSION

Substance use rates diverged during the pandemic, with both increased abstinence and higher-frequency use, attributed mostly to mental health and environmental domain factors with few REM differences.

Changes in the use of alcohol and tobacco in Slovenia during the first wave of the SARS-COV-2 pandemic

Background

In the first months of 2020, the SARS-CoV-2 virus spread all over the world and numerous measures were adopted that had a strong impact on both personal and public life. This contribution explores changes in alcohol and tobacco use during the first months of the COVID-19 pandemic in Slovenia.

Methods

Self-reported changes in alcohol and tobacco use during the first few months of the Covid-19 pandemic were recorded in 495 Slovenian adults, as part of the European Alcohol Use and COVID-19 survey.

Results

About half of the Slovenian sample indicated that the frequency of drinking occasions did not change in the months after the pandemic’s outbreak, while the remainder stated either a decrease (26.0%) or an increase (24.2%). 23.1% reported a decrease and 17.3% an increase in the quantity of alcohol consumed per occasion. Respondents who reported that their overall alcohol consumption decreased were more likely to be male than female and more likely to be younger than middle-aged. Those who reported experiencing at least a substantial level of distress due to financial loss were at a four-times increased risk of reporting an increase in their alcohol consumption compared to individuals who reported no or only some financial distress. Of the 120 people reporting the use of tobacco, almost half indicated an increase in tobacco consumption within the previous month, and about 20% reported a decrease in use. The differences in the results between Slovenia and other European countries are small and the overall pattern suggests that the situation in Slovenia was comparable to other European countries.

Conclusion

As this pandemic continues to evolve, further monitoring is needed to identify the long-term effects of alcohol and tobacco use on public health in relation to the management of COVID-19.

Alcohol access and purchasing behaviour during COVID-19 pandemic restrictions: An exploration of sociodemographic, health and psychosocial correlates in two Canadian provinces

INTRODUCTION

Alcohol access has changed in Canada during the COVID-19 pandemic. This study compares the use of two novel purchasing modes (via delivery and in excess/stockpiling) to traditional, in-person purchasing to determine if their use is associated with sociodemographic and psychosocial characteristics, perceived COVID-19 health risk or consumption frequency.

METHODS

We draw on cross-sectional survey data from 2000 residents of the Canadian provinces of Nova Scotia and New Brunswick, ages 19 years and older that were administered online and by telephone. Associations between purchasing modes and sociodemographic and psychosocial characteristics, perceived COVID-19 health risk or consumption frequency were assessed using logistic regression.

RESULTS

About 70% of people who drink purchased in-person, 17% used delivery and 30% purchased in excess/stockpiled. Sociodemographic and psychosocial attributes varied among those at increased odds of using each purchasing mode. Those at higher COVID-19 health risk were at higher odds of getting alcohol delivered. Increased drinking frequency was associated with alcohol delivery and purchasing in excess/stockpiling.

DISCUSSION AND CONCLUSIONS

This study highlights the need for increased public health considerations regarding changes to alcohol regulations. Alcohol delivery and purchasing in excess/stockpiling is positively associated with heavier drinking. Drinkers at higher COVID-19 health risk were more likely to purchase online for delivery, which suggests novel purchasing modes may serve a partial public health function.

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.

Alcohol consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21 countries

AIMS

To investigate changes in alcohol consumption during the first months of the COVID-19 pandemic in Europe as well as its associations with income and experiences of distress related to the pandemic.

DESIGN

Cross-sectional on-line survey conducted between 24 April and 22 July 2020.

SETTING

Twenty-one European countries.

PARTICIPANTS

A total of 31 964 adults reporting past-year drinking.

MEASUREMENTS

Changes in alcohol consumption were measured by asking respondents about changes over the previous month in their drinking frequency, the quantity they consumed and incidence of heavy episodic drinking events. Individual indicators were combined into an aggregated consumption-change score and scaled to a possible range of -1 to +1. Using this score as the outcome, multi-level linear regressions tested changes in overall drinking, taking into account sampling weights and baseline alcohol consumption [Alcohol Use Disorder Identification Test (AUDIT-C)] and country of residence serving as random intercept. Similar models were conducted for each single consumption-change indicator.

FINDINGS

The aggregated consumption-change score indicated an average decrease in alcohol consumption of -0.14 [95% confidence interval (CI) = -0.18, -0.10]. Statistically significant decreases in consumption were found in all countries, except Ireland (-0.08, 95% CI = -0.17, 0.01) and the United Kingdom (+0.10, 95% CI = 0.03, 0.17). Decreases in drinking were mainly driven by a reduced frequency of heavy episodic drinking events (-0.17, 95% CI = -0.20, -0.14). Declines in consumption were less marked among those with low- or average incomes and those experiencing distress.

CONCLUSIONS

On average, alcohol consumption appears to have declined during the first months of the COVID-19 pandemic in Europe. Both reduced availability of alcohol and increased distress may have affected consumption, although the former seems to have had a greater impact in terms of immediate effects.

The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: A systematic review

BACKGROUND

The aim of this paper was to examine the early impact of COVID-19 on substance use to assess implications for planning substance use treatment and support systems.

METHOD

A systematic review of literature published up to March 2021 was conducted to summarize changes in prevalence, incidence, and severity of substance use associated with COVID-19 and the accompanying public health measures, including lockdown, stay-at-home orders, and social distancing.

RESULTS

We identified 53 papers describing changes to substance use at the population level. The majority of papers described changes related to alcohol use and most relied on self-reported measures of consumption during the COVID-19 pandemic, compared with pre-pandemic use. There was less evidence to support changes in non-alcohol substance use. In general, risky pre-pandemic alcohol use, caregiving responsibilities, stress, depression, anxiety, and current treatment for a mental disorder were found to be associated with increased substance use.

CONCLUSION

This review provides preliminary data on changes in substance use, indicating that certain segments of the population increased their alcohol use early on in the COVID-19 pandemic and may be at greater risk of harm and in need of additional services. There is a need for additional population-level information on substance use to inform evidence-based rapid responses from a treatment system perspective.

The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic

There are some concerns regarding alcohol use behaviors during the COVID-19 pandemic. The mixed findings of the first alcohol use studies during this pandemic may reflect the lack of differentiation between on-premise and home consumption. Most of the countries adopted severe restrictions on drinking place functioning. Alcohol retail store sales temporal data were used to examine alcohol sales changes in the United States (U.S.) throughout the COVID-19 pandemic as a proxy indicator of at-home drinking. Data were sourced from the Monthly Retail Trade Survey, which has provided U.S. representative estimates of sales at retail and food services stores since 1951. In the present study, we analyzed data from seasonally adjusted beer, wine, and liquor store (BWLS) sales from January 1992 to September 2020. Poisson cubic spline models were used to assess nonlinearity in such sales during the period. These models were adjusted to the consumer price index for alcoholic beverages. There was a significant increase in retail alcohol sales during the beginning of the pandemic, reaching a plateau in the third quarter of 2020. During the COVID-19 period (March 2020 to September 2020), there were 41.9 billion dollars in BWLS sales, representing an increase of 20% compared to the same period in 2019. On the other hand, food and drinking place retail sales decreased by 27% during the same period in the same survey. These results may indicate an increase in home drinking during the period, which could potentially lead to higher alcohol consumption and alcohol-related adverse health outcomes. More aggressive efforts should be made to warn the population about the risks associated with increased home alcohol consumption during the pandemic. Additionally, tracking individual alcohol consumption and releasing real-time data at different levels are needed to better assess the effects of increased alcohol consumption during the pandemic.