Good health and well-being has become even more important for people during the ongoing COVID-19 pandemic. People want to stay healthy, want to protect their health, and they want to see functioning health services. But people living with a non-communicable disease (NCD), such as cancer or heart disease, have decreased immunity and are more susceptible to viral infection and COVID-19 complications. And alcohol is a major risk factor for NCDs. Alcohol itself reduces immune system functioning, threatening people’s health even more during the pandemic.
The products and practices of the alcohol industry, including the heavy pandemic-centric marketing and the relentless lobbying to weaken United States (U.S.) state alcohol laws are fuelling the rise in alcohol use and harm.
A direct result of Big Alcohol lobbying pressure is that almost every U.S. federal state has weakened alcohol laws in 2020 according to Boston University researchers. As Movendi International previously reported,
- In the beginning of the pandemic, 31 states included cocktails-to-go as a temporary measure.
- In 15 states the measure was extended by two to five years.
- Another 16 states made cocktails-to-go a permanent law.
- At least nine states passed laws allowing direct home delivery of alcohol.
All but three of the 50 federal states gave liquor stores a lockdown exemption, many classifying the businesses – along with grocery stores and pharmacies – as a COVID-19 essential service. Weakened laws on alcohol delivery and open containers have made alcohol products more available in communities.
As a result of higher availability of alcohol products, consumption has been rising in the U.S. during COVID-19.
- The National Survey on Drug Use and Health reported that before the pandemic more than 25% of American adults engaged in binge alcohol use.
- In the first few weeks of lockdowns, alcohol sales jumped 54% over the previous year.
- A JAMA Network Journal study from September 2020 reported that alcohol consumption was up by 14% in 2020 compared to 2019.
A recent study by RAND published in the journal Drug and Alcohol Dependence looked at alcohol consumption in a nationally representative sample of American adults across three periods of time in 2020 and 2021. The study found that,
- Alcohol use steadily declined for men while remaining the same among women.
- By the third assesment men and women were similar in their average number of alcoholic beverages per day.
- Alcohol use problems increased among both men and women (69% and 49%) respectively.
- For both men and women “using alcohol to cope” was associated with an initial higher level of alcohol problems.
Women and women with young children are exposed to a disproportionate burden of alcohol harm caused:
- One study, published in October 2020 in the Journal of Addiction Medicine, found that between February and April 2020, women had higher heavy alcohol use rates than men.
- Another study published in the Journal Addictive Behaviors in November, 2020 reported that women were consuming more alcohol in response to COVID-19.
- The latest data from the 2019 National Survey of Drug Use and Health (NSDUH) reported by the Substance Abuse and Mental Health Service Administration (SAMHASA) indicates that alcohol use among women has caught up to men’s levels and with catastrophic consequences.
Studies have shown the complexities of balancing home, work and caregiving responsibilities during the pandemic has fallen disproportionately on women,” said Dr. Leena Mittal, chief of the women’s mental health division in the department of psychiatry at Brigham and Women’s Hospital in Boston, as per CNN.
There’s also a lot of marketing of new alcohol products targeting women and especially moms,” added Dr. Mittal.Dr. Leena Mittal, chief of the women’s mental health division, department of psychiatry, Brigham and Women’s Hospital in Boston
David Jernigan, professor of health, law, policy, and management from the School of Public Health in the University of Boston says that if the watered down alcohol policies remain, federal states will see higher volumes and high-risk patterns of alcohol use to take root and stay.
…there is the matter of the messages sent out around alcohol during the pandemic: that it is ‘essential,’ that we have some kind of right to be able to buy it, and that [using alcohol] is a valid means of coping,” said David Jernigan, professor of health, law, policy and management from the School of Public Health in the Boston University, as per, Bostonia.
[Using alcohol] to deal with stress or depression or other psychological problems is a poor coping behavior. Alcohol is a depressant.”
David Jernigan, professor of health, law, policy and management, School of Public Health, Boston University
In the U.S. alcohol kills more people than opioids but receives less attention. Every year, the products and practices of the alcohol industry kill close to 100,000 people. This is far more than the total 93,000 deaths caused by all other drug overdoses combined in 2020.
A recent study published in the journal Hepatology by AASLD estimates that the increased use of alcohol products during the pandemic could kill an additional 8000 Americans from liver disease by 2040. Since conditions like liver disease take a long time to manifest it has a long-term impact on population health.
Alcohol marketing fueling underage alcohol use
Underage alcohol use predicts alcohol use problems later in life. This is why preventing alcohol use among children and adolescents is important to avoid future harm. But the heavy pandemic-centric alcohol marketing can alter the way adolescents view alcohol and their behavior in the future.
Craig Ross, an SPH research assistant professor of epidemiology from Boston University explains how adveritising is used to prime adolescents psychologically to use alcohol products.
Priming is how the human brain develops associations between certain ideas. Advertisers use this unconscious phenomenon to make people feel a certain way about products and influence people to buy those products. Adolescents are rapidly building these associations, specifically around identity and looking for models to base their identity on. Alcohol advertising provides these models and primes adolescent brains for consuming alcohol.
You’re [adolescents are] seeing models of behavior you identify with and you see those things associated with [alcohol use],” said Craig Ross, an SPH research assistant professor of epidemiology, Boston University and executive director of SPH’s project incubator, Idea Hub, as per Bostonia.
When the opportunity presents itself, you’re more likely to accept an [alcoholic beverage].”
Craig Ross, SPH research assistant professor of epidemiology, Boston University
Alcohol is the most widely used substance among youth. The Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health reports that about 25% of 14-to-15-year-olds have had at least one alcoholic beverage, while 11% of teenagers report engaging in binge alcohol use.
In the U.S., the alcohol industry self-regulates alcohol advertising. But self-regulation is no regulation. Big Alcohol fails to adhere to their own code which stipulates no alcohol advertising in media where youth make up more than 28.4% of the audience.
- A 2014 study by Ross and colleagues on alcohol ads on cable TV during 2005 and 2011 revealed that exposure to alcohol ads grew fastest among 18-to-20-year-olds.
- The increase in exposure to alcohol ads was far bigger for minors than that for 21-to-24-year-olds, despite being of legal age for alcohol purchasing.
In an annual project tracking alcohol industry compliance for the US Centers for Disease Control and Prevention (CDC), Ross and colleagues found that between 2018 and 2019, there were 454 million media impressions for noncompliant alcohol ads.
Children and youth are heavily exposed to alcohol marketing in the U.S. And the problem is getting bigger. For the alcohol industry minors are a substantial source of sales revenue and profit.
In 2021, a study revealed that despite what Big Alcohol says about their commitment to reducing underage alcohol use, the industry has made $17.5 billion in sales revenue (in 2016) from alcohol sales to minors in the U.S.
The Alcohol Brand Research Among Underage Drinkers project examined the links between advertising and youth consumption. In over 33 studies the researchers found teens consume more of the brands they’re exposed to in ads. The most popular was the heavily advertised Bud Light.
These alcohol industry tactics of targeting minors have severe consequences:
A study published in the British Medical Journal (BMJ) shows that more American young people are dying from liver cirrhosis caused by alcohol products since 2009. The pandemic has made the situation worse, with Big Alcohol promoting alcohol products as a coping mechanism.
Chronic alcohol use is the primary cause for cirrhosis of the liver. This means American young people are facing severe harm caused by the products and practices of the alcohol industry.
The need to improve services for people with alcohol and other substance use problems
As Movendi International reported previously, demand for alcohol and other substance use problems have steadily increased during the pandemic.
There are currently some virtual support groups, communities and recovery programs for people seeking help. An example is the popular app called Cutback Coach, which helps people to track alcohol intake and set goals to reduce or quit alcohol consumption.
New of expanding telehealth programs is one solution to reaching people in need of help and staying at home due to the pandemic.
Supportive workplaces can go a long way in helping those struggling with alcohol and other substance use problems during the pandemic. This can range from offering employees early intervention and treatment programmes as well as reasonable accomodations. Covering mental healthcare services by insurance policies would enable employees to get the care they need.
Alcohol policy solutions are a necessity
The alcohol industry is deliberately exposing children to harm. During the pandemic Big Alcohol has been engaging crisis-washing to profit their image to protect their profits with no regard for the consequences during one of the largest crises of our time. When an industry’s products are harming people and communities at this rate and scale, it is the responsibility of governments to invest in policy solutions to protect people and communities.
If there are a lot of violations, the government, whether federal or state, has a responsibility to regulate it,” says Ziming Xuan, an SPH professor of community health sciences, Boston University, as per Bostonia.
Ziming Xuan, SPH professor of community health sciences, Boston University
Xuan’s research on 29 alcohol-related policies and regulations has found that combining limits on outlet density with increasing taxes accounts for about 50% of the policy effects.
Alcohol outlet density is how many liquor licenses are given in an area. Reducing outlet density not only reduces alcohol use but also violence in the area. In a 2020 study published in the Journal of Studies on Alcohol and Drugs, Jernigan and colleagues found that if Baltimore, Maryland reduced their alcohol outlet density by a quintile it could save 51 lives from murder, per year.
Alcohol outlet density displays the disporportionate level of alcohol harm placed on more vulnerable people in the United States. Jeringan has observed that alcohol outlets tend to be clustered in neighborhoods with a history of redlining, which is banks refusing loans based on an area’s demographics, particularly the color of its residents’ skin.
Alcohol taxes in the U.S. have depreciated over the years. In a 2017 study published in the Journal of Studies on Alcohol and Drugs, Xuan and colleagues found that from 1991 to 2015, the average inflation-adjusted (in 2015 dollars) state alcohol excise tax rate declined 30% for beer, 32% for distilled spirits, and 27% for wine.
Meanwhile, as per CDC data, the cost of the harm caused by the products and practices of the alcohol industry in the U.S. is about $250 billion a year.
But the current alcohol tax revenue does not even come close to covering these costs to society. 40% of the costs of alcohol harm are borne by the national and local governments. Therefore, increasing taxes is a win-win by reducing alcohol harm and increasing revenue for the government.
The World Health Organization has put together the SAFER technical package to provide a blueprint for the most effective alcohol policy solutions to prevent and reduce alcohol harm.
- Strengthen restrictions on alcohol availability
- Advance and enforce drink driving [driving under the influence] counter measures.
- Facilitate access to screening, brief interventions and treatment.
- Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion.
- Raise prices on alcohol through excise taxes and pricing policies.
The limits on outlet density and increasing taxes as recommended by Xuan are included in the SAFER package. Together with bans on alcohol advertising, sponsorship, and promotions they are the three alcohol policy best buys.
We want to make alcohol less attractive, less affordable, and less available,” said David Jernigan, professor of health, law, policy and management from the School of Public Health in the Boston University, as per, Bostonia.
Those are the three best buys, the most effective and cost-effective interventions according to the World Health Organization. We are never going to treat our way out of this problem.”David Jernigan, professor of health, law, policy and management, School of Public Health, Boston University
[This article was updated on February 9, 2022]
For further reading
USA: Understanding the Alcohol Burden
USA and COVID-19: Big Alcohol Fuels Rise of Multiple Alcohol Harms
USA and COVID-19: Why Is Alcohol Use Rising?
Partnership to End Addiction: “Rise in Alcohol Consumption During Pandemic Could Lead to 8,000 Additional Deaths“