Alcohol Use in Times of the COVID 19: Implications for Monitoring and Policy
Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios – with opposite predictions regarding the impact of the current COVID-19 pandemic on the level and patterns of alcohol consumption – are introduced.
The first scenario predicts an increase in consumption for some populations, particularly men, due to distress experienced as a result of the pandemic. A second scenario predicts the opposite outcome, a lowered level of consumption, based on the decreased physical and financial availability of alcohol.
With the current restrictions on alcohol availability, it is postulated that, for the immediate future, the predominant scenario will likely be the second, while the distress experienced in the first may become more relevant in the medium‐ and longer‐term future.
Monitoring consumption levels both during and after the COVID‐19 pandemic will be necessary to better understand the effects of COVID‐19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies.
Implications of the current situation
- There is a need to closely monitor any change in alcohol use. The tendency for some affected individuals to increase their alcohol use during prior epidemics may be indicative of self‐medication, which can have long‐term deleterious effects, including exacerbating alcohol’s role in the ‘diseases and deaths of despair’.
- The current situation is unique in terms of mass physical distancing and use of social media for interaction and may trigger different behaviours. Any increase in alcohol use, however, would not only add to the usual disease burden associated with alcohol but also add to the COVID‐19 load given that alcohol use, particularly heavy alcohol consumption, may weaken the innate and acquired immune system.
- This monitoring effort should not only look at the overall level of consumption but should differentiate by gender and socio‐economic status. The above‐mentioned review already identified gender differences, and alcohol‐attributable harm differs markedly by socio‐economic status. For instance, the increases of alcohol‐attributable mortality in North America have been almost exclusively borne by the lower socio‐economic strata.
- There is a need for better evidence on the relationship between social isolation, with the exception of interactions via internet and social media, and alcohol use and on the impact of alcohol policy changes. This becomes all the more necessary as some of the changes introduced in high‐income countries may now foreshadow future key market mechanisms for selling alcohol.
- There is a need to quantify the effects of the different elements of the COVID‐19 response overall to be honest in reporting on the impact of global policy initiatives on alcohol use. Assuming that the COVID‐19 pandemic will indeed be associated with a global reduction in alcohol use, this effect should not be promoted as an indicator of the success of current alcohol control policy commitments.