Alcohol Use Trajectories Among U.S. Adults During the First 42 Weeks of the COVID-19 Pandemic
This study characterized the prevalence, alcohol use patterns, and sociodemographic characteristics of U.S. adult subpopulations with distinct alcohol use trajectories during the COVID-19 pandemic’s first 42 weeks.
Adult respondents (n = 8130) in a nationally representative prospective longitudinal study completed 21 biweekly web surveys (March 2020 to January 2021). Past-week alcohol use frequency (alcohol use days [range: 0 to 7]) and intensity (binge alcohol use on usual past-week alcohol use day [yes/no]) were assessed at each time point. Growth mixture models identified multiple subpopulations with homogenous alcohol use trajectories based on mean alcohol use days or binge alcohol use proportional probabilities across time.
Four alcohol use frequency trajectories were identified: Minimal/stable (72.8% [95% CI = 71.8 to 73.8]) with <1 mean past-week alcohol use days throughout; Moderate/late decreasing(6.7% [95% CI = 6.2 to 7.3) with 3.13 mean March alcohol use days and reductions during summer, reaching 2.12 days by January 2021; Moderate/early increasing (12.9% [95% CI = 12.2 to 13.6) with 2.13 mean March alcohol use days that increased in April and then plateaued, ending with 3.20 mean days in January 2021; and Near daily/early increasing(7.6% [95% CI = 7.0 to 8.2]) with 5.58 mean March alcohol use days that continued increasing without returning to baseline.
Four alcohol use intensity trajectories were identified: Minimal/stable (85.8% [95% CI = 85.0% to 86.5%]) with <0.01 binge alcohol use probabilities throughout; Low-to-moderate/fluctuating (7.4% [95% CI = 6.8% to 8%]) with varying binge probabilities across timepoints (range:0.12 to 0.26); Moderate/mid increasing (4.2% [95% CI = 3.7% to 4.6%]) with 0.39 April bingealcohol use probability rising to 0.65 during August–September without returning to baseline; High/early increasing trajectory (2.7% [95% CI = 2.3% to 3%]) with 0.84 binge alcohol use probability rising to 0.96 by June without returning to baseline.
Males, Whites, middle-aged/older adults, college degree recipients, those consistently working, and those above the poverty limit were overrepresented in various increasing (vs. minimal/stable) frequency trajectories. Males, Whites, nonmarried, those without college degree, 18 to 39-year-olds, and middle aged were overrepresented in increasing (vs. minimal/stable) intensity trajectories.
Several distinct U.S. adult sociodemographic subpopulations appear to have acquired new alcohol use patterns during the pandemic’s first 42 weeks. Frequent alcohol use assessment in the COVID-19 era could improve personalized medicine and population health efforts to reduce alcohol use.