The COVID-19 Alcohol Paradox: British Household Purchases During 2020 Compared With 2015-2019
British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox.
Based on purchase data of 79,417 British households from Kantar Worldpanel, the researchers undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on March 23, 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. The researchers also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors.
Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter.
During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015–2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8).
Excess purchases from March 23 to December 31, 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales.
Excess purchases were greater in the most deprived households, compared with the least deprived households.
Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol.
That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased.
A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns.
Research in context
The researchers wanted to find answers to several questions through this study. What impact did pub closures have on alcohol use and therefore health? Did people use more or less alcohol at home as a result? And were these trends the same across society?
They used Kantar’s WorldPanel shopping survey to map out alcohol use habits over time, analysing around 5 million purchases of alcohol from almost 80,000 households between 2015 and 2020.
The first look at the data showed that alcohol buying in England, Scotland and Wales didn’t increase significantly overall between March and July 2020, once missing sales from pubs and restaurants were taken into account. However, public health data showed many people felt they had increased their use. Additionally, official government statistics showed a sharp rise in deaths directly linked to alcohol in 2020.
This created the paradox of how alcohol purchases could have not changed much while alcohol-specific deaths increased?
To answer this question, the researchers annalyzed the shopping data according to how much alcohol households would normally buy before lockdown, where those people lived and how much they earned.
The researchers found that people who were already using the most amount of alcohol, and thus at highest risk of harm, before the pandemic increased their purchases even more. The increase in alcohol buying by the top fifth of pre-pandemic household consumers was 17 times greater than the increase by the bottom fifth.
The purchasing differed geographically as well. households in the north-east of England and Yorkshire and Humber increased their purchases more than those in other parts of Britain.
Worryingly, the households in most deprived communities, who are already at the highest risk of harm had increased their alcohol purchasing even more during the pandemic.
Another extraordinary event like a lockdown in UK could further exacerbate the alcohol problem in UK. It is necessary that the UK government implements effective alcohol policy solutions to curb future problems.