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.

1 M Sechenov 1st Moscow State Medical University Moscow Russia

Campbell Family Mental Health Research Institute Centre for Addiction and Mental Health Toronto Ontario Canada

Centre for Alcohol and Drug Research Aarhus University Copenhagen Denmark

Clínic Foundation for Biomedical Research Barcelona Mallorca Spain

Clinical Addictions Research Group Psychiatry Department Neurosciences Institute Hospital Clínic University of Barcelona Barcelona Mallorca Spain

Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

Department of Addictology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Department of Psychiatry Centre for Interdisciplinary Addiction Research University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Psychiatry Medical Faculty University of Leipzig Leipzig Germany

Department of Psychiatry University of Toronto Toronto Ontario Canada

Department of Public Health Sciences Karolinska Institutet Stockholm Sweden

Faculty of Medicine Institute of Medical Science University of Toronto Medical Sciences Building Toronto Ontario Canada

Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Mallorca Spain

Institute for Mental Health Policy Research Centre for Addiction and Mental Health Toronto Ontario Canada

Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany

Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK

World Health Organization European Office for Prevention and Control of Noncommunicable Diseases Moscow Russia

Zobrazit více v PubMed

World Health Organization (WHO). Coronavirus disease (COVID-19) dashboard. Geneva, Switzerland: WHO. Available at: https://covid19.who.int/ (accessed 7 June 2020).

Hale T., Webster S., Petherick A., Phillips T., Kira B. Oxford COVID-19 Government Response Tracker. Available at: https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tracker (accessed 7 September 2020).

Chiappini S., Guirguis A., John A., Corkery J. M., Schifano F. COVID-19: the hidden impact on mental health and drug addiction. Front Psychol 2020; 11: 767.

Pierce M., Hope H., Ford T., Hatch S., Hotopf M., John A., et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry 2020; 10: 883-892.

Rehm J., Gmel G. E., Gmel G., Hasan O. S. M., Imtiaz S., Popova S., et al. The relationship between different dimensions of alcohol use and the burden of disease-an update. Addiction 2017; 112: 968-1001.

Lancet Gastroenterology and Hepatology Drinking alone: COVID-19, lockdown, and alcohol-related harm. Lancet Gastroenterol Hepatol 2020; 5: 625.

Testino G. Are patients with alcohol use disorders at increased risk for Covid-19 infection? Alcohol Alcohol 2020; 55: 344-346.

Saengow U., Assanangkornchai S., Casswell S. Alcohol: a probable risk factor of COVID-19 severity. Addiction 2020; 116: 204-205.

Rehm J., Kilian C., Ferreira-Borges C., Jernigan D., Monteiro M., Parry C. D. H., et al. Alcohol use in times of the COVID 19: implications for monitoring and policy. Drug Alcohol Rev 2020; 39: 301-304.

Clay J. M., Parker M. O. Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? Lancet Public Health 2020; 5: e259.

Gonçalves P. D., Moura H. F., do Amaral R. A., Castaldelli-Maia J. M., Malbergier A. Alcohol use and COVID-19: can we predict the impact of the pandemic on alcohol use based on the previous crises in the 21st century? A brief review. Front Psychol 2020; 11: 581113.

Vanderbruggen N., Matthys F., Van Laere S., Zeeuws D, Santermans L, Van den Ameele S., et al. Self-reported alcohol, tobacco, and cannabis use during COVID-19 lockdown measures: results from a web-based survey. Eur Addict Res 2020; 26: 309-315.

Niedzwiedz C. L., Green M. J., Benzeval M., Campbell D., Craig P., Demou E., et al. Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK household longitudinal study. J Epidemiol Community Health 2020; 75(3): 224-231. https://doi.org/10.1136/jech-2020-215060

Koopmann A., Georgiadou E., Kiefer F., Hillemacher T. Did the general population in Germany drink more alcohol during the COVID-19 pandemic lockdown? Alcohol Alcohol 2020; 55: 698-699.

Daly M., Robinson E. High-risk drinking in midlife before versus during the COVID-19 crisis: longitudinal evidence from the United Kingdom. Am J Prev Med 2021; 60: 294-297.

Alpers S. E., Skogen J. C., Maeland S., Pallesen S., Rabben Å. K., Lunde L. H., et al. Alcohol consumption during a pandemic lockdown period and change in alcohol consumption related to worries and pandemic measures. Int J Environ Res Public Health 2021; 18: 1220.

Wardell J. D., Kempe T., Rapinda K. K., Single A., Bilevicius E., Frohlich J. R., et al. Drinking to cope during COVID-19 pandemic: the role of external and internal factors in coping motive pathways to alcohol use, solitary drinking, and alcohol problems. Alcohol Clin Exp Res 2020; 44: 2073-2083.

Manthey J., Kilian C., Schomerus G., Kraus L., Rehm J., Schulte B. Alkoholkonsum in Deutschland und Europa während der SARS-CoV-2 Pandemie [Alcohol Use in Germany and Europe during the SARS-CoV-2 Pandemic]. Sucht 2020; 66: 247-258.

Callinan S., Mojica-Perez Y., Wright C. J. C., Livingston M., Kuntsche S., Laslett A. M., et al. Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic. Drug Alcohol Rev 2020; 40: 183-191.

de Goeij M. C. M., Suhrcke M., Toffolutti V., van de Mheen D., Schoenmakers T. M., Kunst A. E. How economic crises affect alcohol consumption and alcohol-related health problems: a realist systematic review. Soc Sci Med 2015; 131: 131-146.

Reinstadler V., Ausweger V., Grabher A.-L., Kreidl M., Huber S., Grander J., et al. Monitoring drug consumption in Innsbruck during coronavirus disease 2019 (COVID-19) lockdown by wastewater analysis. Sci Total Environ 2021; 757: 144006.

Anderson P., Llopis E. J., O'Donnell A., Kaner E. Impact of COVID-19 confinement on alcohol purchases in Great Britain: controlled interrupted time-series analysis during the first half of 2020 compared with 2015-2018. Alcohol Alcohol 2020; 56: 307-316.

Chisholm D., Moro D., Bertram M., Pretorius C., Gmel G., Shield K., et al. Are the ‘best buys’ for alcohol control still valid? An update on the comparative cost-effectiveness of alcohol control strategies at the global level. J Stud Alcohol Drugs 2018; 79: 514-522.

International Monetary Fund. Whatever It Takes: Europe's Response to COVID-19. International Monetary Fund. October 2020. Available at: https://www.imf.org/en/Publications/REO/EU (accessed 25 February 2021).

Kilian C., Manthey J., Braddick F., Matrai S., Gual A., Rehm J. with the European Study Group on Alcohol Use and Covid-19 (ESAC). Changes in alcohol consumption since the outbreak of the SARS-CoV-2 pandemic in Europe: a study protocol. 2020. Available at: https://www.deep-seas.eu/standard-eu-alcohol-survey/. (accessed 1 August 2020)

Stevens G. A., Alkema L., Black R. E., Boerma J. T., Collins G. S., Ezzati M., et al. Guidelines for accurate and transparent health estimates reporting: the GATHER statement. Lancet 2016; 388: e19-e23.

Kilian C. Dissemination strategies 1.2. 2020. Available at: https://doi.org/10.6084/m9.figshare.12738728. (accessed 15 August 2020)

Bush K., Kivlahan D., McDonell M., Fihn S. D., Bradley K. A. The AUDIT alcohol consumption questions (AUDIT-C) an effective brief screening test for problem drinking. Arch Intern Med 1998; 158: 1789-1795.

Georgiadou E., Hillemacher T., Müller A., Astrid M., Anne K., Tagrid L., et al. Alkohol und Rauchen: die Covid-19-Pandemie als idealer Nährboden für Süchte [Alcohol and smoking: The COVID-19 pandemic as an ideal breeding ground for addictions]. Ärzteblatt 2020; 117: 1251-1254.

Nelson J. P. Meta-analysis of alcohol price and income elasticities-with corrections for publication bias. Health Econ Rev 2013; 3: 17.

StataCorp Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC; 2017.

R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2020.

Kilian C. Surveys. 2020. Available at: https://doi.org/10.6084/m9.figshare.12738734.v1. (accessed 15 August 2020)

Rolland B., Haesebaert F., Zante E., Benyamina A, Haesebaert J, Franck N Global changes and factors of increase in caloric/salty food, screen, and substance use, during the early COVID-19 containment phase in France: a general population online survey. (preprint). JMIR Public Health Surveill 2020; 6: e19630.

European Monitoring Centre for Drugs and Drug Addiction Impact of COVID-19 on Patterns of Drug Use and Drug-Related Harms in Europe. Luxembourg: Publications Office of the European Union; 2020.

Kilian C., Manthey J., Probst C., Brunborg G. S., Bye E. K., Ekholm O., et al. Why is per capita consumption underestimated in alcohol surveys? Results from 39 surveys in 23 European countries. Alcohol Alcohol 2020; 55: 554-563.

Dawson D. Volume of ethanol consumption: effects of different approaches to measurement. J Stud Alcohol 1998; 59: 191-197.

Rehm J., Kilian C., Rovira P., Shield K. D., Manthey J. The elusiveness of representativeness in general population surveys for alcohol. Drug Alcohol Rev 2021; 40: 161-165.

Rothman K. J., Gallacher J. E., Hatch E. E. Why representativeness should be avoided. Int J Epidemiol 2013; 42: 1012-1014.

Davis C., Thake J., Vilhena N. Social desirability biases in self-reported alcohol consumption and harms. Addict Behav 2010; 35: 302-311.

Dryhurst S., Schneider C. R., Kerr J., Freeman A. L. J., Recchia G., van der Bles A. M., et al. Risk perceptions of COVID-19 around the world. J Risk Res 2020; 23: 994-1006.

Statista. Alcoholic drinks-Price per Unit. Europe. 2020. Available at: https://www.statista.com/outlook/10000000/102/alcoholic-drinks/europe (accessed 31 July 2020).

Seabrook R. A new measure of alcohol affordability for the UK. Alcohol Alcohol 2010; 45: 581-585.

Naughton F., Ward E., Khondoker M., Belderson P., Minihane M. A., Dainty J., et al. Health behaviour change during the UK COVID-19 lockdown: findings from the first wave of the C-19 health behaviour and well-being daily tracker study. Br J Health Psychol 2021; 26: 624-643.

Office for National Statistics. Comparisons of all-cause mortality between European countries and regions: January to June 2020. London, UK: Office for National Statistics; 2020. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/comparisonsofallcausemortalitybetweeneuropeancountriesandregions/januarytojune2020 (accessed 11 March 2021).

Holmes J., Colin A. Alcohol deaths rise sharply in England and Wales. BMJ 2021; https://doi.org/10.1136/bmj.n607

Hamilton I. Is alcohol really ‘essential’ during COVID-19? [online]. BMJ Opinion; 2020. Available at: https://blogs.bmj.com/bmj/2020/04/07/ian-hamilton-is-alcohol-really-essential-during-covid-19/ (accessed 8 July 2020).

Paradis C. Open versus Closed: The Risks Associated With Liquor Retail Stores During COVID-19. Ottawa, Canada: Canadian Centre on Substance Use and Addiction; 2021.

Nadkarni A., Kapoor A., Pathare S. COVID-19 and forced alcohol abstinence in India: the dilemmas around ethics and rights. Int J Law Psychiatry 2020; 71: 101579.

Neufeld M., Lachenmeier D. W., Ferreira-Borges C., Rehm J. Is alcohol an ‘essential good’ during COVID-19? Yes, but only as a disinfectant! Alcohol Clin Exp Res 2020; https://doi.org/10.1111/acer.14417

Reynolds J., Wilkinson C. Accessibility of ‘essential’ alcohol in the time of COVID-19: casting light on the blind spots of licensing? Drug Alcohol Rev 2020; 39: 305-308.

Huckle T., Parker K., Romeo J. S., Casswell S. Online alcohol delivery is associated with heavier drinking during the first New Zealand COVID-19 pandemic restrictions. Drug Alcohol Rev 2020; https://doi.org/10.1111/dar.13222

Colbert S., Wilkinson C., Thornton L., Richmond R. COVID-19 and alcohol in Australia: industry changes and public health impacts. Drug Alcohol Rev 2020; 39: 435-440.

Alcohol use and COVID-19: three-year impact for the Czech Republic

What drove changes in alcohol sales during the COVID-19 pandemic in Czechia? An interrupted time series analyses

Changes in ambulance departures for assault calls during COVID-19 pandemic restrictions

Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries

Use of alcohol, tobacco, cannabis, and other substances during the first wave of the SARS-CoV-2 pandemic in Europe: a survey on 36,000 European substance users