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Multicenter Study
. 2020 Nov 26;10(11):e044276.
doi: 10.1136/bmjopen-2020-044276.

Assessing international alcohol consumption patterns during isolation from the COVID-19 pandemic using an online survey: highlighting negative emotionality mechanisms

Samantha N Sallie  1 , Valentin Ritou  2 , Henrietta Bowden-Jones  3   4 , Valerie Voon  3
Affiliations
Multicenter Study

Assessing international alcohol consumption patterns during isolation from the COVID-19 pandemic using an online survey: highlighting negative emotionality mechanisms

Samantha N Sallie et al. BMJ Open. .

Abstract

Objectives: The COVID-19 pandemic has required drastic safety measures to control virus spread, including an extended self-isolation period. Stressful situations increase alcohol craving and consumption in alcohol use disorder (AUD) and non-AUD drinkers. Thus, we assessed how COVID-19 related stress may have affected drinking behaviours in the general population.

Design: We developed an online cross-sectional survey, Habit Tracker (HabiT), which measured changes in drinking behaviours before and during COVID-19 quarantine. We also assessed psychiatric factors such as anxiety, depression (Hospital Anxiety and Depression Scale) and impulsivity (Short-Impulsive Behavior Scale). Lastly, we related drinking behaviours to COVID-19 specific stress factors.

Setting: HabiT was released internationally, with individuals from 83 countries participating.

Participants: Participants were included if they were 18 years of age or older and confirmed they were proficient in English. The survey was completed by 2873 adults with 1346 usable data (46.9% accurately completed).

Primary outcome measures: Primary outcome measures were change in amount and severity of drinking behaviours before and during quarantine, and current drinking severity during quarantine.

Results: Although drinking behaviours decreased overall during quarantine, 36% reported an increase in alcohol use. Those who increased alcohol use during quarantine were older individuals (95% CI 0.04 to 0.1, p<0.0001), essential workers (95% CI -0.58 to -0.1, p=0.01), individuals with children (95% CI -12.46 to 0.0, p=0.003), those with a personal relationship with someone severely ill from COVID-19 (95% CI -2 to -0.38, p=0.01) and those with higher depression (95% CI 0.67 to 1.45, p<0.0001), anxiety (95% CI 0.61 to 1.5, p=0.0002), and positive urgency impulsivity (95% CI 0.16 to 0.72, p=0.009). Furthermore, country-level subsample analyses indicated that drinking amount (95% CI 9.36 to 13.13, p=0.003) increased in the UK during quarantine.

Conclusions: Our findings highlight a role for identifying those vulnerable for alcohol misuse during periods of self-isolation and underscore the theoretical mechanism of negative emotionality underlying drinking behaviours driven by stress. Limitations include a large degree of study dropout (n=1515). Future studies should assess the long-term effects of isolation on drinking behaviours.

Keywords: COVID-19; depression & mood disorders; psychiatry; public health; substance misuse.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Changes in amount and severity of drinking behaviours in the HabiT sample between prequarantine and quarantine periods. Units of alcohol consumed weekly (top left) and changes in drinking severity (AUDIT-C) (bottom right) decreased during the quarantine period and more individuals either increased or decreased their weekly units consumed during quarantine than remained the same (top right). Furthermore, those who increased their weekly alcohol unit consumption during the quarantine period had significantly higher drinking severity indices (full AUDIT) compared with those who decreased or did not change their drinking behaviours during the quarantine period (bottom left). AUDIT, Alcohol Use Disorders Identification Test; HabiT, Habit Tracker.
Figure 2
Figure 2
Regression plots of the significant relationships between drinking severity and psychiatric measures in subjects who increased weekly alcohol unit consumption during quarantine. Drinking severity indices of the group who increased their drinking during the quarantine period were significantly positively related to depression severity, anxiety severity and positive urgency (impulsivity subset).
See this image and copyright information in PMC

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