​More people reduced than increased their alcohol use since the onset of the COVID-19 pandemic in Europe. Those already drinking at high levels prior to COVID-19 mainly increased their alcohol consumption. This is the outcome of a recent meta-analysis.1

What is already known? Major adverse events and crises affecting society – such as economic crises, terrorist attacks and natural disasters – can cause changes in alcohol use at population level. Similarly, the COVID-19 pandemic may result in shifts in alcohol consumption. Preliminary findings from individual studies looking at alcohol use over the course of the pandemic suggest that changes in drinking differ by gender and age group. There appears to have been a particular rise in alcohol intake in people reporting at-risk drinking prior to March 2020.

What does this study add? This is the first meta-analysis with robust quantitative assessments of changes in alcohol use due to the pandemic across many countries in Europe. This meta-analysis gathers data from 72 observational studies, of which 64 in the general population studies and 8 studies focusing on people with alcohol use disorder.

Overall reduction in alcohol use
The findings of this meta-analysis suggest that the group of drinkers indicating a reduction in their consumption was slightly higher (3.8%) than the group of drinkers indicating an increase. In addition, a higher proportion of people reported drinking less frequently (8%), consuming lower amounts of alcohol (12.2%) and having fewer heavy episodic drinking occasions (17.7%).

People having alcohol problems
At the same time, evidence suggests that, with few exceptions, high-level drinking patterns solidified or even intensified during the pandemic among those with pre-pandemic high drinking levels or alcohol use disorder.

Explanations
The findings of an alcohol use decline are in line with alcohol purchase data and other population consumption indicators. The most important driver behind the overall decrease in consumption is probably the reduction in potential drinking occasions due to measures aimed at limiting social gatherings. The increasing alcohol use among those already drinking at high levers prior to COVID-19 could be explained as a coping strategy for the increased levels of distress. These are caused by the measures taken to contain the spread of the virus (e.g., social isolation, income insecurity and job loss), as well as the threat of personal exposure to COVID-19 or the illness of loved ones.

Country specific changes
A recent systematic review investigated country specific changes in alcohol use during the COVID-19 pandemic. A significant decrease in heavy episodic drinking was observed in Spain, whereas a significant increase in the proportion of people with problematic alcohol use was observed in the United Kingdom. The heterogeneity of the findings from this systematic review indicates that the impact on alcohol use of the COVID-19 pandemic and pandemic-related policies, including social distancing and alcohol- specific policies, appears to be variable and dependent on multiple factors.2

Strengths

  • First meta-analysis of European data.
  • Broad search strategy, including both peer-reviewed studies and direct contact with scientists in 47 countries to identify additional or non-peer reviewed works not yet in the public domain.

Limitations

  • As most studies were of cross-sectional design, no causal conclusions can be drawn, and secondary factors may also have had an impact on consumption changes.
  • The validity of self- report data on changes in alcohol use remains unclear.

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