Commentary on Nordeck et al.: Disruption of social roles and daily routines in the initial phase of the COVID-19 pandemic may explain changes in alcohol use frequency.

Abstract

The early months of the COVID-19 pandemic dramatically changed the structure of daily life for many people. A consideration of the ways and extent to which different demographic subgroups experienced changes in their roles and daily routines can provide a framework to understand how the COVID-19 pandemic influenced drinking frequency. Social role theory [1] and routine activities theory [2] hold that people's roles and responsibilities serve to organize their daily lives. They influence how people allocate their time to different activities, and they shape the social networks with which people interact [3]. Social norms and the level of ‘wetness’ of these activities and peer groups influence how much alcohol people consume [3]. As reported by Nordeck et al. [4], including by sex, parenting status, age and socio-economic status, some groups showed sustained increases in drinking frequency and other groups showed initial increases that attenuated over the months of the pandemic. In line with social role and routine activities theories, we would expect groups that experienced COVID-19 impacts leading to greater daily structure or involving roles incompatible with drinking to report less frequent drinking, but the opposite for pandemic impacts leading to less structure and circumstances more compatible with drinking. From prior research, similar role transitions and changes in the structure of everyday life are associated with subsequent changes in alcohol consumption, especially those related to family and employment. Transitions to marriage and parenthood are associated with less alcohol consumption, while transitions out of marriage are associated with increased use [3, 5]. Becoming unemployed is also associated with more drinking [6], although employment can also be related to increased drinking. For example, women who become employed after staying home with children increase alcohol use [7]. Role transitions and social network shifts also occur throughout the life-course. Of note, during retirement, increased social opportunities and leisure time may coincide with more drinking, including problematic drinking occurring in private [8, 9]. Seemingly underlying these changes in drinking are transitions between roles and activities that are more structured or discordant with drinking and those that are less structured or afford easy access to alcohol. Governmental measures and public health recommendations during the COVID-19 pandemic—physical and social distancing, in particular—changed much regarding people's daily activities and relationships [10, 11]. Many people reported impacts on time with friends and family, along with disruptions in their daily work and leisure routines [12]. These impacts were not experienced equally across social groups, including those groupings examined by Nordeck et al. [4]. Therefore, framing COVID-19 impacts in research and theories on how social roles and routines relate to alcohol use may provide some explanation as to why some groups experienced sustained increases and others attenuated increases in the frequency of alcohol use during the initial phases of the COVID-19 pandemic. These theories may be especially relevant when results are at odds with a drinking-to-cope framework [13, 14], which has been the predominant justification for studies focused on alcohol consumption during the pandemic. Among the groups experiencing adjustments to roles and routines inconsistent with drinking were women and young adults. Parents, especially women, took on more responsibilities for younger children who could not go to daycare and those conducting schooling at home [15]. Some college students and other young adults found themselves living back at home with parents and having fewer opportunities to drink [16]. Conversely, COVID-19 impacts on higher socio-economic status (SES) individuals and older adults indicated transitions who relaxed the daily structure of their lives and disrupted their work and leisure routines. Many workers with college degrees and higher incomes transitioned to telework, which potentially resulted in more time available for drinking, while essential and lower-income workers continued to work outside the home which potentially continued to limit the frequency of their alcohol use [17]. More older adults reported being unable to enjoy their normal routines because of COVID-19 and found themselves more isolated at home [12], with potentially less social control of more problematic drinking behaviors. Without clear measures of drinking quantity, however, we do not know from this study whether those groups that continued in structured activities throughout the pandemic reported more stress and perhaps more heavy episodic drinking on the limited days each week when they were free from obligations. It is important to consider the variety of mechanisms, including stress and mental health as well as other possible explanations related to changes in social roles and routines, as these may suggest different prevention targets for specific social groups in future pandemic or crisis scenarios. K.C. is an Associate Editor of the Addiction journal. She has no financial or other relevant links to companies with an interest in the topic of this article. K.K.-J. has no financial or other relevant links to companies with an interest in the topic of this article.