Abstract
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, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We 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 23rd March to 31st December 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.
Highlights
During 2020, COVID-19 mitigation measures were put in place in Great Britain (England, Scotland and Wales) in an attempt to control the spread of the virus and limit its impact on public services
Many studies have suggested that COVID-19 confinements and other mitigation measures have led to reporting of increased mental health problems, including anxiety and depression [4, 5]
Using British household data for the six years 2015 to 2020, we study the impact of COVID-19 on alcohol purchases and consider the extent to which any changes varied over time and by household characteristics, such as age of main shopper, household income, social grade, area of residential deprivation and how much alcohol households normally purchased
Summary
During 2020, COVID-19 mitigation measures were put in place in Great Britain (England, Scotland and Wales) in an attempt to control the spread of the virus and limit its impact on public services. The level and geographic scope of restrictions varied considerably over the year, from the initial national ‘lockdown’ implemented at the end of March, with some relaxation during May and June, to ongoing restrictions for the rest of the year that differed across and within England, Scotland and Wales, in terms of non-essential travel, social gatherings, and openings and controls on a large range of retail, hospitality and leisure outlets [1,2,3], Table 1. From July onwards, restrictions varied according to local authority and devolved status (England, Scotland or Wales), affecting the size and type of social gatherings, and whether, where and when on-trade alcohol sales could take place, i.e., outside or inside the premises, at the bar or only at tables, and in terms of licencing hours. Analyses of off-trade purchase and sales data [10, 11] found no increase in purchases or sales, when taking into account foregone purchases due to pub closures
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