Article

Alcohol use among young Australian adults in May‐June 2020 during the COVID‐19 pandemic: a prospective cohort study

June 2021
Addiction 116(12)

DOI:10.1111/add.15599

Authors:

Philip James Clare

The University of Sydney

Alexandra Aiken

UNSW Sydney

Wing See Yuen

UNSW Sydney

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Aims To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. Design Prospective longitudinal cohort Setting Secondary schools in New South Wales, Tasmania, and Western Australia. Participants Subsample of a cohort (n=443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in Sep 2017 – July 2018, Sep 2018 - May 2019 and Aug 2019 - Jan 2020), and in May-June 2020. Measurements The primary predictors were time, gender, and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm, and drinking contexts. Findings Overall consumption (frequency x quantity) during the restrictions declined by 17% (incidence rate ratio [IRR] 0.83; 95% confidence interval [CI] 0.73, 0.93), compared to February 2020, and there was a 34% decline in the rate of alcohol-related harms in the same period (IRR 0.66; 95% CI 0.55, 0.80). Changes in alcohol consumption were largely consistent by gender. Conclusions From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.

Beyond Confinement: A Systematic Review on Factors Influencing Binge Drinking Among Adolescents and Young Adults During the Pandemic

Article

Full-text available

Feb 2025

Objectives: This study aimed to enhance the understanding of factors influencing changes in binge drinking (BD) behavior during the COVID-19 pandemic, with a particular focus on its impact on the health of individuals aged 12 to 25 years. Methods: A systematic review was conducted, encompassing studies published between January 2020 and September 2024. Articles were retrieved from PubMed, Web of Science, and Scopus, following PRISMA guidelines and the Joanna Briggs Institute (JBI) review protocols. Inclusion criteria targeted studies focusing on BD during the COVID-19 pandemic in adolescents or school-aged individuals without specific medical conditions. Exclusions included studies limited to a single gender, ethnicity, or profession, as well as doctoral theses and editorials. JBI tools were used to assess the quality of the selected studies. Results: From 33 studies (19 cross-sectional and 14 longitudinal), trends in BD during the pandemic varied: 2 studies reported an increase, while 21 indicated a decrease. Key factors linked to increased BD included pandemic stressors (e.g., isolation, social disconnection and non-compliance with restrictions), psychosocial issues (e.g., depression, anxiety, boredom, and low resilience), prior substance use, and sociodemographic variables (e.g., low education, economic extremes, living arrangements, and limited family support). Female gender and academic disengagement were also risk factors. Conversely, factors like stay-at-home orders, fear of contagion, family support, studying health sciences, and resilient coping strategies contributed to reduced BD. Other variables, such as pandemic stress and self-efficacy, had inconsistent effects. Conclusions: Factors contributing to increased BD included pandemic-related stress, mental health conditions, and unhealthy habits, while protective factors included stay-at-home orders, social support, and resilient coping. The study highlights the need for effective prevention and intervention strategies, emphasizing a holistic approach in healthcare, early detection, and tailored interventions, particularly for vulnerable groups such as adolescents.

The Effect of COVID-19 Restrictions on Calls for Service on Drugs, Alcohol, and Mental Health

Article

Dec 2024
Am J Crim Justice

This study tested the effect of COVID-19 restrictions on calls for service related to drugs, alcohol, and mental health. The calls for service regarding these outcomes before, during, and after COVID-19 restrictions were aggregated into daily counts (N = 3,213). Two different measures, including count and rate, were used for these outcomes. The results of the multivariate analyses, which included negative bino-mial regression for the count measures, ordinary least squares (OLS) regression for the rate measures, and daily interrupted time series analyses, indicated that calls related to drugs and mental health significantly increased during the COVID-19 restrictions. However, while alcohol-related calls also increased, this rise was not statistically significant. The limitations and implications of the study are discussed.

The Frequency and Predictive Factors of Change in Alcohol Consumption during the COVID-19 Pandemic: Results from a Multi-Country Longitudinal Study

Article

Full-text available

Aug 2024

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at different time waves: T1 = 22 April–1 June 2020; T2 = 2 May–29 June 2021 and T3 = 29 April–25 June 2022. The surveys included questions on self-reported retrospective alcohol consumption, demographics, health, anxiety and depression symptoms and recent life events. Results: Of 4999 respondents, most (82.3%) reported no change in drinking habits during the pandemic, whereas 12.5% reported drinking less and 5.1% drinking more. Predictive factors for increased alcohol consumption include age 35–54 years, male gender, high educational level, moderate-severe depression symptoms, excessive drinking before the COVID-19 pandemic, no change in general health status and job loss. Predictive factors for decreased alcohol consumption were age 18–34 years, male gender, having chronic disease(s), moderate-severe depression symptoms, excessive drinking before the pandemic and job loss. Conclusion: The proportion of participants who reported a decrease in alcohol consumption during the COVID-19 pandemic was higher compared to those who reported an increase. Excessive drinking before the pandemic, depression symptoms and job loss were predictors for both drinking more and drinking less alcohol during the COVID-19 pandemic with an stronger association for an increase in alcohol consumption.

A review of factors influencing drinking behaviours in young Australian adults using a behavioural framework approach

Article

Oct 2023

Issues Young adults (aged 18–24 years) are more likely to binge drink than any other age group in Australia. These behaviours expose young adults to possible adverse events, with potential for acute harms. Approach A behavioural framework (capability, opportunity, motivation—behaviour [COM‐B model]) was used to explore factors that influence the drinking behaviours of young Australian adults. Potential studies were identified by searching four online data bases. Content pertaining to factors moderating young adults' alcohol consumption behaviours (either increasing or decreasing alcohol consumption) in an Australian population was extracted. Factors were then categorised/mapped into the six sub‐components of the COM‐B model. A narrative synthesis/discussion was subsequently undertaken. Key Findings Factors increasing or reducing alcohol consumption behaviours were identified across all components of the COM‐B model. Overall, alcohol consumption behaviours appear strongly influenced by physical and social opportunities, and young adults have reflective and automatic motivations (i.e., habitual processes, emotional responding and analytical decisional making that directs behaviour) to consume alcohol with purpose and/or reason. Implications and Conclusion The use of a behavioural framework (e.g., the COM‐B model) facilitates an integrated understanding of factors influencing alcohol consumption behaviours. Future harm minimisation strategies need to consider the interrelated, contemporary factors underpinning a young adult's decision to consume alcohol within the context of modern Australian society.

Hazardous alcohol use among Danish adolescents during the second wave of COVID-19: Link between alcohol use and social life

Article

Full-text available

Jan 2023

Background: Adolescent drinking has historically been closely linked to social events, and across many countries, students typically increase drinking rates when they transition to upper secondary school. COVID-19-related restrictions offered a unique possibility to examine how changes in social life impact adolescent drinking in the transition to upper secondary school. Aim: The current study investigated changes in hazardous alcohol use, social life and well-being among Danish first-year students (mean age = 16.8 years) during the second wave of the COVID-19 pandemic when restrictions gradually became more intensified. Methods: Data were collected at two time points among 352 Danish students in the first months of upper secondary school (August and November 2020). Multilevel regression models tested changes across time on past 30 days hazardous alcohol use (dependent variables). Separate models tested whether changes in alcohol use were related to gender, social interaction, loneliness and mental health. Results: During increased COVID-19-related restrictions in the second wave, students decreased the frequency and quantity of drinking (number of drinking days and binge drinking), which was associated with attending fewer parties. Students also reported less high-intensity drinking and fewer alcohol-related consequences. Students reported better mental health, but more students were affected by loneliness. Changes in mental health or loneliness were not related to reduced hazardous alcohol use. Conclusion: Our results provide evidence that alcohol use decreased among Danish students transitioning to upper secondary school during the COVID-19 pandemic when restrictions increased, thereby providing support for a close link between adolescent alcohol use and social life; this is an important frame that is relevant when designing interventions to promote healthier and less risky choices throughout the next phase(s) of the pandemic and in general.

Longitudinal and self‐attributed change in alcohol use among young adults during the COVID‐19 pandemic in Australia

Article

Full-text available

Jan 2023

Introduction: The COVID-19 pandemic introduced a unique concern regarding the potential for pandemic-related increases in alcohol use. However, most studies which have measured pandemic-related changes to date utilise self-attribution measures of changes in alcohol use using cross-sectional designs, which rely on accurate self-attributions for validity. There has been minimal investigation of correspondence of self-attributed and longitudinally measured changes in alcohol use during the pandemic. The current study seeks to examine this correspondence. Methods: A total of 856 participants originally recruited from Australian secondary schools completed follow-up surveys of an ongoing study at two timepoints (2018-2019, mean age 18.6 and 2020-2021, mean age 19.9; 65.3% female). Alcohol use was measured as any drinking (1+ drinks) and binge drinking (5+ drinks) frequency in the past 6 months. The correspondence and relationship between 'longitudinal change' measured from the first to the second timepoint and 'self-attributed change' measured at the second timepoint were examined. Results: For both any drinking and binge drinking frequency, moderate correspondence was observed between self-attributed and longitudinal change in drinking (37.1% and 39.3%). Most participants with longitudinal increases in any drinking or binge drinking frequency failed to correctly self-attribute this increase. Discussion and conclusions: The findings suggest that self-attributed increases do not correspond well with longitudinally measured increases in pandemic-related drinking and may underestimate increases measured longitudinally. Method of measurement needs to be taken into account if data are to be used to identify sub-groups at risk of alcohol use increases and facilitate appropriate direction of public health efforts.

Factors Associated with Self-Reported Changes in Alcohol Use among Young Adults during the COVID-19 Pandemic: A Comparative Analysis between Canada and France

Article

Full-text available

Dec 2022
Int J Environ Res Publ Health

While the COVID-19 pandemic impacted young adults’ alcohol use patterns, little is known about how changes in alcohol use may differ across different settings. Our objective was to identify and compare factors associated with changes in alcohol use among young adults in Canada and France during the first year of the COVID-19 pandemic. We conducted an online cross-sectional survey in October–December 2020 with young adults aged 18–29 (n = 5185) in Canada and France. In each country, weighted multinomial logistic regressions were performed to identify factors associated with self-reported decrease and increase in alcohol use separately (reference: no change). Respectively, 33.4% and 21.4% reported an increase in alcohol use in Canada and France, while 22.9% and 33.5% reported a decrease. Being 25–29 was a predictor of decrease in Canada, while living away from family was associated with an increase in France. In both countries, participants were more likely to report an increase if they reported depressive symptoms, smoking tobacco, or cannabis use. Conversely, those who had been tested for COVID-19 and those who were highly compliant with COVID-19 preventive measures were more likely to report a decrease. Efforts are needed to develop alcohol use interventions for young adults, including in ways that prioritize those with mental health challenges.

Alcohol use contexts (social settings, drinking games/specials, and locations) as predictors of high‐intensity drinking on a given day among U.S. young adults

Article

Full-text available

Dec 2022

Background This study examined whether variability in young adult drinking social settings, drinking games/drink price specials, and locations differentiated daily high‐intensity drinking (HID) likelihood; whether contexts varied by legal drinking age and college status (attending a 4‐year college full‐time); and whether legal drinking age and college status moderated drinking context/intensity associations. Methods Participants (n = 818 people, 46.3% female) were part of the Young Adult Daily Life Study in 2019 to 2022. They were originally selected because they were past 30‐day drinkers from the 2018 U.S. national probability Monitoring the Future 12th grade sample and because they reported one or more days of alcohol use during 14‐day data collection bursts across the following 4 years (n = 5080 drinking days). Weighted multilevel modeling was used to estimate drinking context/intensity associations. Drinking intensity was defined as moderate (females 1 to 3, males 1 to 4 drinks), binge (4 to 7, 5 to 9 drinks), or HID (8+, 10+ drinks). Models controlled for other within‐person (weekend, historical time period) and between‐person (sex and race/ethnicity) covariates. Results Contexts differentiating HID and binge drinking days included drinking with large groups, strangers, pregaming, drinking games, and more drinking locations. Legal drinking age was associated with lower odds of free drinks but greater odds of drinking at bars/restaurants. College status was associated with lower odds of drinking alone or free drinks, but greater odds of drinking with friends, large groups, pregaming, drinking games, discounted price drinks, and at bars/restaurants, parties, and more drinking locations. Legal drinking age and college status moderated some context‐intensity associations. Conclusions Social settings, pregaming, drinking games, and drinking at more locations were associated with increased risk of HID on a given day. Legal drinking age and college status were associated with specific drinking contexts and moderated some context/intensity associations. Incorporating the contexts associated with HID into interventions may help to reduce HID and related consequences in young adults.

COVID-19 Lockdown Effects on Mood, Alcohol Consumption, Academic Functioning, and Perceived Immune Fitness: Data from Young Adults in Germany

Article

Full-text available

Sep 2022

Recently, a study was conducted in the Netherlands to evaluate the impact of the coronavirus disease (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates, such as alcohol consumption. The Dutch study revealed that lockdowns were associated with significantly poorer mood and reductions in perceived immune fitness. Overall, a reduction in alcohol consumption during lockdown periods was shown. Academic functioning in terms of self-reported performance was unaffected. However, a significant reduction in interactions with other students and teachers was reported. However, there was considerable variability among students; both increases and reductions in alcohol consumption were reported, as well as both improvements and poorer academic functioning during periods of lockdown. The aim of the current online study was to replicate these findings in Germany. To achieve this, a slightly modified version of the survey was administered among young adults (aged 18 to 35 years old) in Germany. The survey assessed possible changes in self-reported academic functioning, mood, and health correlates, such as smoking and alcohol consumption, perceived immune functioning, and sleep quality during periods of lockdown as compared to periods with no lockdowns. Retrospective assessments were made for five periods, including (1) ‘BP’ (the period before the COVID-19 pandemic), (2) ‘L1’ (the first lockdown period, March–May 2020), (3) ‘NL1’ (the first no-lockdown period, summer 2020), (4) ‘L2’ (the second lockdown, November 2020 to May 2021), and (5) ‘NL2’ (the second no-lockdown period, summer 2021). This article describes the content of the survey and the corresponding dataset. The survey was completed by 371 participants. Dataset: The dataset is submitted as a Supplementary File. Dataset License: CC0.

Changes in alcohol use during the COVID‐19 pandemic and previous pandemics: A systematic review

Article

Full-text available

Apr 2022
ALCOHOL CLIN EXP RES

The objective of this study is to summarize the research on the relationships between exposure to the COVID‐19 pandemic or previous pandemics and changes in alcohol use. A systematic search of Medline and Embase was performed to identify cohort and cross‐sectional population studies that examined changes in alcohol use during or following a pandemic compared to before a pandemic occurred. Outcomes examined included differences in the volume and frequency of alcohol consumption and the frequencies of heavy episodic drinking (HED) and alcohol‐related problems during a pandemic compared to before a pandemic. Quality assessment was performed using the Cochrane Risk of Bias Tool for Nonrandomized Studies. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The search yielded 672 articles; 27 were included in the narrative review, of which 6 were cohort studies (all from high‐income countries). A total of 259,188 participants were included. All cohort studies examined the impact of COVID‐19 and associated pandemic‐related policies, including social distancing and alcohol‐specific policies, on alcohol use. Cohort studies demonstrated a consistent significant decrease in total alcohol consumption (Australia) and a significant increase in the frequency of alcohol use (United States). A significant decrease in the frequency of HED was observed in Australia and Spain but not in the United States. A significant increase in the proportion of people with problematic alcohol use was observed in the United Kingdom. Initial insights into changes in alcohol use indicate substantial heterogeneity. Alcohol use may have decreased in some countries, while HED and the proportion of people with problematic alcohol use may have increased. The lack of high‐quality studies from low‐ and middle‐income countries reflects a dearth of information from countries inhabited by most of the world's population.

Alcohol use and the COVID-19 pandemic: Historical trends in drinking, contexts, and reasons for use among U.S. adults

Article

Full-text available

Mar 2022

Objective The current study used U.S. national data to examine drinking trends prior to and during the COVID-19 pandemic in 2020, focusing on changes in U.S. young- and middle-adult alcohol prevalence, frequency, and drinking contexts and reasons, and whether they differed by age and college status. Methods Data from 2015 to 2020 from 16,987 young adults (ages 19–30) and 23,584 middle adults (ages 35–55) in the national Monitoring the Future study were used to model historical trends and potential 2020 shifts (data collection April 1 to November 30, 2020) in prevalence (30-day, daily, binge drinking) and frequency (30-day, binge drinking). For young adults, data on drinking contexts and negative affect reasons for drinking were examined. Moderation by age and college status was also tested. Results 2020 was associated with (1) downward deviation in 30-day (young and middle adults) and binge drinking (young adults) prevalence; (2) upward deviation in daily drinking prevalence (middle adults); (3) among drinkers, upward deviation in frequency of 30-day (young and middle adults) and binge drinking (young adults); and (4) changes in drinking contexts and reasons among drinkers. Among college students, in particular, 2020 was associated with a downward deviation from expected historical trends in drinking prevalence. Upward deviations in daily prevalence and both binge and 30-day drinking frequency were stronger at ages 25–30 (vs. 19–24) and 35–45 (vs. 50–55). Conclusions Among U.S. young and middle adults, deviations from expected historical trends in population alcohol use that occurred during the pandemic included decreases in alcohol use prevalence, increases in alcohol frequency, and increases in the use of alcohol to relax/relieve tension and because of boredom. These shifts were likely due, in part, to increased drinking while alone and at home—which increased during the pandemic.

A Remote Questionnaire-Based Study to Compare Alcohol Use in 1030 Final-Year High School Students in Split-Dalmatia County, Croatia Before and During the National Lockdown Due to the COVID-19 Pandemic

Article

Full-text available

Jan 2022
MED SCI MONITOR

Background The COVID-19 pandemic affected drinking behaviors among adolescents. This remote questionnaire-based study aimed to compare alcohol use in 1030 final-year high school students in Split-Dalmatia County (SDC), Croatia before and during the national lockdown due to the COVID-19 pandemic. Material/Methods An online self-reported questionnaire survey was conducted among 1030 final-year high school students (57.96% female; mean age 17.71 years, SD=0.66) in SDC. The data were collected from June 6 to July 20, 2020 and from October 12 to December 28, 2020. Differences in drinking habits between groups were detected with the chi-squared (χ²) test and before and during the COVID-19 lockdown using the Z test. Results Before the lockdown, 84.66% of students were consuming alcohol, most frequently with friends (78.64%) and “to feel better” (29.51%), while during the lockdown, 44.76% of them were drinking, most frequently with friends (34.37%) and due to boredom (17.48%). Drinking alone (P=0.005) and with family members (P=0.003) significantly increased during the lockdown. No difference in drinking between girls and boys was found before the lockdown, but boys were drinking more during the lockdown (P<0.001). There was no difference in drinking prevalence in different schools before the lockdown, but during the lockdown, more students from vocational schools were drinking (P<0.001) and with higher frequency (P=0.002). Among 53.98% of students during the lockdown, a reduction in frequency of drinking was found (P<0.001), most significantly on islands (P=0.05). Conclusions During the lockdown due to the COVID-19 pandemic, alcohol consumption by final-year high school students in SDC significantly decreased, particularly in girls and in gymnasium/private school students.

Alcohol home delivery usage and its relationship to alcohol consumption in New South Wales during COVID-19

Article

May 2024

Background: Rapid growth in the use of alcohol home delivery services, combined with increases in home drinking during COVID-19, raises potential concerns around increased consumption. This paper aims to assess the relationship between alcohol home delivery use and consumption across levels of COVID-19 restrictions in New South Wales (NSW), Australia. Methods: A 5-wave longitudinal survey of 586 NSW residents (Mage = 35; 65.3% female) conveniently sampled across 2020. Home delivery usage and the number of daily standard drinks consumed during a typical week were assessed with a survey. Logistic regression models were estimated within each wave to identify predictors of home delivery usage, and hierarchical logistic mixed effects models were estimated to predict purchase source (home delivery vs other) at the occasion level. Results: From baseline, alcohol home delivery use rose significantly during lockdown (20% to 34%), with respondents using home delivery during lockdown and the partial re-opening wave consuming significantly more than those who were not. Use of home delivery was significantly higher during lockdown and the partial re-opening amongst people who drank more heavily, with respondents aged 36 or older more likely to use delivery services in all waves except lockdown. Conclusions: Alcohol home delivery usage increased during lockdown suggesting restrictions impeding on-premise consumption coincided with an increase in home delivery. Associations between persons who drink more heavily and use of home delivery during lockdown and the partial re-opening suggest a subset of the population that may be at increased risk of harmful consumption when accessing alcohol delivery services.

Exploring the relationship between solitary drinking and living without other adults on alcohol consumption during the COVID-19 pandemic

Article

Full-text available

Mar 2024

Aims The COVID-19 pandemic presents the opportunity to learn about solitary drinking as many people were forced to spend time at home. The aim of this study is to examine the relationship between solitary drinking and living without other adults on alcohol consumption. Methods A longitudinal study with four survey waves (between May and November 2020) obtained seven-day drinking diary data from Australian adults living in New South Wales. In May, a convenience sample of 586 participants (Mage = 35.3, SD = 14.8; 65.3% women) completed the first wave. Participants then completed a survey in June (n = 319, 54.4% response rate), July/August (n = 225, 38.4% response rate), and November (n = 222, 37.9% response rate). Information about alcohol consumption including risky drinking (more than four drinks on one occasion), household structure, solitary drinking, and demographics were collected. We conducted random-effects panel bivariate and multivariable regression analyses predicting the number of standard drinks and risky drinking. Results Participants with solitary drinking occasions consumed more and had more risky drinking occasions than participants with no solitary drinking occasions, which was also found to be the case during lockdown. Living without other adults was associated with less consumption and less risky drinking than living with other adults. However, participants who lived without other adults and had frequent solitary drinking occasions (solitary drinking in >50% drinking occasions) reported more consumption than participants without a solitary drinking occasion. Conclusions Individuals who consume alcohol alone and live without other adults or spend long periods of time at home may be more at risk of alcohol-related harm.

Alcohol Misuse Among Youth Living With and at High Risk for Acquiring HIV During the COVID-19 Stay-at-Home Orders: A Study in Los Angeles and New Orleans

Article

Feb 2023

Background To slow the spread of the COVID-19 virus, governments across the globe instituted stay-at-home orders leading to increased stress and social isolation. Not surprisingly, alcohol sales increased during this period. While most studies primarily focused on alcohol consumption among college students or adults, this study investigates alcohol misuse among marginalized youth in the USA. We examined risk factors associated with hazardous alcohol use and binge drinking including risk behaviors, life stressors and demographic characteristics. Methods In October 2020, youth living with or at high risk for acquiring human immunodeficiency virus (HIV), participating in community-based research to improve HIV prevention and care, were invited to complete an online survey to assess the impact of the stay-at-home orders on multiple aspects of their daily life. Results Respondents (n = 478) were on average 23 years old; cisgender (84%), not-heterosexual (86.6%), Latino or Black/African American (73%) and assigned male at birth (83%); 52% reported being employed and 14% reported living with HIV. White participants and those who use drugs had higher odds of hazardous alcohol use and binge drinking, compared with other race categories and non-drug users, respectively. Conclusion Contrary to findings from adult studies, we did not observe an increase in hazardous or binge drinking among youth at risk for HIV. Hazardous alcohol use and binge drinking was more likely among White participants, those who use drugs and those who were hazardous/binge drinkers prior to the COVID-19 lockdown, which points to the importance of identifying and treating youth who misuse alcohol early to prevent future alcohol misuse.

Alcohol use among Australian parents during the COVID-19 pandemic – April-2020 to May 2021

Article

Nov 2022
ADDICT BEHAV

Aims This study examined the trajectory of alcohol use frequency among parents from April-2020 to May-2021 during the COVID-19 pandemic in the state of Victoria, Australia (who experienced one of the longest lockdowns in the world), compared to parents from the other states of Australia (who experienced relatively fewer restrictions). We further examined the extent to which baseline demographic factors were associated with changes in alcohol use trajectories among parents. Method: Data were from the COVID-19 Pandemic Adjustment Survey (2,261 parents of children 0-18 years). Alcohol use frequency was assessed over 13 waves. Baseline demographic predictors included parent gender, age, speaking a language other than English, number of children, partnership status, education, employment, and income. Results: Overall, alcohol trajectories declined over time. Victorian parents, in comparison to parents from other states, reported a smaller reduction in alcohol use frequency across 2020, with a more notable decline during 2021. Female/other gender, speaking a language other than English at home, unemployment, and lower income (Victoria only) were associated with alcohol trajectories of less frequent use, and older age was associated with a trajectory of more frequent use. Conclusions: Results suggest subtle difference in alcohol trajectories reflecting COVID-19 restrictions, when comparing Victoria and other states in Australia. Socioeconomically advantaged groups were most at risk for elevated trajectories of alcohol use frequency. Population level support may beneficial to reduce drinking behaviours.

Examining the relationship between alcohol consumption, psychological distress and COVID-19 related circumstances: An Australian longitudinal study in the first year of the pandemic

Article

Jul 2022
ADDICT BEHAV

Objective The aim of this study is to examine the relationship between alcohol consumption, psychological distress and COVID-19 related circumstances (being in lockdown, working from home, providing home-schooling and being furloughed) over the first eight months of the pandemic in Australia. Method A longitudinal study with six survey waves over eight months with a convenience sample of 770 participants. Participants were aged 18 or over, lived in Australia and consumed alcohol at least monthly. Demographic data was obtained in the first wave. Data on alcohol consumption, psychological distress (Kessler 10), and COVID-19 related circumstances (being in lockdown, working from home, providing home-schooling and being furloughed) were obtained in each survey wave. Results Results from the fixed-effect bivariate regression analyses show that participants reported greater alcohol consumption when they had high psychological distress compared to when they had low psychological distress. Meanwhile, participants reported greater alcohol consumption when they worked from home compared to when they did not work from home. Participants also reported greater alcohol consumption when they provided home-schooling compared with when they did not provide home-schooling. The fixed-effect panel multivariable regression analyses indicated a longitudinal relationship between higher psychological distress and providing home-schooling on increased alcohol consumption. Conclusion Broader drinking trends during the COVID-19 pandemic typically indicate increases and decreases in drinking among different members of the population. This study demonstrates that in Australia, it was those who experienced psychological distress and specific impacts of COVID-19 restrictions that were more likely to increase their drinking.

Alcoholic Consumption of Young Italians During the SARS-CoV-2 Pandemic

Article

Jun 2022

Background The international health emergency caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which, at the end of 2019, hit the world, forced the governments of all countries to adopt stringent restrictive measures to contain the spread of the virus. Several studies have revealed worsening levels of anxiety, depression and perceived stress related to these restrictions and the resulting lifestyle changes. Some studies have also confirmed the presence of a relationship between SARS-CoV-2-related emotional distress and drinking behavior. Indeed, is a well-known fact that alcohol consumption is one of the behavioral strategies used to reduce negative emotional states. However, it was documented that young people developed different responses to alcohol use during the pandemic than adults. Objective The aim of this work was to investigate the consumption habits of young Italians and how the consumption and purchase of alcoholic beverages have changed following the pandemic. New ways of drinking alcohol were also interesting to observe, such as online. Methods Young people between 18 and 35 years old were subjected to an anonymous questionnaire of 22 questions on the adoption of forms of behavior at risk through alcohol consumption, on the quantity and occasions of preferential consumption, and on the methods and quantities of alcoholic beverage purchase, before and during the SARS-CoV-2 pandemic. The subjects who declared themselves "non-drinkers" were not included in the statistical survey. Results About 33% of the enrolled "drinkers" (268/823), adopted risky forms of alcoholic behavior. Males reported a higher average habit of drinking wine or alcohol (M = 1.9953 ± 1.39743, F = 1.7373 ± 1.36688, p <0.005); an increased frequency of drinking (M = 2.3025 ± 0.80610 F = 2.0494 ± 0.75043 p <0.001); a higher average number of drinks consumed (M = 1.5182 ± 0.85646, F = 1.2618 ± 0.53292, p <0.001) and binge drinking to the greatest extent (M = 1.1933 ± 0.96522 F = 0.8176 ± 0.85446 p <0.001). Education and employment were significantly correlated with the frequency of alcohol consumption (r = 0.107 p <0.005 and r = 0.120 p = 0.001 respectively). Subjects reported buying alcoholic beverages during the pandemic with a frequency of "less than once a month" (N = 291, 35.36%) and mainly in shops (N = 556, 67.56%), while before the pandemic they mainly bought alcohol once a week (N = 431, 52.37%) and predominantly in bars / clubs (N = 619, 75.21%). New ways of drinking alcohol such as online drinking, have not been significantly identified. Conclusion A change in alcohol consumed and alcohol purchased before and during the SARS-CoV-2 pandemic was revealed.

Changes in Emerging Adults’ Alcohol and Cannabis Use From Before to During the COVID-19 Pandemic: Evidence From a Prospective Birth Cohort

Article

Full-text available

Feb 2022

Objective: Prospective research is needed to better-understand changes in substance use from before to during the coronavirus disease (COVID-19) pandemic, among emerging adults (18–25 years), a high-risk group for substance use. Method:N = 1,096 (weighted sample N = 1,080; 54% female) participants enrolled in the Québec Longitudinal Study of Child Development, who completed prepandemic (2019; 21 years) and COVID-19 (mid-March to mid-June 2020) surveys. COVID-19-related and preexisting factors were examined as moderators of change in substance use. Results: Full sample analyses revealed decreased binge drinking (p < .001, Bayes factor [BF] = 22, Cohen’s f² = 0.02), but no changes in alcohol and cannabis use. Stratified analyses revealed emerging adults who reported <monthly use prepandemic increased their alcohol use (p < .001, BF > 150, f² = 0.05) and binge drinking (p < .001, BF = 27, f² = 0.01), but not their cannabis use. Conversely, emerging adults who reported >monthly use prepandemic decreased their binge drinking (p < .001, BF > 150, f² = .12) and cannabis use (p < .001, BF > 150, f² = .06), but did not change their alcohol use frequency. Several factors moderated change in substance use, including employment loss (p = .005, BF > 39, f² = .03) and loneliness (p = .018, BF > 150, f² = .10) during COVID-19. Conclusions: Changes in alcohol and cannabis use frequency among emerging adults in the first 3 months of COVID-19 largely differed according to prepandemic substance use, COVID-19-related factors, and preexisting factors. While some youth with preexisting vulnerabilities (e.g., more frequent substance use prepandemic) remained stable or decreased their substance use during COVID-19, emerging adults who experienced employment loss, loneliness, and financial concerns during COVID-19 increased their substance use, highlighting the need for increased supports for vulnerable populations.

A longitudinal study of alcohol consumption among adults in Victoria, Australia during the COVID-19 pandemic

Article

Full-text available

Dec 2024
PLOS ONE

Objectives Whilst public health measures were effective in reducing COVID-19 transmission, unintended negative consequences may have occurred. This study aims to assess changes alcohol consumption and the heavy episodic drinking (HED) during the pandemic. Methods Data were from the Optimise Study, a longitudinal cohort of Australian adults September 2020–August 2022 that over-sampled priority populations at higher risk of contracting COVID-19, developing severe COVID-19 or experiencing adverse consequences of lockdowns. Frequency of alcohol consumption (mean number of days per week) and past-week HED were self-reported. Generalised linear models estimated the association between time and (1) the frequency of alcohol consumption and (2) heavy episodic drinking. Results Data from 688 participants (mean age: 44.7 years, SD:17.0; 72.7% female) and 10,957 surveys were included. Mean days of alcohol consumption per week decreased from 1.92 (SD: 1.92) in 2020 to 1.54 (SD:1.94) in 2022. The proportion of participants reporting HED decreased from 25.4% in 2020 to 13.1% in 2022. During two lockdown periods, known as “lockdown five”, (OR:0.65, 95%CI [0.47,0.90]) and “lockdown six” (OR:0.76, 95%CI [0.67,0.87]), participants were less likely to report HED. Conclusions Participants alcohol drinking frequency and HED decreased during the pandemic. This study provides a strong description of alcohol consumption during the pandemic and suggests that lockdowns did not have the unintended consequences of increased alcohol consumption.

Impact of personalized alcohol intake and cognitive feedback on alcohol use behavior in hazardous drinkers: A quasi‐randomized trial

Article

Full-text available

Jul 2023

Background Worldwide, alcohol use is a major contributor to the burden of disease and mortality. A sizeable literature suggests that brief web‐based interventions that incorporate personalized normative and/or health consequences feedback are effective at reducing alcohol intake. The relative efficacy of an intervention that also includes individualized feedback about brain health has not been examined, nor has the utility of integrating a smartphone app component. Method Participants (N = 436, Mage = 21.27) completed baseline protocols (n = 178 recorded alcohol use via an app for 14 days) and were then assigned to one of three feedback conditions using randomized block allocation with stratification based on the total number of standard drinks consumed. Control participants received no feedback; Alcohol Intake Feedback (Alc) participants received personalized information about their alcohol use; Alcohol Intake plus Cognitive Feedback (AlcCog) participants received personalized details about alcohol use plus individualized brain‐health information related to impulsivity. The impact of feedback on alcohol consumption behavior was examined as a function of feedback condition and hazardous/non‐harmful drinking status (as defined by the World Health Organization) at an 8‐week follow‐up. Results Hazardous drinkers in both the Alc and AlcCog conditions reduced their alcohol intake by 31% to 50% more than those in the Control condition. Reductions were not related to whether participants completed web‐ plus app‐based components or web‐only components of the intervention. There was no change in the alcohol intake of non‐harmful drinkers. Conclusions This proof‐of‐concept study showed that hazardous drinkers respond well to brief electronic interventions that incorporate personalized normative and/or health consequences feedback. Further research is required to determine how best to make impulsivity‐related brain‐health consequences of drinking manifest and how to maximize the potential of smartphones apps.

Assessing the effects of COVID-19 restrictions on alcohol consumption in Melbourne, Australia using high-resolution wastewater sampling

Article

Jun 2023
SCI TOTAL ENVIRON

The impact of the COVID-19 pandemic and related restrictions on alcohol consumption in Australia remains unclear. High-resolution daily samples from a wastewater treatment plant (WWTP) which served one of the largest cities in Australia, Melbourne, were analysed for temporal trends in alcohol consumption under extended periods of COVID-19 restrictions in 2020. Melbourne experienced two major lockdowns in 2020, which divided the year of 2020 into five periods (pre-lockdown, first lockdown, between lockdown, second lockdown and post second-lockdown). In this study, daily sampling identified shifts in alcohol consumption during different periods of restrictions. Alcohol consumption in the first lockdown period, when bars closed and social and sports events ceased, was lower than pre-lockdown period. However, alcohol consumption was higher in the second lockdown period than the previous lockdown period. There were spikes in alcohol consumption at the start and end of each lockdown (except for post lockdown). For most of 2020, the usual weekday-weekend variations in alcohol consumption were less evident but there was a significant difference in alcohol consumption between weekdays and weekends after the second lockdown. This suggests that drinking patterns eventually returned to normal after the end of the second lockdown. This study demonstrates the usefulness of high-resolution wastewater sampling in evaluating the effects on alcohol consumption of social interventions in specific temporal locations.

Alcohol consumption among adolescents during the COVID-19 pandemic, ConVid Adolescents – Behavior Research

Article

Full-text available

Apr 2023
Rev Bras Epidemiol

Objective To describe the prevalence of alcohol consumption before and during the COVID-19 pandemic and to analyze the factors associated with this behavior during the period of social distancing among Brazilian adolescents. Methods Cross-sectional study using data from the ConVid Adolescents survey, carried out via the Internet between June and September 2020. The prevalence of alcohol consumption before and during the pandemic, as well as association with sociodemographic variables, mental health, and lifestyle were estimated. A logistic regression model was used to assess associated factors. Results 9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI 16.64–18.85) before the pandemic to 12.80% (95%CI 11.85–13.76) during the pandemic. Alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9; 95%CI 1.08–1.53), place of residence in the South (OR=1.82; 95%CI 1.46–2.27) and Southeast regions (OR=1.33; 95%CI 1.05–1.69), having three or more close friends (OR=1.78; 95%CI 1.25–2.53), reporting worsening sleep problems during the pandemic (OR=1.59; 95%CI 1.20–2.11), feeling sad sometimes (OR=1,83; 95%CI 1,40–2,38) and always (OR=2.27; 95%CI 1.70–3.05), feeling always irritated (OR=1,60; 95%CI 1,14–2,25), being a smoker (OR=13,74; 95%CI 8.63–21.87) and a passive smoker (OR=1.76; 95%CI 1.42–2.19). Strict adherence to social distancing was associated with lower alcohol consumption (OR=0.40; 95%CI 0.32–0.49). Conclusions The COVID-19 pandemic led to a decrease in consumption of alcoholic beverages by Brazilian adolescents, which was influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle in this period. Managers, educators, family and the society must be involved in the articulation of Public Policies to prevent alcohol consumption. Keywords: Underage drinking; Adolescent; COVID-19; Health surveys; Brazil

Age- and Sex-Varying Associations Between Depressive Symptoms and Substance Use from Modal Ages 35 to 55 in a National Sample of U.S. Adults

Article

Jan 2023

It is important to examine normative age-related change in substance use risk factors across the lifespan, with research focusing on middle adulthood particularly needed. The current study examined time-varying associations between depressive symptoms and alcohol, cigarette, and marijuana use from modal ages 35 to 55 in a national sample of US adults, overall and by sex. Data were obtained from 11,147 individuals in the longitudinal Monitoring the Future study. Participants were in 12th grade (modal age 18) in 1976–1982 and (for the data reported in this study) were surveyed again at modal ages 35 (in 1993–1999), 40, 45, 50, and 55 (in 2013–2019). Weighted time-varying effect modeling was used to examine age-related change in associations among depressive symptoms, any and heavy use of cigarettes, alcohol, and marijuana. Across midlife, greater depressive symptoms were associated with decreased odds of any alcohol use during the 40 s and 50 s, but with increased odds of binge drinking from ages 35–40, and—at most ages—any and pack + cigarette use and any and frequent marijuana use. The association between depressive symptoms and substance use was generally similar for men and women. Results highlight the increased risk for binge drinking, smoking, and marijuana with higher levels of depressive symptoms and underscore the importance of screening and interventions for depressive symptoms and substance use in midlife.

Change in University Student Health Behaviours after the Onset of the COVID-19 Pandemic

Article

Full-text available

Dec 2022
Int J Environ Res Publ Health

Introduction: The COVID-19 pandemic has caused many disruptions in the lives of the population. In particular, the health behaviours of university students were impacted. Thus, the aim of this study was to evaluate the evolution of these behaviours from before the COVID-19 period to May 2021, during which lockdowns or curfews were in effect. Methods: Two retrospective online cross-sectional studies were conducted among university students in Normandy in May 2020 and May 2021. Socio-demographics and academic characteristics were collected. Tobacco smoking, binge drinking, cannabis use, and moderate and vigorous physical activity were collected for the 4 weeks before the COVID-19 lockdown in May 2020 and in May 2021. Results: Overall, 6991 university students were included in the study (3483 in 2020 and 3508 in 2021) with a mean age of 20.8 (standard deviation = 2.5) and 73.4% of women. After logistic regression, binge drinking (occasional and regular), cannabis use (occasional), moderate physical activity (regular), and vigorous physical activity (occasional) decreased in 2020 and 2021 compared to the pre-COVID-19 period. Tobacco smoking (occasional) and vigorous physical activity (regular) decreased only in 2020. Regular tobacco and cannabis use did not change significantly in 2020 and 2021 compared to the pre-COVID-19 period. Discussion: Student health behaviours changed in May 2020 and May 2021 due to the implementation of measures restricting mobility and social interaction. Even if some risky consumption decreased in 2020 after the first lockdown, there was no rebound phenomenon in 2021: consumption either remained lower or similar to the pre-COVID-19 period. These behaviours need to be monitored in the future to assess the long-term effects of these restrictions on student health behaviours.

The impact of COVID-19 on child and adolescent mental health and treatment considerations

Article

Full-text available

Jul 2022
BEHAV RES THER

Patterns and predictors of alcohol use during the early stages of the COVID‐19 pandemic in Australia: Longitudinal cohort study

Article

Full-text available

May 2022
ALCOHOL CLIN EXP RES

Background The COVID‐19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and with public health efforts to manage the outbreak, could result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with different patterns of use. Methods Data were obtained from a longitudinal survey of a representative Australian adult sample (N = 1296, 50% female, Mage = 46.0) conducted from March to June 2020, during the first wave of the COVID‐19 outbreak in Australia. Change in alcohol consumption was examined using Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C) scores from waves one, three, five, and seven of the study, each 4 weeks apart. Factors associated with alcohol consumption were examined, including depression (PHQ‐9) and anxiety (GAD‐7) symptoms, health risk tolerance, stress and coping, work and social impairment (WSAS), COVID impacts, and sociodemographic variables. We tested changes in alcohol use across the full sample using a mixed effects repeated measure ANOVA model and a multinomial logistic regression to identify factors assessed at wave 1 that were independently associated with alcohol use. Results There was no significant change in AUDIT‐C scores across the study. For most participants, alcohol use did not increase during the early phase of the COVID‐19 pandemic in Australia. COVID‐19 exposure, higher perceived coping, depression symptoms, and male gender were associated with greater odds of increasing or elevated levels of alcohol use. Social changes, which included working from home, had mixed effects on alcohol consumption. Conclusions Although no evidence was found for increased alcohol use overall during the early months of the pandemic, several factors were associated with alcohol consumption at risky levels. Greater understanding of motivations for drinking across public and private contexts, along with targeted support for high‐risk groups, could assist in reducing harm associated with alcohol consumption.

Substance Use Among Youth During the COVID-19 Pandemic: a Systematic Review

Article

Full-text available

Jun 2022
Curr Psychiatr Rep

Purpose of Review To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic. Recent Findings The pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Summary Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.

Changes in Secondary Substance Use After the Onset of the COVID-19 Pandemic Among People Who Use Cannabis: Findings From a Web-Based Sample of Adults in the United States

Article

Full-text available

Apr 2022

The coronavirus disease 2019 (COVID-19) pandemic has had widespread impacts on mental health and substance use. Increases in cannabis use have been documented in the United States, but little is known about how other substance use has changed among people who use cannabis. We sought to examine changes in alcohol, tobacco, opioid, and stimulant use during COVID-19 and explore how these changes relate to patterns of cannabis use. Data were obtained from a web-based survey of adults in the United States who use cannabis (n = 1,471) administered in September 2020. Using data reported in retrospective (prepandemic) and time-of-survey assessment periods, we explored changes in the prevalence of regular (≥ weekly) alcohol, tobacco, opioid, and stimulant use during COVID-19 among respondents who used medical and nonmedical cannabis. We used modified Poisson regression to examine cannabis-related correlates of increasing or decreasing secondary substance use during the pandemic. There was a slight but significant increase in ≥weekly alcohol use in the medical use group only (41.4%-47.0%, p = .034). ≥ Weekly tobacco, opioid, and stimulant use did not change significantly. Pandemic-concurrent shifts in secondary substance use depended on interacting cannabis-related factors including medical cannabis use, prepandemic cannabis frequency, and pandemic-concurrent frequency changes. For example, ≥ weekly prepandemic cannabis use was significantly and positively associated with decreasing opioid use frequency among the medical cannabis use group only. Assessments of the pandemic's effects on substance use should consider relationships between cannabis and other substances, which may differ according to cannabis-specific behaviors, motives, and contexts of use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Changes in retrospectively recalled alcohol use pre, during and post alcohol sales prohibition during COVID pandemic in Botswana

Article

Apr 2022
INT J DRUG POLICY

Background The COVID-19 pandemic has seen the implementation of unprecedented legislation and policy, including drug control measures which in some countries, like Botswana, included a temporary full alcohol sales ban. However, the association of such absolute prohibition of alcohol sales on population drinking, including hazardous drinking, during the COVID-19 period has not yet been determined. This study investigated changes in retrospectively recalled alcohol use and hazardous drinking pre (prior 5th August 2020), during (5th August to 3rd September 2020) and post (after 4th September) the second alcohol sales ban in Botswana. Predictors of hazardous drinking across the three time points were also investigated. Methods An online cross-sectional study involving a convenience sample of 1318 adults with a past 12 months drinking history in Botswana was conducted in October 2020 following a month long alcohol sales prohibition. Participants completed a modified Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) alongside demographic questions. Participants were expected to retrospectively recall their alcohol use pre, during and post the second alcohol sales ban. Results The prevalence of alcohol use among participants with a past 12 months drinking history was 91.7% (95%CI= 90.1–93.1) before the second ban, 62.3% (95%CI= 59.7–64.9) during the second ban, and 90.4% (95%CI= 88.7–91.8) after the ban.. Hazardous drinking temporarily decreased by 30% during the second alcohol sales ban, and rose to the pre-ban levels of about 60% after the ban. Significant predictors of hazardous drinking at any of the three time points (pre, during and post the second ban) were being male (AOR ranging from 1.50 to 2.13 for all time points), earning between P3000-P6000 (AOR= 1.69 prior sales ban), being a student (AOR=0.56 during the sales ban), and being employed (AOR= 1.45 post the sales ban). Conclusion The alcohol sales ban was associated with short-lived changes in alcohol consumption and hazardous drinking thereby likely contributed in providing the anticipated and much needed temporary relief to the health system sought by COVID-19 pandemic measures.

Impact of Gambling Supply Reduction During COVID-19 Shutdowns on Gambling Problems and Gambling Behaviour in Australia: A National Longitudinal Study

Article

Full-text available

Jun 2022
J GAMBL STUD

Restricting access to gambling products is one possible harm reduction strategy. We examined whether land-based gambling product supply restrictions during the COVID-19 pandemic impacted gambling problems and gambling engagement. In a three-wave, online, longitudinal study, 462 Australian adults (Mage = 44.94; 87% male) who gambled completed survey measures of demographics, gambling engagement (land-based and online), gambling problems, and psychological distress. Analyses were pre-registered and examined the impacts of restrictions on gambling problems and engagement. During the period of restrictions, there were no significant differences in gambling problems (OR = 0.88 [95%CI 0.55–1.42], p = .610) nor online gambling (B = 4.48 [95%CI-0.40–9.35], p = .071) between states experiencing and not experiencing restrictions. There was a small overall reduction in gambling engagement at 2-(t = 2.03, p = .043) and 5-months (t = 2.37, p = .019) post-restrictions, but no change in gambling problems (t = 1.25, p = .211; t = 1.50, p = .134). Amongst those at moderate-to-high risk of problems at baseline, there were no significant reductions in gambling engagement (t = 0.58, p = .564; t = 1.20, p = .232) or problems (t = 0.92, p = .359; t = 1.53, p = .126) at 2- and 5-months post-restrictions. Findings show only a modest impact of COVID-related supply restrictions on gambling engagement and no impact on gambling problems up to 5 months follow-up. The wide-ranging psychosocial and financial impacts of the pandemic may have overshadowed any potential beneficial effects of the supply restrictions on problem gambling levels. Policies to promote and improve access to problem gambling treatment services are needed even following periods of reduced availability of gambling products.

Alcohol Consumption During the COVID-19 Pandemic: A Critical Review

Article

Mar 2025
HUM PSYCHOPHARM CLIN

Objective The purpose of this systematic review was to summarize the impact of the 2019 coronavirus disease (COVID‐19) pandemic on individuals' alcohol consumption. Methods PubMed was searched to identify relevant studies. Articles were included if they provided information on overall (changes in) alcohol consumption, and factors that may influence alcohol consumption including demographics, socioeconomic status, educational background, living situation, and health status. Following screening, 100 articles were identified and included in this review. Results Overall findings show no change (51%) or a reduction (23%) in alcohol consumption during the COVID‐19 pandemic. However, across countries, on average 1 in 4 individuals reported an increase in alcohol consumption (26%), in particular during the COVID‐19 lockdown periods. Most common correlates of increased alcohol consumption were being female, having a child at home, higher educational level, and poorer mental health (including higher scores for stress, anxiety and depression). Conclusion Although overall alcohol consumption was reduced during the COVID‐19 pandemic, a considerable subpopulation of drinkers increased their alcohol consumption.

Drug use and sexual behavior during COVID-19 lockdown in Australia

Article

Oct 2023
J Subst Use

A cross-sectional study on health behavior changes during COVID-19 among adults in Malaysia

Article

Full-text available

Oct 2024

Introduction COVID-19 has triggered significant disruptions globally, necessitating swift adaptations in individuals’ health behaviors. Methods This cross-sectional study was conducted during Phase Four of Malaysia’s National Recovery Plan and examines how the pandemic has affected health behaviors among adult Malaysians. The study gathered data online using convenience sampling with 1,004 respondents aged 18 and above. The research focused on diverse health domains, including eating habits, physical activity, smoking, alcohol consumption, and sleep patterns. The Wilcoxon Signed Rank test and descriptive statistics were employed to compare health behaviors before and after COVID-19. Results Findings indicate noteworthy shifts in eating behaviors, with increased water and fruit consumption (p < .001). The frequency of home-cooked meals stayed relatively stable despite declining dinner preference and increasing daily snacks. Physical activity declined, marked by increased sedentary behavior and screen time (p < .001). There were differences in the patterns of smoking and alcohol consumption; some had started these behaviors during the pandemic. Notably, intentions to quit smoking among respondents were more prominent than attempts to stop drinking. Respondents’ sleep patterns also changed, with more sleeping fewer than seven hours daily (p < .001). Conclusion The study emphasizes the need for focused interventions to address new challenges by highlighting the impact on health behaviors. As Malaysia navigates the post-pandemic landscape, understanding and mitigating the persisting effects on health behaviors are crucial for promoting overall well-being.

Examining how the first year of the COVID-19 pandemic affected alcohol use in different socio-demographic groups in an Australian representative longitudinal sample

Article

Aug 2024
ADDICTION

Background and aims Research examining how alcohol consumption changed across different socio‐demographic groups during the pandemic has largely relied upon convenience samples recruited after the onset of the COVID‐19 pandemic. The aim of this study was to measure whether the pandemic shifted alcohol consumption in different gender, age and income groups in Australia. Design, setting and participants This was a longitudinal study using four waves (2017–20) of the annual Household, Income and Labour Dynamics in Australia (HILDA) Survey to compare pre‐pandemic consumption (2017–19) with consumption in 2020. A total of 11 636 participants in Australia aged 15 years and older took part. Measurements Participants were asked annually about their alcohol consumption, demographics and income. Findings There was a statistically significant increase in alcohol consumption during the first year of the pandemic [incident rate ratio (IRR) = 1.1, 95% confidence interval (CI) = 1.1, 1.1], largely driven by changes in drinking frequency. We found a significant difference in consumption change from pre‐COVID‐19 to during COVID‐19 for participants aged under 55 years compared with those aged over 55 years. In addition, participants aged 15–34 reported less alcohol consumption during the pandemic than those aged 35 years and older. No significant differences were identified across gender and income groups. Conclusions Alcohol consumption in Australia increased during the first year of the COVID‐19 pandemic. Survey participants aged 55 years and over seemed to be the least impacted by the public health measures introduced during the pandemic, such as the closure of licensed premises.

The impact of the COVID-19 pandemic on dietary behaviors among school-age children, adolescents, and young adults: a systematic review and meta-analysis

Article

Full-text available

May 2024
NUTR REV

Context The COVID-19 pandemic has had a global impact on food security and nutrition, both in the short and long term. The influence on school-age children, adolescents, and young adults may be particularly significant and long-lasting. Objective This systematic review and meta-analysis aimed to quantify the impact of the COVID-19 pandemic on dietary habits among school-age children, adolescents, and young adults worldwide. Data Sources PubMed, Web of Science, and Embase were searched from inception to October 5, 2023. Data Extraction We included observational studies published in English that reported dietary quality scores and dietary intake quantities during and before the COVID-19 pandemic among school-age children, adolescents, and young adults. We included a total of 22 cohort studies and 20 cross-sectional studies of high or moderate quality. Data Analysis We conducted a meta-analysis, expressing dietary quality scores and dietary intake quantities as standardized mean differences (SMD) with 95% confidence intervals (CIs). For studies with low heterogeneity, we used a fixed-effects model; otherwise, we applied a random-effects model. The Newcastle–Ottawa Scale was employed by 2 reviewers independently to evaluate methodological quality. The analysis indicated that, overall, juice intake increased (SMD = 0.12, 95% CI: 0.04 to 0.20), while alcohol consumption reduced during the COVID-19 pandemic (SMD = −0.28, 95% CI: −0.47 to −0.08). However, the age-stratified results varied. Among school-age children, intake of fruit, dairy products, sugar, and juice increased. Adolescents showed an increase in meal frequency and vegetable intake. Young adults showed reduced carbohydrate and alcohol intakes, while protein and dairy product intakes increased, based on limited included studies. Conclusion Dietary changes in school-age children from before to during the pandemic were mixed, while dietary behavior changes in adolescents and young adults tended to be more positive. Considering the lasting effects of negative dietary behaviors, attention should be given to addressing the increased sugar and juice intakes. It is also crucial that caregivers and researchers monitor whether positive dietary behaviors will rebound after returning to normal study and life. Systematic Review Registration PROSPERO registration no. CRD42023420923.

How did COVID ‐19 restrictions impact alcohol consumption in Australia? A longitudinal study

Article

Jan 2024

Introduction The state of Victoria experienced more stringent public health measures than other Australian states during the COVID‐19 pandemic. This study investigated how these public health measures impacted: (i) total alcohol consumption; (ii) location‐specific consumption; and (iii) consumption among different pre‐pandemic drinking groups, in Victoria compared to the rest of Australia during the first year of the pandemic. Method A longitudinal study with six survey waves was conducted between April and December 2020. A total of 775 adults completed data on alcohol use, including detailed consumption location information. Based on their 2019 consumption, participants were classified into low, moderate or high‐risk groups. Data were analysed descriptively. Results There was no difference in total alcohol consumption from 2019 levels among Victorians and those from the other Australian states when Victoria was the only state in lockdown. Location‐specific consumption was relatively similar for Victoria and the rest of Australia, with an increase in home drinking, and a decrease in consumption in someone else's home, licensed premises and public spaces during lockdown compared with 2019. Participants in the high‐risk group reported a reduction of two standard drinks per day in November 2020 compared with 2019. In contrast, consumption remained relatively stable for participants in the low and moderate‐risk groups once accounting for regression to the mean. Discussion and Conclusion Contrary to expectations, restrictions on licensed premises appeared to impact high‐risk drinkers more than low and moderate‐risk drinkers. Reducing availability of on‐premise alcohol may be an effective way to reduce consumption in heavier drinkers.

Psychoactive substance intoxication leading to general hospital admission in young and middle-aged people during and after the first lockdown

Article

Nov 2023
THERAPIE

Beverage- and Context-Specific Alcohol Consumption During COVID-19 in the United States: The Role of Alcohol To-Go and Delivery Purchases

Article

Jul 2023

Background: Alcohol delivery and to-go sales may contribute to changes in drinking patterns, including where and what people drink. This study tested whether home delivery and to-go alcohol purchases were associated with context- and beverage-specific consumption volumes during the first year of the COVID-19 pandemic after adjusting for pre-pandemic consumption volumes. Methods: Data are from a pre-pandemic panel were compared to a during-pandemic panel of the National Alcohol Survey (n=1,150 adult drinkers, 52.7% female). Outcomes were past-year alcohol consumption volumes in standard drinks (overall, by beverage type, and by location). Independent variables included past-year alcohol delivery and to-go purchases (separately). Covariates comprised baseline beverage- or context-specific volume, demographics, COVID-19 impacts, and drinking motivations. Negative binomial regression tested associations between alcohol purchases and change in overall, beverage-, and context-specific consumption. Results: On average, respondents who had alcohol delivered (vs. not) reported consuming larger volumes overall (IRR=1.58, 95% CI: 1.07, 2.32, p=0.02), of wine (IRR=2.90, 95% CI: 1.50, 5.63, p<0.01), of spirits (IRR=1.59, 95% CI: 1.03, 2.44, p=0.04), and at home (IRR=1.59, 95% CI: 1.10, 2.31, p=0.01). People who bought alcohol to-go (vs. not) reported larger volumes of wine (IRR=1.41, 95% CI: 1.02, 1.96, p=0.04), at home (IRR=1.60, 95% CI: 1.10, 2.32, p=0.01) and in bars (IRR=4.55, 95% CI: 2.55, 8.11, p<0.001). Finally, people who had alcohol delivered reported drinking smaller volumes in bars (IRR=0.49, 95% CI: 0.24, 0.98, p=0.04). Conclusions: During the first year of the pandemic, adults who had alcohol delivered or bought it to go reported larger volumes for several locations and beverage types.

Generation COVID: Young adult substance use

Article

Jun 2023

Opposing theories posited that young adult substance use during the COVID-19 pandemic would decline due to restricted access and social engagement or increase due to efforts to cope with rising distress, loneliness, and isolation. Peer-reviewed global longitudinal studies found (a) overall declines in commonly used substances in 2020 with some rebounding in 2021; (b) individual differences in this pattern, with declines linked to factors limiting access and increases to pre-existing risk; and (c) under-developed evidence to evaluate increased coping-related use. Given potential links between surging mental health disorders and substance use, further surveillance and wider dissemination of substance use programming is needed, particularly for vulnerable individuals and settings.

General hospital admissions in young and middle-aged people who use psychoactive substances: Impact of Covid-19 lockdowns

Article

Jun 2023
INT J DRUG POLICY

Backgrounds: The Covid-19 pandemic offered a unique opportunity to investigate trends in hospitalizations related to psychoactive substance intoxication, since the usual health burden of social use at parties and gatherings was likely to be decreased during lockdowns and curfew periods. Since young adults are the main users of psychoactive substances for experimental and recreational purposes, this study identified and compared hospitalization trends in young adults and adults over 30 years old. Methods: This national cohort study was conducted using the French hospital discharge database. An interrupted time-series analysis for the period between 2014 and 2020 was performed in two groups: young (age 18-29) and other adults (30+) to ascertain the trends in the monthly incidence of hospitalization related to psychoactive substance intoxication (opiates, cocaine, benzodiazepines, psychostimulants, alcohol and cannabis). Hospitalization characteristics during the first and second lockdown and the period between them were compared to the reference period (from 01/01/2014 to 29/02/2020). Results: Among 1,358,007 stays associated with psychoactive substance intoxication, 215,430 concerned young adults. Compared with adults 30+, hospitalization trends in young adults showed a greater decrease in the number of stays during lockdown, with a maximum decrease of -39% during the first lockdown (1,566 vs. 2,576; CI95%: 2,285-2,868) versus -20% (10,212 vs. 12,894; CI95%: 12,001-13,787) in the second lockdown. Presentations for alcohol intoxication decreased throughout the pandemic, particularly during the second lockdown, while admissions for benzodiazepine intoxication increased during both lockdowns. Admissions for cannabis intoxication increased throughout the entire period. Conclusions: Lockdowns were associated with fewer hospitalizations related to psychoactive substance intoxication in both age groups, especially among young adults, which might reflect a decrease in social use. Recreational use might therefore be an important target for prevention and risk minimization.

Characteristics associated with buying alcohol to-go and for delivery during the first year of the COVID-19 pandemic among a national sample of US adults

Article

May 2023
DRUG ALCOHOL REV

Introduction: This study: (i) determined the population coverage of alcohol delivery and to-go/carryout policies (i.e., policies permitting bars/restaurants to sell individual drinks for off-site consumption) in 2019 and 2020; and (ii) identified characteristics associated with alcohol delivery and to-go purchases. Methods: Data are from the National Alcohol Survey and Alcohol Policy Information System (n = 1677 adults, 52.1% female). Population coverage models summed state populations across state-level bar/restaurant delivery and to-go/carryout policies by beverage. Regression outcomes were past-year alcohol delivery and to-go purchases. Independent variables included demographics, excessive drinking, COVID-19 impacts and state COVID-19 bar/restaurant alcohol laws. Chi-squared tests and logistic regression models tested associations between delivery/to-go purchases and independent variables. Results: Overall, 7.5% of adults had alcohol delivered and 14.5% bought alcohol to-go. From December 2019 to December 2020, the number of people living in states allowing beer/wine/spirits delivery (284%) and to-go sales (627%) rose steeply. People who were Black (vs. White; adjusted odds ratio [aOR] 2.92, p < 0.001), excessive drinkers (vs. non-excessive drinkers; aOR 2.06, p < 0.001) or lived in states allowing beer/wine/spirits to-go sales (aOR 2.20, p = 0.01) had higher odds of buying alcohol to-go. Conversely, older people had lower odds of buying alcohol to-go (aOR 0.97, p < 0.001). People with some college or more (vs. high school degree or less, aOR 2.21, p < 0.001) and a higher economic burden (vs. fewer COVID-19 impacts, aOR 2.32, p = 0.05) had higher odds of alcohol delivery. Discussion and conclusions: A select sub-population defined by socioeconomic status, race, excessive drinking and state policies bought alcohol for delivery or to-go in the Unites States.

O consumo de bebidas alcoólicas entre adolescentes durante a pandemia de COVID-19, ConVid Adolescentes — Pesquisa de Comportamentos

Preprint

Full-text available

Dec 2022
Rev Bras Epidemiol

Objetivo: Descrever as prevalências de consumo de bebidas alcoólicas antes e durante a pandemia de Covid 19 e analisar os fatores associados a esse comportamento durante o período de distanciamento social em adolescentes brasileiros. Métodos: Estudo transversal, utilizando os dados da pesquisa Convid Adolescentes, realizada via web entre junho e setembro de 2020. Foi estimada a prevalência do consumo de álcool antes e durante a pandemia e associação com variáveis sociodemográficas, saúde mental, estilos de vida. Foi utilizado modelo de regressão logística para avaliar os fatores associados. Resultados: Foram avaliados 9.470 adolescentes. O consumo de bebida alcoólica reduziu de 17,70% (IC95%: 16,64;18,85) antes da pandemia, para 12,80% (IC95%: 11,85;13,76) durante a pandemia. O maior consumo de álcool esteve associado a faixa etária de 16 e 17 anos (OR=2,9;1,08-1,53), morar na região Sul (OR=1,82;1,46;2,27) e Sudeste (OR=1,33;1,05;1,69), ter 03 ou mais amigos próximos (OR=1,78;1,25;2,53), relatar piora dos problemas de sono durante a pandemia (OR=;1,59;1,20;2,11), sentir-se triste às vezes e sempre (OR=2,27;1,70;3,05), irritado sempre, ser fumante (OR=13,74;8,63;21,87) e fumante passivo (OR=1,76;1,42;2,19) se associaram ao maior consumo de álcool. A adesão à restrição de forma muito rigorosa associou-se ao menor consumo de álcool (OR=0,40;0,32;0,49). Conclusões: A pandemia causada pela Covid 19 levou à diminuição no consumo de bebidas alcóolicas pelos adolescentes brasileiros, sendo influenciada por fatores sociodemográficos, de saúde mental, adesão as medidas de restrição social e estilo de vida. Faz-se necessário o envolvimento de gestores, educadores, família e sociedade na articulação de Políticas Públicas para prevenção do consumo de álcool.

Correction to: Impact of Gambling Supply Reduction During COVID‑19 Shutdowns on Gambling Problems and Gambling Behaviour in Australia: A National Longitudinal Study

Article

Full-text available

Jun 2022
J GAMBL STUD

Changes in mental health and help-seeking among young Australian adults during the COVID-19 pandemic: a prospective cohort study

Article

Full-text available

May 2021

Background Young people may have elevated risk for poorer mental health during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal studies documenting this impact are lacking. This study assessed changes in mental health and help-seeking since COVID-19 restrictions in young Australians, including gender differences. Methods Data were drawn from a recent subsample ( n = 443; 60% female; M age = 22.0) of a prospective cohort originally recruited in secondary school to complete annual surveys. The subsample completed an additional COVID-19 survey during COVID-19 restrictions (May–June 2020), which was compared to responses from their latest annual survey (August 2019–March 2020). Mixed effect models with time and gender as the primary predictors were conducted for: (i) scores on the Patient Health Questionnaire Depression 9-item (PHQ-9) and Generalised Anxiety Disorder 7-item (GAD-7) modules assessed before and during COVID-19 restrictions, and (ii) self-reported help-seeking from a health professional in February 2020, and the month preceding May–June 2020. Results Mean symptom scores increased from before to during COVID-19 restrictions on the PHQ-9 (coefficient: 1.29; 95% CI 0.72–1.86) and GAD-7 (0.78; 95% CI 0.26–1.31), but there was no increase in help-seeking over time (odds ratio 0.50; 95% CI 0.19–1.32). There was no evidence of differential changes by gender. Conclusions This study found increases in depression and anxiety symptoms but not greater help-seeking among young Australian adults during the first wave of the pandemic. Increasing availability and awareness of accessible treatment options and psychoeducation is critical, as well as further research into risk and protective factors to help target treatment to this vulnerable age group.

Changes in alcohol consumption associated with social distancing and self-isolation policies triggered by COVID-19 in South Australia: a wastewater analysis study

Article

Full-text available

Sep 2020
ADDICTION

Aim: To assess the effects of social distancing and social isolation policies triggered by COVID-19 on alcohol consumption using wastewater analysis in Adelaide, South Australia DESIGN: Longitudinal quantitative analysis of influent wastewater data for alcohol concentration. Setting: Adelaide, South Australia PARTICIPANTS: Wastewater catchment area representative of 1.1 million inhabitants MEASUREMENTS: Twenty-four-hour composite influent wastewater samples were collected from four wastewater treatment plants in Adelaide, South Australia for seven consecutive days (Wednesday - Tuesday) every two months from April 2016 - April 2020. The alcohol metabolite ethyl sulfate was measured in samples using chromatography-tandem mass spectrometry. Data were population-weighted adjusted with consumption expressed as standard drinks/day/1000 people. Weekly consumption and weekend to mid-week consumption ratios were analysed to identify changes in weekday alcohol use pattern. Findings: Estimated weekend alcohol consumption was significantly lower (698 standard drinks/day/1000 people) after self-isolation measures were enforced in April 2020 compared with the preceding sampling period in February 2020 (1047 standard drinks/day/1000 people), p<0.05. Weekend to midweek consumption ratio was 12% lower than the average ratio compared with all previous sampling periods. April 2020 recorded the lowest alcohol consumption relative to April in previous years, dating back to 2016. Conclusions: Wastewater analysis suggests that introduction of social distancing and isolation policies triggered by COVID-19 in Adelaide, South Australia, was associated with a decrease in population-level weekend alcohol consumption.

Acute mental health responses during the COVID-19 pandemic in Australia

Article

Full-text available

Jul 2020
PLOS ONE

The acute and long-term mental health impacts of the COVID-19 pandemic are unknown. The current study examined the acute mental health responses to the COVID-19 pandemic in 5070 adult participants in Australia, using an online survey administered during the peak of the outbreak in Australia (27th March to 7th April 2020). Self-report questionnaires examined COVID-19 fears and behavioural responses to COVID-19, as well as the severity of psychological distress (depression, anxiety and stress), health anxiety, contamination fears, alcohol use, and physical activity. 78% of respondents reported that their mental health had worsened since the outbreak, one quarter (25.9%) were very or extremely worried about contracting COVID-19, and half (52.7%) were worried about family and friends contracting COVID-19. Uncertainty, loneliness and financial worries (50%) were common. Rates of elevated psychological distress were higher than expected, with 62%, 50%, and 64% of respondents reporting elevated depression, anxiety and stress levels respectively, and one in four reporting elevated health anxiety in the past week. Participants with self-reported history of a mental health diagnosis had significantly higher distress, health anxiety, and COVID-19 fears than those without a prior mental health diagnosis. Demographic (e.g., non-binary or different gender identity; Aboriginal and Torres Strait Islander status), occupational (e.g., being a carer or stay at home parent), and psychological (e.g., perceived risk of contracting COVID-19) factors were associated with distress. Results revealed that precautionary behaviours (e.g., washing hands, using hand sanitiser, avoiding social events) were common, although in contrast to previous research, higher engagement in hygiene behaviours was associated with higher stress and anxiety levels. These results highlight the serious acute impact of COVID-19 on the mental health of respondents, and the need for proactive, accessible digital mental health services to address these mental health needs, particularly for those most vulnerable, including people with prior history of mental health problems. Longitudinal research is needed to explore long-term predictors of poor mental health from the COVID-19 pandemic.

Alcohol Consumption Reported during the COVID-19 Pandemic: The Initial Stage

Article

Full-text available

Jun 2020
Int J Environ Res Publ Health

Physical health is not the only area affected by the outbreak of the SARS-CoV-2 virus pandemic. There are also other consequences that have globally affected many millions at other levels, namely: Societal, political, economic, and cultural. This study aims to survey alcohol drinking throughout the pandemic so as to investigate those factors considered most relevant; i.e., sociodemographic and clinical. A longitudinal study was designed. The first (or initial) stage was completed between April 10–20 2020 on 443 subjects during the enforcement of the “Lockdown” in Poland. The second stage will be due in June 2020. As well as an in-house questionnaire, the study used: The Alcohol Use Disorder Identification Test (AUDIT), General Health Questionnaire (GHQ-28), Perceived Stress Scale (PSS-10), and the Brief COPE Inventory (Mini COPE). Alcohol was the most commonly used psychoactive substance (73%) identified. More than 30% changed their drinking habits because of the pandemic, with 16% actually drinking less, whilst 14% did so more. The former group was significantly younger than the latter. Amongst the stress-related coping strategies, it was found that current alcohol drinkers were significantly less able to find anything positive about the pandemic situation (positive reframing) and were mentally less able to cope. Those drinking more now were found to have been drinking more intensively before the pandemic started.

Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults

Article

Full-text available

Jun 2020
Int J Environ Res Publ Health

The novel coronavirus (COVID-19) has enforced dramatic changes to daily living including economic and health impacts. Evidence for the impact of these changes on our physical and mental health and health behaviors is limited. We examined the associations between psychological distress and changes in selected health behaviors since the onset of COVID-19 in Australia. An online survey was distributed in April 2020 and included measures of depression, anxiety, stress, physical activity, sleep, alcohol intake and cigarette smoking. The survey was completed by 1491 adults (mean age 50.5 ± 14.9 years, 67% female). Negative change was reported for physical activity (48.9%), sleep (40.7%), alcohol (26.6%) and smoking (6.9%) since the onset of the COVID-19 pandemic. Significantly higher scores in one or more psychological distress states were found for females, and those not in a relationship, in the lowest income category, aged 18–45 years, or with a chronic illness. Negative changes in physical activity, sleep, smoking and alcohol intake were associated with higher depression, anxiety and stress symptoms. Health-promotion strategies directed at adopting or maintaining positive health-related behaviors should be utilized to address increases in psychological distress during the pandemic. Ongoing evaluation of the impact of lifestyle changes associated with the pandemic is needed.

Mitigating and learning from the impact of COVID‐19 infection on addictive disorders

Article

Full-text available

Apr 2020

The COVID‐19 pandemic and the measures required to address it are cutting a swathe through people's lives and the global economy. People with addictive disorders are particularly badly affected as a result of poverty, physical and mental health vulnerabilities and disruption of access to services. The pandemic may well increase the extent and severity of some addictive disorders. Current research is suffering from the termination of face‐to‐face data collection and other restrictions. There is an urgent need to coordinate efforts nationally and internationally to mitigate these problems and to find innovative ways of continuing to provide clinical and public health services to help people with addictive disorders.

Accounting for missing data in statistical analyses: Multiple imputation is not always the answer

Article

Full-text available

Mar 2019
INT J EPIDEMIOL

Background: Missing data are unavoidable in epidemiological research, potentially leading to bias and loss of precision. Multiple imputation (MI) is widely advocated as an improvement over complete case analysis (CCA). However, contrary to widespread belief, CCA is preferable to MI in some situations. Methods: We provide guidance on choice of analysis when data are incomplete. Using causal diagrams to depict missingness mechanisms, we describe when CCA will not be biased by missing data and compare MI and CCA, with respect to bias and efficiency, in a range of missing data situations. We illustrate selection of an appropriate method in practice. Results: For most regression models, CCA gives unbiased results when the chance of being a complete case does not depend on the outcome after taking the covariates into consideration, which includes situations where data are missing not at random. Consequently, there are situations in which CCA analyses are unbiased while MI analyses, assuming missing at random (MAR), are biased. By contrast MI, unlike CCA, is valid for all MAR situations and has the potential to use information contained in the incomplete cases and auxiliary variables to reduce bias and/or improve precision. For this reason, MI was preferred over CCA in our real data example. Conclusions: Choice of method for dealing with missing data is crucial for validity of conclusions, and should be based on careful consideration of the reasons for the missing data, missing data patterns and the availability of auxiliary information.

A comparison of multiple imputation methods for missing data in longitudinal studies

Article

Full-text available

Dec 2018
BMC MED RES METHODOL

Background: Multiple imputation (MI) is now widely used to handle missing data in longitudinal studies. Several MI techniques have been proposed to impute incomplete longitudinal covariates, including standard fully conditional specification (FCS-Standard) and joint multivariate normal imputation (JM-MVN), which treat repeated measurements as distinct variables, and various extensions based on generalized linear mixed models. Although these MI approaches have been implemented in various software packages, there has not been a comprehensive evaluation of the relative performance of these methods in the context of longitudinal data. Method: Using both empirical data and a simulation study based on data from the six waves of the Longitudinal Study of Australian Children (N = 4661), we investigated the performance of a wide range of MI methods available in standard software packages for investigating the association between child body mass index (BMI) and quality of life using both a linear regression and a linear mixed-effects model. Results: In this paper, we have identified and compared 12 different MI methods for imputing missing data in longitudinal studies. Analysis of simulated data under missing at random (MAR) mechanisms showed that the generally available MI methods provided less biased estimates with better coverage for the linear regression model and around half of these methods performed well for the estimation of regression parameters for a linear mixed model with random intercept. With the observed data, we observed an inverse association between child BMI and quality of life, with available data as well as multiple imputation. Conclusion: Both FCS-Standard and JM-MVN performed well for the estimation of regression parameters in both analysis models. More complex methods that explicitly reflect the longitudinal structure for these analysis models may only be needed in specific circumstances such as irregularly spaced data.

A Model to Determine the Likely Age of an Adolescent's First Drink of Alcohol

Article

Full-text available

Jan 2013
Pediatrics

Objective: With the use of a new cohort of adolescent subjects, predictors from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) interview and the Achenbach Youth Self Report (YSR) were combined to model age of first drink (AFD). Methods: Subjects consisted of 820 adolescents (ages 14-17) drawn from the current phase of the Collaborative Study on the Genetics of Alcoholism. Three Cox proportional hazards models were considered. Model 1 contained SSAGA variables equivalent to AFD predictors from our previous study: interview age, family history of alcohol dependence, and number of conduct disorder symptoms. Model 2 incorporated 2 additional SSAGA questions (best friends drink and smoked a cigarette before a reported AFD) plus 8 YSR-derived scale scores. Model 3 was a reduced version of model 2, retaining only significant predictors. Results: Model 2 was a significant improvement over model 1. Model 3 was the best and the most parsimonious of the 3 with respect to likelihood ratio and Wald χ(2) tests and retained only 5 variables from model 2. Included variables were the following: (1) best friends drink, (2) membership in a high-risk alcohol dependence family, (3) number of conduct disorder symptoms, (4) YSR externalizing score, and (5) YSR social problems score. Conclusions: Adding variables to those from our original study improved our ability to model the likely age of alcohol initiation. In addition to the SSAGA, the YSR appears to have utility as a research tool to predict the age of alcohol initiation.

Amelia: A Program for Missing Data

Article

Full-text available

Jan 1998
J STAT SOFTW

Amelia is a complete R package for multiple imputation of missing data. The pack-age implements a new expectation-maximization with bootstrapping algorithm that works faster, with larger numbers of variables, and is far easier to use, than various Markov chain Monte Carlo approaches, but gives essentially the same answers. The program also im-proves imputation models by allowing researchers to put Bayesian priors on individual cell values, thereby including a great deal of potentially valuable and extensive information. It also includes features to accurately impute cross-sectional datasets, individual time series, or sets of time series for different cross-sections. A full set of graphical diagnostics are also available. The program is easy to use, and the simplicity of the algorithm makes it far more robust; both a simple command line and extensive graphical user interface are included.

Use and Abuse of Alcohol and Illicit Drugs in US Adolescents Results of the National Comorbidity Survey-Adolescent Supplement

Article

Full-text available

Apr 2012

Comprehensive descriptions of substance use and abuse trajectories have been lacking in nationally representative samples of adolescents. To examine the prevalence, age at onset, and sociodemographic correlates of alcohol and illicit drug use and abuse among US adolescents. Cross-sectional survey of adolescents using a modified version of the Composite International Diagnostic Interview. Combined household and school adolescent samples. Nationally representative sample of 10,123 adolescents aged 13 to 18 years. Lifetime estimates of alcohol and illicit substance use and DSM-IV diagnoses of abuse, with or without dependence. By late adolescence, 78.2% of US adolescents had consumed alcohol, 47.1% had reached regular drinking levels defined by at least 12 drinks within a given year, and 15.1% met criteria for lifetime abuse. The opportunity to use illicit drugs was reported by 81.4% of the oldest adolescents, drug use by 42.5%, and drug abuse by 16.4%. The median age at onset was 14 years for alcohol abuse with or without dependence, 14 years for drug abuse with dependence, and 15 years for drug abuse without dependence. The associations observed by age, sex, and race/ethnicity often varied significantly by previous stage of use. Alcohol and drug use is common in US adolescents, and the findings of this study indicate that most cases of abuse have their initial onset in this important period of development. Prevention and treatment efforts would benefit from careful attention to the correlates and risk factors that are specific to the stage of substance use in adolescents.

Stressful life experiences, alcohol consumption, and alcohol use disorder: The epidemiologic evidence for four main types of stressors

Article

Full-text available

Mar 2011
PSYCHOPHARMACOLOGY

Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of chronicity and severity. We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders. Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities. Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.

MICE: Multivariate Imputation by Chained Equations in R

Article

Full-text available

Dec 2011
J STAT SOFTW

Multivariate Imputation by Chained Equations (MICE) is the name of software for imputing incomplete multivariate data by Fully Conditional Speci cation (FCS). MICE V1.0 appeared in the year 2000 as an S-PLUS library, and in 2001 as an R package. MICE V1.0 introduced predictor selection, passive imputation and automatic pooling. This article presents MICE V2.0, which extends the functionality of MICE V1.0 in several ways. In MICE V2.0, the analysis of imputed data is made completely general, whereas the range of models under which pooling works is substantially extended. MICE V2.0 adds new functionality for imputing multilevel data, automatic predictor selection, data handling, post-processing imputed values, specialized pooling and model selection. Imputation of categorical data is improved in order to bypass problems caused by perfect prediction. Special attention to transformations, sum scores, indices and interactions using passive imputation, and to the proper setup of the predictor matrix. MICE V2.0 is freely available from CRAN as an R package mice. This article provides a hands-on, stepwise approach to using mice for solving incomplete data problems in real data.

How Many Imputations Are Really Needed? Some Practical Clarifications of Multiple Imputation Theory

Article

Full-text available

Oct 2007

Multiple imputation (MI) and full information maximum likelihood (FIML) are the two most common approaches to missing data analysis. In theory, MI and FIML are equivalent when identical models are tested using the same variables, and when m, the number of imputations performed with MI, approaches infinity. However, it is important to know how many imputations are necessary before MI and FIML are sufficiently equivalent in ways that are important to prevention scientists. MI theory suggests that small values of m, even on the order of three to five imputations, yield excellent results. Previous guidelines for sufficient m are based on relative efficiency, which involves the fraction of missing information (gamma) for the parameter being estimated, and m. In the present study, we used a Monte Carlo simulation to test MI models across several scenarios in which gamma and m were varied. Standard errors and p-values for the regression coefficient of interest varied as a function of m, but not at the same rate as relative efficiency. Most importantly, statistical power for small effect sizes diminished as m became smaller, and the rate of this power falloff was much greater than predicted by changes in relative efficiency. Based our findings, we recommend that researchers using MI should perform many more imputations than previously considered sufficient. These recommendations are based on gamma, and take into consideration one's tolerance for a preventable power falloff (compared to FIML) due to using too few imputations.

Hard lockdown and a “health dictatorship”: Australia’s lucky escape from covid-19

Article

Dec 2020
Br Med J

Paul Smith

Alcohol Use in Australia during the Early Days of the COVID-19 Pandemic: Initial results from the COLLATE project: Alcohol use during the COVID-19 pandemic

Article

Jun 2020

Aims The effect of social isolation measures used to control the spread of COVID‐19 are negatively impacting the mental health of many. One of the consequences of exposure to disasters/pandemics is an increase in alcohol use. The current study aimed to examine what predisposing (distal) and pandemic‐related (proximal) factors were associated with increased drinking in the wake of the COVID‐19 pandemic. Methods On the 1st of April 2020, 5,158 Australians completed a survey from the COvid‐19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project, a nationwide study aimed at tracking key mental health concerns. Using logistic regression, distal (demographics and previous drinking behaviours) and proximal factors (employment, lifestyle factors and mood) were assessed for their association with increased drinking since the onset of the COVID‐19 pandemic. Results Distal factors including heavier drinking pre‐pandemic, middle age, average or higher income; and proximal factors including job loss, eating more, changes to sleep as well as stress and depression, were all associated with increased drinking in the COVID‐19 pandemic environment. Female sex and self‐reported history of mental illness became non‐significant after proximal measures were added to the model. Living alone, exercise, anxiety or status as an essential or health care worker were not associated with increased drinking. Conclusions These results provide guidance as to who might be targeted to receive support based on predisposing demographic factors and pre‐pandemic drinking behaviour. Second, they indicate what behaviours/factors accompany increased alcohol use and provide targets for psychosocial and psychoeducational supports to address these proximal factors. This article is protected by copyright. All rights reserved.

Drinking to Cope with the Pandemic: The Unique Associations of COVID-19-Related Perceived Threat and Psychological Distress to Drinking Behaviors in American Men and Women

Article

Jun 2020
ADDICT BEHAV

The 2019 Coronavirus pandemic has brought about significant and unprecedented changes to the modern world, including stay-at-home orders, high rates of unemployment, and more than a hundred thousand deaths across the United States. Derived from the self-medication hypothesis, this research explored how perceived threat and psychological distress related to the COVID-19 pandemic are associated with drinking behavior among an American sample of adults. We also evaluated whether links between COVID-19-related perceived threat and psychological distress with drinking behavior are different for men and women. Participants (N=754; 50% women) completed an online Qualtrics Panels study between April 17th and 23rd, 2020. Results suggested that psychological distress related to the COVID-19 pandemic was consistently related to alcohol use indices, and moderation results indicated this pattern was significant only among women for number of drinks consumed during the recent heaviest drinking occasion and number of drinks consumed on a typical evening. COVID-related distress’ link to frequency of drinking and heavy drinking episodes was not different for men and women. Our results suggest that continued monitoring, particularly among women, should be conducted as this pandemic continues to evolve to identify the long-term public health impacts of drinking to cope with COVID-19 distress.

COVID‐19 and alcohol in Australia: Industry changes and public health impacts

Article

Jun 2020

Illicit drug use and harms in Australia in the context of COVID ‐19 and associated restrictions: Anticipated consequences and initial responses

Article

May 2020

Alcohol use in times of the COVID 19: Implications for monitoring and policy

Article

May 2020

Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios—with opposite predictions regarding the impact of the current COVID‐19 pandemic on the level and patterns of alcohol consumption—are introduced. The first scenario predicts an increase in consumption for some populations, particularly men, due to distress experienced as a result of the pandemic. A second scenario predicts the opposite outcome, a lowered level of consumption, based on the decreased physical and financial availability of alcohol. With the current restrictions on alcohol availability, it is postulated that, for the immediate future, the predominant scenario will likely be the second, while the distress experienced in the first may become more relevant in the medium‐ and longer‐term future. Monitoring consumption levels both during and after the COVID‐19 pandemic will be necessary to better understand the effects of COVID‐19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies.

Patterns of financial attributes and behaviors of emerging adults in the United States

Article

Jul 2018
CHILD YOUTH SERV REV

The growing socioeconomic and market complexities require all young adults to make sound financial decisions, yet a large number of them lack the necessary skills and knowledge. Literature on identifying the latent financial characteristics of American emerging adults are sparse. Based on the 2015 National Financial Capability Study, the present research explores heterogeneous patterns in financial attributes and behaviors of emerging adults (N = 3050, 18–24 years). Results indicate four different classes. More than half of the emerging adults were found to be financially precarious (32%) or financially at-risk (36%) who scored low on several financial attributes and behaviors. Financially striving (10%) and financially stable (22%) scored moderate to high on these indicators. Findings suggest that a deeper understanding of patterns of financial behaviors and attributes of emerging adults can help in designing appropriate need-based programs and increasing their program participation. Understanding this diversity in financial capabilities of emerging adults has implications for their economic wellbeing and financial socialization of their eventual children. Findings have implications for policymakers, practitioners, and socialization agencies, including families and parents.

Drinking Contexts and Alcohol Consumption: How Much Alcohol Is Consumed in Different Australian Locations?

Article

Jul 2016
J STUD ALCOHOL DRUGS

Objective: The aim of this study was to examine where Australians in different demographic groups and drinker categories consume their alcohol. Method: Results were taken from the Australian arm of the International Alcohol Control study, a telephone survey of 2,020 Australian adults with an oversample of risky drinkers. The 1,789 respondents who reported consuming alcohol in the past 6 months were asked detailed questions about the location of their alcohol consumption and how much alcohol they consumed at each place. Results: Sixty-three percent of all alcohol consumption reported by respondents was consumed in the drinker's own home, with much less consumed at pubs, bars, and nightclubs (12%). This is driven primarily by the number of people who drink in the home and the frequency of these events, with the amount consumed per occasion at home no more than in other people's homes or pubs, and significantly less than at special events. The average consumption on a usual occasion at each of these locations was more than five Australian standard drinks (above the Australian low-risk guideline for episodic drinking). Short-term risky drinkers had the highest proportion of consumption in pubs (19%), but they still consumed 41% of their units in their own home. Conclusions: The majority of alcohol consumed in Australia is consumed in the drinker's own home. Efforts to reduce long-term harms from drinking need to address off-premise drinking and, in particular, drinking in the home.

Why young people's substance use matters for global health

Article

Feb 2016

During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.

An introduction to Socio-Economic Indexes for Areas (SEIFA)

Article

Jan 2011

B. Pink

Measuring Alcohol Consumption

Article

Sep 2004

This article is an overview of different approaches to measuring alcohol consumption: self-reports and objective measures such as blood alcohol concentration (BAC) and aggregate level measures. These approaches are evaluated as regards their ability to capture quantity, frequency, volume and variability of drinking. This review focuses on self-report measures and on the current knowledge of undercoverage error when compared with sales data. In the comparative evaluation of measures, two analytical aims are examined: a) description and testing of differences across groups for which ordinal information is sufficient and b) establishment of cutoff points and risk relationships for which unbiased interval scale level is required. First, minimal differences were found between self-report measures when the recall period was sufficiently long enough. Second, prospective diaries appear to be stronger measures than retrospective recalls. However, prospective diaries commonly cover only short reporting periods and should be combined with simple retrospective measures to capture rare and infrequent drinking episodes. In regard to undercoverage, the discrepancy cannot be fully explained by non-response or concealment of consumption by drinkers. It is argued that undercoverage of sales data may be more related to sample frame defects–-e.g., the non-inclusion of particular subpopulations such as the homeless or institutionalized.

Cohort profile: the Australian Parental Supply of Alcohol Longitudinal Study (APSALS)

Article

May 2015
INT J EPIDEMIOL

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was established in 2010 to investigate the short- and long-term associations between exposure to early parental alcohol provision, early adolescent alcohol initiation, subsequent alcohol use and alcohol-related harms, controlling for a wide range of parental, child, familial, peer and contextual covariates. The cohort commenced with 1927 parent-child dyads comprising Australian Grade 7 school students (mean age = 12.9 years, range = 10.8-15.7 years), and a parent/guardian. Baseline, 1- and 2-year follow-up data have been collected, with > 90% retention, and a 3-year follow-up is under way. The data collected include child, familial, parental and peer factors addressing demographics, alcohol use and supply, parenting practices, other substance use, adolescent behaviours and peer influences. The cohort is ideal for prospectively examining predictors of initiation and progression of alcohol use, which increases markedly through adolescence. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Young adult sequelae of adolescent cannabis use: An integrative analysis

Article

Sep 2014

Background Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use. Methods We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765). Findings We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0·37, 95% CI 0·20–0·66) and degree attainment (0·38, 0·22–0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44–34·12), use of other illicit drugs (7·80, 4·46–13·63), and suicide attempt (6·83, 2·04–22·90). Interpretation Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects. Funding Australian Government National Health and Medical Research Council.

Amelia II: A program for missing data

Article

Jan 2012
J STAT SOFTW

Amelia II is a complete R package for multiple imputation of missing data. The package implements a new expectation-maximization with bootstrapping algorithm that works faster, with larger numbers of variables, and is far easier to use, than various Markov chain Monte Carlo approaches, but gives essentially the same answers. The program also improves imputation models by allowing researchers to put Bayesian priors on individual cell values, thereby including a great deal of potentially valuable and extensive information. It also includes features to accurately impute cross-sectional datasets, individual time series, or sets of time series for different cross-sections. A full set of graphical diagnostics are also available. The program is easy to use, and the simplicity of the algorithm makes it far more robust; both a simple command line and extensive graphical user interface are included.

Health of the world's adolescents: A synthesis of internationally comparable data

Article

Apr 2012
LANCET

Adolescence and young adulthood offer opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify definitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the world's adolescents. The worst adolescent health profiles are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents.

Global burden of disease in young people aged 10-24 years: A systematic analysis

Article

Jun 2011
LANCET

Young people aged 10-24 years represent 27% of the world's population. Although important health problems and risk factors for disease in later life emerge in these years, the contribution to the global burden of disease is unknown. We describe the global burden of disease arising in young people and the contribution of risk factors to that burden. We used data from WHO's 2004 Global Burden of Disease study. Cause-specific disability-adjusted life-years (DALYs) for young people aged 10-24 years were estimated by WHO region on the basis of available data for incidence, prevalence, severity, and mortality. WHO member states were classified into low-income, middle-income, and high-income countries, and into WHO regions. We estimated DALYs attributable to specific global health risk factors using the comparative risk assessment method. DALYs were divided into years of life lost because of premature mortality (YLLs) and years lost because of disability (YLDs), and are presented for regions by sex and by 5-year age groups. The total number of incident DALYs in those aged 10-24 years was about 236 million, representing 15·5% of total DALYs for all age groups. Africa had the highest rate of DALYs for this age group, which was 2·5 times greater than in high-income countries (208 vs 82 DALYs per 1000 population). Across regions, DALY rates were 12% higher in girls than in boys between 15 and 19 years (137 vs 153). Worldwide, the three main causes of YLDs for 10-24-year-olds were neuropsychiatric disorders (45%), unintentional injuries (12%), and infectious and parasitic diseases (10%). The main risk factors for incident DALYs in 10-24-year-olds were alcohol (7% of DALYs), unsafe sex (4%), iron deficiency (3%), lack of contraception (2%), and illicit drug use (2%). The health of young people has been largely neglected in global public health because this age group is perceived as healthy. However, opportunities for prevention of disease and injury in this age group are not fully exploited. The findings from this study suggest that adolescent health would benefit from increased public health attention. None.

Risk functions for alcohol-related problems in a 1988 US National sample

Article

Nov 1996

To assess the relationship of alcohol use and three types of alcohol-related problems (ICD-10 dependence syndrome, work problems and drunk driving), risk curves were developed for average number of drinks per day during last year (volume) and number of days drinking five or more drinks during one day (5+). Using data from the 1988 National Health Interview Alcohol Supplement, risk curves were derived from data on 22,102 current drinkers who consumed at least 12 drinks in the last year. The emphasis in this analysis was on the proportion of drinkers at lower levels reporting different types of problems. The results indicate that even at lower levels of drinking (volume averaging one or fewer drinks/day) there is considerable risk for drunk driving and less risk for work problems and alcohol dependence. The risk for all types of problems at lower and moderate levels of drinking was significantly higher for respondents who had five or more drinks during one day in the last year. These findings underscore the importance of examining risk (physical and social) at lower levels of drinking and for using both overall volume and heavier quantity per occasion drinking measures when assessing risk for any alcohol-related problem.

Predictors of Initiation of Alcohol Use Among US Adolescents

Article

Nov 2007
Arch Pediatr Adolesc Med

To identify precursors of adolescent alcohol initiation and binge drinking. Prospective cohort study. Self-report questionnaires. A total of 5511 Growing Up Today Study participants aged 11 to 18 years in 1998. Main Exposures Individual, family, and social factors. First whole drink of alcohol and binge drinking. Between 1998 and 1999, 611 girls (19%) and 384 boys (17%) initiated alcohol use. Older age, later maturational stage, smoking, adults drinking in the home, underage sibling drinking, peer drinking, possession of or willingness to use alcohol promotional items, and positive attitudes toward alcohol were associated with an increased likelihood of alcohol initiation. Girls who ate family dinner at home every day were less likely to initiate alcohol use than girls who ate family dinner only on some days or never (odds ratio, 0.66; 95% confidence interval, 0.50-0.87). Girls with higher social self-esteem and boys with higher athletic self-esteem were more likely to initiate alcohol use than those with lower self-esteem. Among teens who initiated alcohol use, 149 girls (24%) and 112 boys (29%) further engaged in binge drinking. Among girls, positive attitudes toward alcohol, underage sibling drinking, and possession of or willingness to use alcohol promotional items were associated with binge drinking; among boys, positive attitudes toward alcohol and older age were associated with binge drinking. Eating family dinner at home every day may delay alcohol uptake among some adolescents. Alcohol promotional items appear to encourage underage alcohol initiation and binge drinking; this may warrant marketing restrictions on the alcohol industry.

Taking the Pulse of the Nation

Jan 2020

Melbourne Institute

Melbourne Institute. Taking the Pulse of the Nation. 2020.

Global Economic and Markets Research report: CBA Card Spend-week ending 3

Cliftonk

Clifton K. Global Economic and Markets Research report: CBA Card Spend-week ending 3 April 2020. Sydney, Australia: Commonwealth Bank of Australia; 2020.

Alcohol Consumption During the COVID-19 Period

May 2020

N Biddle
B Edwards
M Gray
K Sollis

Biddle N, Edwards B, Gray M, Sollis K. Alcohol Consumption During the COVID-19 Period: May 2020. COVID-19 Briefing Paper. Canberra, Australia: Australian National University; 2020.

COVID-19: a chronology of state and territory government announcements (up until

Jun 2020
30

R Storen
N Corrigan

Storen R, Corrigan N. COVID-19: a chronology of state and territory government announcements (up until 30 June 2020). Canberra, ACT: Parliament of Australia; 2020.

COVID-19) in Australia

Sep 2020

T Ambrogetti
R Gilbert
Janif A Coronavirus

Ambrogetti T, Gilbert R, Janif A. Coronavirus (COVID-19) in Australia 2020 [8 Sep

Oxford COVID-19 Government Response Tracker

Jan 2020

T Hale
N Angrist
E Cameron-Blake
L Hallas
B Kira
S Majumdar

Hale T, Angrist N, Cameron-Blake E, Hallas L, Kira B, Majumdar S, et al. Oxford COVID-19 Government Response Tracker. Blavatnik School of Government.; 2020.

The school health & alcohol harm reduction project: details of intervention development & research procedures. The School Health & Alcohol Harm Reduction Project: Details of intervention development & research procedures

Jan 2006

N Mcbride
F Farringdon
L Meuleners
R Midford

McBride N, Farringdon F, Meuleners L, Midford R. The school health & alcohol harm reduction project: details of intervention development & research procedures. The School Health & Alcohol Harm Reduction Project: Details of intervention development & research procedures. Perth: National Drug Research Institute; 2006.

Socio-economic indexes for areas (SEIFA), postal area (POA) Index of Relative Socio-Economic Advantage and Disadvantage, data cube

Jan 2006

Statistics Abo

Statistics ABo. Socio-economic indexes for areas (SEIFA), postal area (POA) Index of Relative Socio-Economic Advantage and Disadvantage, data cube; 2008. Author. Canberra,, Australia; 2006.

Monitoring the Future: Questionnaire Responses from the Nation's High School Seniors

Jan 1979

L D Johnston

Johnston LD. Monitoring the Future: Questionnaire Responses from the Nation's High School Seniors, 1979: ERIC;

Alcohol Consumption During the COVID-19 Period

Graym Biddlen Edwardsb
Sollisk

Risk functions for alcohol‐related problems in a 1988 US national sample

Jan 1996
1427

Midanik L. T.

Impact of COVID-19 on the drinks industry: Alcohol Beverages Australia

Alcohol Beverages Australia

Alcohol Beverages Australia. Impact of COVID-19 on the drinks industry: Alcohol Beverages Australia; 2020. Available from: https://www.alcoholbeveragesaustralia.org.au/wp-content/uploads/ABA-Industry-report-oncoronavirus.pdf.

The School Health and Alcohol Harm Reduction Project: Details of Intervention Development and Research Procedures

Jan 2006

N Mcbride
F Farringdon
L Meuleners
R Midford

McBride N., Farringdon F., Meuleners L., Midford R. The School Health and Alcohol Harm Reduction Project: Details of Intervention Development and Research Procedures. Perth, Australia: National Drug Research Institute; 2006.

Impact of COVID-19 on the drinks industry. Sydney Australia: Alcohol Beverages Australia

Alcohol Beverages Australia

Alcohol use among young Australian adults in May‐June 2020 during the COVID‐19 pandemic: a prospective cohort study

Abstract

No full-text available

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