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Changes in alcohol consumption and alcohol problems before and after the COVID-19 pandemic: a prospective study in heavy drinking young adults

Abstract

Most past studies examining changes in alcohol use from before to during the COVID-19 pandemic used cross-sectional designs that required participants to retrospectively report on their pre-pandemic alcohol consumption. The few longitudinal studies conducted so far also commonly relied on retrospective reports of pre-pandemic alcohol use, and no previous longitudinal studies included multiple assessments that occurred both prior to and after the onset of the pandemic. Here, in 234 heavy drinking young adults (aged 21–29 years), we (1) prospectively examined within-person changes in alcohol consumption/patterns and alcohol problems assessed at multiple timepoints before and after the pandemic onset (February 2018 to March 2022), to examine trajectories of changes in alcohol involvement after the start of COVID in the context of deviations from pre-COVID trajectories (using individual growth models fitted in a multilevel structural equation modeling framework), and (2) tested theoretically informed mechanisms (that is, changes in negative affectivity, coping-motivated drinking and solitary drinking) in explaining pandemic-associated changes in alcohol consumption/patterns and alcohol problems using correlated slopes models. The results showed significant reductions in alcohol use quantity and frequency, as well as alcohol problems, from pre- to post-pandemic onset, which were largely driven by significant decreases in weekend (versus weekday) drinking quantity and frequency and drinks per drinking day. Negative affectivity significantly decreased, and solitary drinking significantly increased, from pre- to post-pandemic onset, with no significant change to coping drinking motives; changes in these variables were not related to decreases in alcohol involvement, and the magnitude of changes in all variables from pre- to post-pandemic onset did not generally differ for males and females. The results indicate that alcohol use and concomitant alcohol-related problems significantly decreased in these heavy drinking young adults during the pandemic, and these decreases were evident up to two years post pandemic onset.

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Fig. 1: Assessments across the study period.

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Data availability

Study aims, hypotheses and the data analytic plan were pre-registered on OSF prior to any data analyses being completed (https://osf.io/kjfa6). Study designs for the parent study were pre-registered at ClinicalTrials.gov (under ID NCT03467191). Data, analysis code and analysis results can be found on OSF (https://osf.io/kjfa6). Supplementary Information is available online.

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Acknowledgements

This study was supported by National Institutes of Health (NIH) grant no. R01 AA025936 to K.G.C. The work by A.G.C.W. was supported by NIH grant no. R01 AA026879. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The NIH did not have any role in the study design, collection, analysis or interpretation of the data, writing the manuscript or the decision to submit the paper for publication. We thank the staff and students of the Behavioral Health Research Lab at Carnegie Mellon University for their help in conducting this study, as well as S. Yadav for help with creating Fig. 1.

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Contributions

Conceptualization was provided by K.G.C. and A.G.C.W., methodology by K.G.C. and C.E.F., formal analysis by G.C.H. and A.G.C.W., funding acquisition by K.G.C. and investigations by G.L., K.G.C. and F.A.C.-Á. The original draft was written by K.G.C., and review and editing was provided by A.G.C.W., G.C.H., C.E.F., G.L. and F.A.C.Á.

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Correspondence to Kasey G. Creswell.

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Extended data

Extended Data Fig. 1 AUDIT scores from pre- to post-pandemic onset.

Model estimated changes for Alcohol Use Disorder Identification Test (AUDIT) scores from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 2 B-YAACQ scores from pre- to post-pandemic.

Model estimated changes for Brief-Young Adult Alcohol Consequences Questionnaire (B-YAACQ) scores from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 3 Coping motives from pre- to post-pandemic.

Model estimated changes for coping drinking motives from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 4 Drinks per drinking day from pre- to post-pandemic.

Model estimated changes for drinks per drinking day from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 5 Negative affectivity from pre- to post-pandemic.

Model estimated changes for negative affectivity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 6 Solitary drinking from pre- to post-pandemic.

Model estimated changes for solitary drinking from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 7 Total drinking frequency from pre- to post-pandemic.

Model estimated changes for total drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 8 Total drinking quantity from pre- to post-pandemic.

Model estimated changes for total drinking quantity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 9 Weekday drinking frequency from pre- to post-pandemic.

Model estimated changes for weekday drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 10 Weekday drinking quantity from pre- to post-pandemic.

Model estimated changes for weekday drinking quantity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 11 Weekend drinking frequency from pre- to post-pandemic.

Model estimated changes for weekend drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 12 Weekend drinking quantity from pre- to post-pandemic.

Model estimated changes for weekend drinking quantity from pre- to post-pandemic overlaid on the raw data.

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Creswell, K.G., Hisler, G.C., Lyons, G. et al. Changes in alcohol consumption and alcohol problems before and after the COVID-19 pandemic: a prospective study in heavy drinking young adults. Nat. Mental Health 2, 728–739 (2024). https://doi.org/10.1038/s44220-024-00247-9

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