CC BY
31
FACTORS ASSOCIATED WITH INCREASE IN ALCOHOL CONSUMPTION DURING FIRST MONTHS OF COVID-19 PANDEMIC AMONG ONLINE SOCIAL MEDIA USERS IN RUSSIA
Gil AU Demin AK
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
The significant proportion of the Russian population are active online social media users. Changes in alcohol consumption in this target group during the COVID-19 pandemic remain understudied. The aim of this survey was to investigate changes in alcohol consumption and factors associated with the increase in alcohol use among online social media users in Russia during the first months of the COVID-19 pandemic. An online survey was conducted among 1,518 users of online social networking services popular in Russia from June to September 2020. The survey revealed that 35.4% of men and 25.6% of women started drinking more frequently during the first months of the pandemic; 24.9% of men and 17.7% of women increased their usual consumption (volume) of alcohol on a typical drinking occasion, whereas 28.5% of men and 27.9% of women increased the frequency of heavy episodic drinking. Adjusted binary logistic regression analysis revealed a positive association between the increase in the frequency of alcohol consumption and the following factors: age from 18 to 29 years (OR: 1.710; 95% CI: 1.002-2.917), severe restrictions in everyday private life (OR: 3.127; 95% CI: 1.011-9.675) and severe negative professional or financial consequences due to the spread of SARS-CoV-2 (OR: 2.247; 95% CI: 1.131-4.465). The odds of an increase in the frequency of heavy episodic drinking were more than twice higher (OR: 2.329; 95% CI: 1.001-5.428) among those who had experienced severe negative consequences of the pandemic to their professional and financial situation. Higher typical frequency and usual consumption (volume) of alcohol on a typical drinking occasion and higher typical frequency of heavy episodic drinking before the pandemic were positively significantly associated with the increase in these parameters of alcohol consumption during the first months of the pandemic. In times of large-scale epidemics and public health crises, it is advisable to consider the possibility of implementing screening and brief interventions, including via online social media, to prevent problems associated with alcohol use.
Keywords: alcohol, COVID-19, coronavirus, pandemic, social media, Facebook, VKontakte, Odnoklassniki, Twitter, Russia
Author contributions: Gil AU planned the study, designed the electronic questionnaire form, collected date, performed statistical analysis, interpreted the results and wrote the manuscript; Demin AK interpreted the results and wrote the manuscript.
Acknowledgements: the authors thank Uri and Raisa Gil for their help in disseminating information about the survey in online social media, for their critical comments on the interpretation and discussion of the results.
CR1 Correspondence should be addressed: Artyom U. Gil
Trubetskaya, 8, str. 2, Moscow, 119991, Russia; gil.artyom@gmail.com
Received: 21.11.2021 Accepted: 19.12.2021 Published online: 30.12.2021
DOI: 10.24075/brsmu.2021.064
ФАКТОРЫ, ВЗАИМОСВЯЗАННЫЕ С РОСТОМ ПОТРЕБЛЕНИЯ АЛКОГОЛЯ В ПЕРВЫЕ МЕСЯЦЫ ПАНДЕМИИ COVID-19 СРЕДИ ПОЛЬЗОВАТЕЛЕЙ СОЦИАЛЬНЫХ ОНЛАЙН-СЕТЕЙ В РОССИИ
А. Ю. Гиль А. К. Дёмин
Первый Московский государственный медицинский университет имени И. М. Сеченова (Сеченовский Университет), Москва, Россия
Значительная часть населения активно пользуется социальными онлайн-сетями, однако изменения потребления алкоголя в этой целевой группе в период пандемии COVID-19 малоизучены. Целью исследования было оценить изменения потребления алкоголя и факторов, связанных с ростом его потребления, в первые месяцы пандемии COVID-19 среди пользователей социальных онлайн-сетей в России. В период с июня по сентябрь 2020 г 1518 пользователей наиболее популярных в России социальных онлайн-сетей прошли опрос в отношении изменений потребления алкоголя в первые месяцы пандемии COVID-19. Выявлено, что в первые месяцы пандемии 35,4% мужчин и 25,6% женщин увеличили частоту употребления алкоголя; 24,9% мужчин и 17,7% женщин увеличили разовый объем потребления алкоголя, и 28,5% мужчин и 27,9% женщин увеличили частоту случаев эпизодического употребления алкоголя в больших разовых количествах. На многофакторном уровне возраст 18-29 лет (ОШ = 1,710; 95% ДИ = 1,002-2,917), очень сильные ограничения в повседневной жизни (3,127; 1,011-9,675) и очень сильные негативные последствия в отношении профессиональной или финансовой ситуации в связи с распространением SARS-CoV-2 (2,247; 1,131-4,465) были положительно взаимосвязаны с ростом частоты потребления алкоголя. Шансы увеличения частоты эпизодического употребления алкоголя в больших разовых количествах были более чем в два раза выше (2,329; 1,001-5,428) среди лиц, испытавших очень сильные негативные последствия в отношении профессиональной или финансовой ситуации. Более высокие привычные частота употребления алкоголя, разовый объем употребляемого алкоголя и частота эпизодического употребления алкоголя в больших разовых количествах до пандемии были положительно статистически значимо связаны с ростом этих параметров потребления алкоголя в первые месяцы пандемии.
Ключевые слова: алкоголь, COVID-19, коронавирус, пандемия, социальные сети, Facebook, ВКонтакте, Одноклассники, Twitter, Россия
Вклад авторов: А. Ю. Гиль — планирование исследования, разработка электронной формы сбора данных; сбор, обработка и статистический анализ данных; интерпретация результатов, написание статьи; А. К. Дёмин — интерпретация результатов исследования, написание статьи.
Благодарности: авторы благодарят Ю. Я. Гиль и Р. Г. Гиль за помощь в распространении информации об опросе в социальных сетях, за ценные критические замечания в отношении интерпретации и обсуждения результатов исследования.
[X] Для корреспонденции: Артем Юрьевич Гиль
ул. Трубецкая, д. 8, стр. 2, г. Москва, 119991; gil.artyom@gmail.com
Поступила: 21.11.2021 Статья принята к печати: 19.12.2021 Опубликована онлайн: 30.12.2021 DOI: 10.24075/vrgmu.2021.064
Decisive action taken to counter COVID-19 in Russia and worldwide during the first months of the pandemic slowed the spread of SARS-CoV-2 infection, but it also had a significant impact on many other aspects of life. During the nationwide Russian lockdown, implemented in the second quarter of 2020, the official unemployment rate grew by 2.1%, reaching 6.4%, and the real disposable income of the population fell by 8.4% in comparison with the same period in 2019 [1]. Income reduction and complete loss of income were reported by 61% and 13.5% of the population, respectively; 9.8% of the Russian population lost their jobs [2]. According to recent studies investigating the impact of COVID-19 restrictions across countries, the rates of depression, anxiety and stress among some population groups, especially among women, young adults and people with chronic diseases, have increased [3, 4]. In times of crisis, some turn to alcohol to cope with psychoemotional stress; this can heighten the risk of adverse short-term and long-term health effects and negative social consequences [5, 6]. Increased substance use following large-scale disasters is often the sign of people adopting a self-medicating strategy to deal with emotional distress [7-9]. Research warns that the COVID-19 pandemic may lead to a medium- and long-term increase in alcohol consumption, especially among men [10]. Early studies into the effects of the pandemic have discovered an association between poor overall mental health and increased alcohol use [11]. According to a study conducted in Canada, stress was the third most common (44%) cause of drinking during the pandemic. In the USA, psychological distress caused by the pandemic was associated with increased frequency of alcohol use in both men and women [12]. Research demonstrates that while some proportion of the adult population are increasing their alcohol consumption during the pandemic, an equal proportion are cutting down on alcohol, and 50-70% of the population are not changing their level of alcohol consumption [11, 13]. Because changes in alcohol consumption during the current pandemic may have serious long-term social and economic implications for individuals, groups of people and society as a whole [14, 15], there is a need to monitor these changes and analyze the contributing factors that come forward during a large-scale crisis.
In Russia, online social networking services are actively used by the significant proportion of the population. This opens up a possibility to rapidly assess alcohol consumption among Russian residents and remotely (i.e., via the Internet) implement brief interventions aimed at preventing health problems and other adverse outcomes associated with alcohol use. The aim of this study was to assess changes in alcohol consumption and the factors associated with the increase in alcohol use in the first months of the COVID-19 pandemic among online social media users in Russia in order to explore the possibility of delivering screening and preventive interventions, including those implemented via the Internet, aimed at identifying and preventing alcohol-related problems during large-scale epidemics and public health crises.
METHODS
An anonymous online survey was conducted from June 18 to September 30, 2020 among users of online social media popular in Russia (Odnoklassniki, VKontakte, Facebook and Twitter). The following inclusion criteria were applied: age > 18 years, being an Internet user with or without a user account in the online social media mentioned above, informed consent to participate in the anonymous confidential online survey. Non-inclusion criteria: permanent residence of the respondent outside Russia. Exclusion criteria: refusal to participate or have one's personal data
processed at any stage of the study, inconsistent contradictory answers to the questions included in the survey. Any participant could refuse to participate at any stage of the study. The link to the survey was posted in the online social media in various groups, on popular pages and in the news feed. The survey was adapted from the pan-European study of alcohol use during the COVID-19 pandemic [10] and modified to assess alcohol consumption behaviors in the 3 months preceding the survey. A few original questions were added to the questionnaire to assess consumption of unrecorded alcohol, such as the homemade alcohol {samogon, homemade wine, braga), alcohol brought from abroad, falsified and counterfeit alcoholic beverages, alcohol-containing liquids not intended for drinking, and other types of unrecorded alcohol. Changes in alcohol use during the first months of the pandemic were assessed from changes in the amount and frequency of alcohol consumption and the frequency of heavy episodic drinking defined as 6 or more drinks or 60g of pure ethanol on a single occasion. Statistical analysis included calculation of descriptive statistics and estimation of the proportion of respondents stratified by sociodemographic or other characteristics who had reduced or increased the frequency of drinking or the amount of alcohol consumed. We also assessed associations between the increase in drinking frequency / amount of consumed alcohol during the first months of the pandemic (dependent variables) and the sociodemographic factors, typical frequency of drinking, the typical amount of consumed alcohol, and the typical frequency of heavy episodic drinking in the past 12 months preceding the pandemic, the perceived strength of COVID-19-associated restrictions in public and everyday private life, stress, negative impact of the pandemic on professional and financial situation, and other adverse consequences of the pandemic (independent variables). The presence, direction, strength and statistical significance of the associations were assessed using unadjusted and adjusted binary logistic regression analysis. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated as measures of association. Data processing and statistical analysis were conducted in SPSS v.22 (Chicago, IL; USA).
RESULTS
Of 1,518 respondents, 57.9% were women and 42.1% were men. The majority of the respondents (87.1%) had had an alcoholic drink at least once in 12 months preceding the study (Table 1). Over half of the respondents (55.9%) were 30-49 years old and almost two-thirds had attended and/or completed higher education (63.8%). More men than women lived in larger settlements (p = 0.010) and higher-i ncome households (p < 0.001). During the first months of the pandemic, their income had changed or fallen less often than that of women (p = 0.014). The usual frequency of drinking, the number of standard drinks consumed on a typical occasion, the frequency of heavy episodic drinking, and the proportion of persons consuming unrecorded alcohol were higher among men than among women (p < 0.001). Overall, the male respondents reported they had encountered restrictions in public (p = 0.007) and everyday private (p = 0.003) life less often than women. However, almost a quarter of men (23.2%) and a third of women (30.8%) said they had encountered severe restrictions in public life, whereas one-fifth of men (19.9%) and a quarter of women (25.4%) reported having faced severe restrictions in their everyday private life during the first months of the pandemic. Men had experienced the negative effects of the pandemic on their professional or financial situation significantly less frequently than women (p = 0.005). Only 30.4% of men and 23.5% of women reported they had experienced no negative effects on their professional or financial situation. The pandemic
was a source of stress for 50.4% of men and 69.5% of women p < 0.001). A history of confirmed SARS-CoV-2 infection in a respondent, their family or close friends was reported by 21.9% of the participants, with no significant differences by sex (Table 1). In the first months of the pandemic, 35.4% of men and 25.6% of women had used alcohol more frequently than before the pandemic; 24.9% of men and 17.7% of women had increased usual consumption (volume) of alcohol on a typical drinking occasion; the frequency of heavy episodic drinking had increased in 28.5% of men and 27.9% of women.
Results of unadjusted and adjusted logistic regression analysis are shown in Tables 2-4.
Factors associated with the increase in the frequency of alcohol consumption during the first months of the pandemic
After adjustment for confounders, positive statistically significant associations between the increase in the frequency of alcohol consumption during the first months of the pandemic and the following factors were identified: age of 18-29 years (OR: 1.710;
95% CI: 1.002-2.917), higher typical frequency of alcohol use before the pandemic (from OR: 3.190, 95% CI: 1.887-5.392 for consumption 2-4 times a months, to OR: 18.727, 95% CI: 9.639-36.383 for consumption more than 2-3 times a month), higher usual consumption (volume) of alcohol on a typical drinking occasion before the pandemic (from OR: 1.941, 95% CI: 1.244-3.029 to OR: 2.234, 95%CI: 1.180-4.233), heavy episodic drinking with a frequency of once a month (OR: 2/061; 95% CI: 1.157-3.671) and once a week before the pandemic (OR: 2.012; 95% CI: 1.081-3.746), severe restrictions in everyday private life due to SARS-CoV-2 containment measures (OR: 3.127; 95% CI: 1.01 1-9.675) and severe negative consequences of the pandemic to the professional or financial situation (OR: 2.247; 95% CI: 1.131-4.465, Table 2).
Factors associated with the increase of the usual consumption (volume) of alcohol on a typical drinking occasion during the first months of the pandemic
Positive statistically significant associations were identified between the increase of the usual consumption (volume) of
Characteristic Men Women Both sexes p*
n (%) n (%) n (%)
Age (years)
18-29 150 (23.5) 172 (19.6) 322 (21.2) 0.159
30-49 351 (54.9) 497 (56.5) 848 (55.9)
> 50 138 (21.6) 210 (23.9) 348 (22.9)
Education
Secondary or below 143 (22.4) 161 (18.3) 304 (20.0) 0.108
Primary /vocational school or college 95 (14.9) 151 (17.2) 246 (16.2)
Higher (complete or incomplete) 401 (62.8) 567 (64.5) 968 (63.8)
Settlement size
< 50,000 population 111 (17.4) 196 (22.3) 307 (20.2) 0.010
50,000 to 1 million 251 (39.3) 362 (41.2) 613 (40.4)
Over 1 million 277 (43.3) 321 (36.5) 598 (39.4)
Income per household member (rubles)
< 9,999 130 (20.3) 221 (25.1) 351 (23.1) < 0.001
10,000-19,999 157 (24.6) 225 (25.6) 382 (25.2)
20,000-39,999 136 (21.3) 226 (25.7) 362 (23.8)
40,000-59,999 116 (18.2) 128 (14.6) 244 (16.1)
> 60,000 100 (15.6) 79 (9.0) 179 (11.8)
Changes in the average monthly household income since the beginning of the SARS-CoV-2 pandemic
Did not change or increased 341 (53.4) 402 (45.7) 743 (48.9) 0.014
Slightly fell 124 (19.4) 187 (21.3) 311 (20.5)
Moderately fell 79 (12.4) 149 (17.0) 228 (15.0)
Dropped significantly 95 (14.9) 141 (16.0) 236 (15.5)
Typical frequency of alcohol use in the past 12 months before pandemic
Never 84 (13.4) 108 (12.6) 192 (12.9) < 0.001
Once a month or less frequently 121 (19.3) 314 (36.5) 435 (29.3)
2-4 times a month 183 (29.2) 227 (26.4) 410 (27.6)
2-3 times a week 118 (18.8) 116 (13.5) 234 (15.7)
More often than 2-3 times a week 121 (19.3) 95 (11.0) 216 (14.5)
Number of standard alcoholic drinks consumed on a typical drinking occasion in the past 12 months before pandemic**
1-2 136 (26.0) 424 (57.1) 560 (44.2) < 0.001
3-6 256 (48.9) 256 (34.5) 512 (40.4)
7+ 131 (25.0) 63 (8.5) 194 (15.3)
Table 1. Sociodemographic characteristics of the respondents and characteristics related to typical alcohol use and the SARS-CoV-2 pandemic, by sex (%)
Characteristic Men Women Both sexes P*
n (%) n (%) n (%)
Typical frequency of heavy episodic drinking (6 or more standard drinks on a single occasion) in the past 12 months before pandemic
Never 191 (31.3) 446 (52.3) 637 (43.6) <0.001
Less than once a month 124 (20.3) 176 (20.7) 300 (20.5)
Once a month 96 (15.7) 102 (12.0) 198 (13.5)
Once a week 136 (22.3) 96 (11.3) 232 (15.9)
Every day or almost every day 63 (10.3) 32 (3.8) 95 (6.5)
Reported consumption of unrecorded alcohol
Yes 320 (51.3) 359 (41.9) 679 (45.8) < 0.001
No 304 (48.7) 498 (58.1) 802 (54.2)
Reported encountering COVID-19-related restrictions in public life in the past 3 months
No restrictions 61 (9.7) 65 (7.5) 126 (8.4) 0.007
Slight restrictions 222 (35.3) 267 (30.8) 489 (32.7)
Moderate restrictions 200 (31.8) 267 (30.8) 467 (31.2)
Severe restrictions 146 (23.2) 267 (30.8) 413 (27.6)
Reported encountering COVID-19-related restrictions in their everyday private life in the past 3 months
No restrictions 81 (12.8) 72 (8.3) 153 (10.2) 0.003
Slight restrictions 255 (40.3) 317 (36.6) 572 (38.2)
Moderate restrictions 171 (27.0) 257 (29.7) 428 (28.6)
Severe restrictions 126 (19.9) 220 (25.4) 346 (23.1)
Reported negative consequences of the pandemic to their professional or financial situation in the past 3 months
No negative consequences 189 (30.4) 203 (23.5) 392 (26.4) 0.005
Slight negative consequences 235 (37.8) 336 (38.9) 571 (38.5)
Moderate negative consequences 114 (18.4) 163 (18.9) 277 (18.7)
Severe negative consequences 83 (13.4) 161 (18.7) 244 (16.4)
Reported confirmed SARS-CoV-2 infection in themselves, their family or close friends in the past 3 months
Yes 137 (22.1) 186 (21.8) 323 (21.9) 0.949
No 484 (77.9) 667 (78.2) 1151 (78.1)
Reported stress due to the spread of SARS-CoV-2 in the past 3 months
Yes 292 (50.4) 574 (69.5) 866 (61.6) < 0.001
No 287 (49.6) 252 (30.5) 539 (38.4)
Note: * — significance of differences between the groups was assessed using x2-test for heterogeneity; ** — among alcohol drinkers (those who consumed alcohol at least once in the past 12 months).
Table 2. Associations of sociodemographic factors, typical frequency and volume of alcohol use, unrecorded alcohol consumption, negative consequences of the COVID-19 pandemic with the increase in the frequency of alcohol consumption in the first months of the COVID-19 pandemic, 2020, (OR, 95% CI)
Variables Respondents who increased frequency of alcohol consumption Unadjusted Adjusted
n / N % OR (95% CI) OR (95% CI)
Sex
Male 191/539 35.4 1.511 (1.188-1.921) 0.946 (0.664-1.348)
Female 198/743 26.6 1.0 1.0
Age (years)
18-29 91/267 34.1 1.559 (1.076-2.257) 1.710 (1.002-2.917)
30-49 228/734 31.1 1.358 (0.994-1.856) 1.082 (0.690-1.698)
> 50 70/281 24.9 1.0 1.0
Education
Secondary or below 69/236 29.2 1.610 (1.027-2.525) 1.514 (0.807-2.839)
Primary /vocational school or college 39/191 20.4 1.0 1.0
Higher (complete or incomplete) 281/855 32.9 1.908 (1.305-2.789) 1.644 (0.952-2.842)
Settlement size
s 50,000 population 54/240 22.5 0.506 (0.356-0.718) 0.952 (0.576-1.574)
Variables Respondents who increased frequency of alcohol consumption Unadjusted Adjusted
n / N % OR (95% CI) OR (95% CI)
50,000 to 1 million 141/510 27.6 0.666 (0.512-0.865) 1.272 (0.871-1.858)
Over 1 million 194/532 36.5 1.0 1.0
Income per household member (rubles)
< 9,999 73/276 26.4 0.622 (0.409-0.944) 1.048 (0.561-1.957)
10,000-19,999 83/305 27.2 0.646 (0.430-0.972) 1.009 (0.569-1.791)
20,000-39,999 101/321 31.5 0.794 (0.533-1.181) 1.222 (0.705-2.117)
40,000-59,999 73/219 33.3 0.864 (0.564-0.324) 0.934 (0.528-1.650)
> 60,000 59/161 36.6 1.0 1.0
Changes in the average monthly household income since the beginning of the SARS-CoV-2 pandemic
Did not change or increased 166/628 26.4 1.0 1.0
Slightly fell 84/258 32.6 1.344 (0.980-1.841) 1.074 (0.687-1.680)
Moderately fell 58/194 29.9 1.187 (0.832-1.693) 0.822 (0.485-1.393)
Dropped significantly 81/202 40.1 1.863 (1.336-2.598) 1.432 (0.803-2.552)
Typical frequency of alcohol use in the past 12 months before pandemic
Once a month or less frequently 32/430 7.4 1.0 1.0
2-4 times a month 110/404 27.2 4.653 (3.053-7.093) 3.190 (1.887-5.392)
2-3 times a week 115/233 49.4 12.121 (7.788-18.865) 7.017 (3.898-12.632)
More often than 2-3 times a week 132/215 61.4 19.780 (12.576-31.110) 18.727 (9.639-36.383)
Number of standard alcoholic drinks consumed on a typical drinking occasion in the past 12 months before pandemic
1-2 84/517 16.2 1.0 1.0
3-6 198/505 39.2 3.325 (2.477-4.461) 1.941 (1.244-3.029)
7+ 91/186 48.9 4.938 (3.409-7.152) 2.234 (1.180-4.233)
Typical frequency of heavy episodic drinking (6 or more standard drinks on a single occasion) in the past 12 months before pandemic
Never 61/441 13.8 1.0 1.0
Less than once a month 69/289 23.9 1.954 (1.333-2.864) 1.184 (0.712-1.969)
Once a month 77/192 40.1 4.171 (2.809-6.194) 2.061 (1.157-3.671)
Once a week 119/229 52.0 6.739 (4.634-9.801) 2.012 (1.081-3.746)
Every day or almost every day 51/92 55.4 7.749 (4.738-12.674) 1.094 (0.444-2.695)
Reported consumption of unrecorded alcohol
Yes 221/642 34.4 1.498 (1.174-1.912) 1.246 (0.897-1.730)
No 158/609 25.9 1.0 1.0
Reported encountering COVID-19-related restrictions in public life in the past 3 months
No restrictions 17/87 19.5 1.0 1.0
Slight restrictions 84/407 20.6 1.071 (0.598-1.916) 0.703 (0.250-1.977)
Moderate restrictions 133/413 32.2 1.956 (1.108-3.454) 1.068 (0.349-3.270)
Severe restrictions 151/363 41.6 2.933 (1.659-5.184) 1.020 (0.315-3.299)
Reported encountering COVID-19-related restrictions in their everyday private life in the past 3 months
No restrictions 18/111 16.2 1.0 1.0
Slight restrictions 101/470 21.5 1.414 (0.815-2.453) 1.636 (0.622-4.304)
Moderate restrictions 133/385 34.5 2.727 (1.579-4.711) 2.594 (0.890-7.564)
Severe restrictions 134/304 44.1 4.073 (2.342-7.081) 3.127 (1.011-9.675)
Reported negative consequences of the pandemic to their professional or financial situation in the past 3 months
No negative consequences 65/318 20.4 1.0 1.0
Slight negative consequences 142/492 28.9 1.579 (1.129-2.208) 1.240 (0.772-1.990)
Moderate negative consequences 87/239 36.4 2.228 (1.525-3.255) 1.524 (0.848-2.739)
Severe negative consequences 89/211 42.2 2.839 (1.930-4.177) 2.247 (1.131-4.465)
Reported confirmed SARS-CoV-2 infection in themselves, their family or close friends in the past 3 months
Yes 82/278 29.5 0.956 (0.714-1.280) 0.846 (0.575-1.245)
No 295/969 30.4 1.0 1.0
Reported stress due to the spread of SARS-CoV-2
Yes 254/746 34.0 1.587 (1.218-2.068) 1.306 (0.892-1.911)
No 108/440 24.5 1.0 1.0
alcohol on a typical drinking occasion during the pandemic and the following factors: drinking alcohol 2 times a week and more often before the pandemic (from OR: 2.587; 95% CI: 1.360-4.918 to OR: 12.021; 95% CI: 5.712-25.300), consuming 3 or more alcoholic drinks on a typical drinking
occasion before the pandemic (for 3-6 drinks OR: 2.145; 95% CI: 1.270-3.623; for 7 or more drinks OR: 2.922; 95% CI: 1.448-5.894) and increased frequency (once a week) of heavy episodic drinking (OR: 2.380; 95% CI: 1.180-4.800) (Table 3).
Table 3. Associations of sociodemographic factors, typical frequency and volume of alcohol use, consumption of unrecorded alcohol, negative consequences of the COVID-19 pandemic with the increase in the usual consumption (volume) of alcohol on a typical drinking occasion in the first months of the COVID-19 pandemic, 2020, (OR, 95% CI)
Variables Respondents who increased the usual consumption (volume) of alcohol on a typical drinking occasion Unadjusted Adjusted
n / N % OR (95% CI) OR (95% CI)
Sex
Male 129/519 24.9 1.537 (1.166-2.026) 0.875 (0.592-1.295)
Female 127/717 17.7 1.0 1.0
Age (years)
18-29 55/261 21.1 1.353 (0.872-2.100) 1.609 (0.875-2.961)
30-49 157/708 22.2 1.444 (0.999-2.088) 1.396 (0.838-2.325)
> 50 44/267 16.5 1.0 1.0
Education
Secondary or below 49/244 21.9 1.680 (0.990-2.851) 1.810 (0.884-3.703)
Primary /vocational school or college 25/175 14.3 1.0 1.0
Higher (complete or incomplete) 182/837 21.7 1.667 (1.059-2.625) 1.797 (0.950-3.398)
Settlement size
< 50,000 population 39/232 16.8 0.614 (0.412-0.915) 0.986 (0.568-1.709)
50,000 to 1 million 90/491 18.3 0.682 (0.503-0.925) 1.017 (0.664-1.558)
Over 1 million 127/513 24.8 1.0 1.0
Income per household member (rubles)
s 9,999 54/259 20.8 0.926 (0.573-1.497) 1.300 (0.647-2.609)
10,000-19,999 60/295 20.3 0.897 (0.561-1.436) 1.434 (0.755-2.723)
20,000-39,999 66/310 21.3 0.951 (0.598-1.511) 1.473 (0.794-2.734)
40,000-59,999 41/214 19.2 0.833 (0.502-1.383) 0.887 (0.460-1.710)
> 60,000 35/158 22.2 1.0 1.0
Changes in the average monthly household income since the beginning of the SARS-CoV-2 pandemic
Did not change or increased 102/603 16.9 1.0 1.0
Slightly fell 50/255 19.6 0.417 (0.288-0.603) 0.917 (0.550-1.528)
Moderately fell 41/186 22.0 0.499 (0.324-0.769) 0.990 (0.559-1.753)
Dropped significantly 63/192 32.8 0.579 (0.366-0.916) 1.686 (0.915-3.104)
Typical frequency of alcohol use in the past 12 months before pandemic
Once a month or less frequently 21/421 5.0 1.0 1.0
2-4 times a month 66/386 17.1 3.929 (2.353-6.559) 2.587 (1.360-4.918)
2-3 times a week 70/225 31.1 8.602 (5.105-14.494) 4.617 (2.309-9.233)
More often than 2-3 times a week 99/204 48.5 17.959 (10.703-30.136) 12.021 (5.712-25.300)
Number of standard alcoholic drinks consumed on a typical drinking occasion in the past 12 months before pandemic
1-2 44/509 8.6 1.0 1.0
3-6 132/492 26.8 3.875 (2.682-5.598) 2.145 (1.270-3.623)
7+ 76/186 40.9 7.302 (4.771-11.174) 2.922 (1.448-5.894)
Typical frequency of heavy episodic drinking (6 or more drinks on a single occasion) in the past 12 months before pandemic
Never 32/440 7.3 1.0 1.0
Less than once a month 45/284 15.8 2.401 (1.485-3.882) 1.434 (0.781-2.632)
Once a month 43/192 22.4 3.680 (2.244-6.034) 1.876 (0.956-3.681)
Once a week 90/228 39.5 8.315 (5.317-13.004) 2.380 (1.180-4.800)
Every day or almost every day 46/92 50.0 12.750 (7.397-21.978) 2.376 (0.905-6.240)
Reported consumption of unrecorded alcohol
Yes 145/620 23.4 1.385 (1.046-1.834) 0.906 (0.628-1.308)
No 106/587 18.1 1.0 1.0
Variables Respondents who increased the usual consumption (volume) of alcohol on a typical drinking occasion Unadjusted Adjusted
n / N % OR (95% CI) OR (95% CI)
Reported encountering COVID-19-related restrictions in public life in the past 3 months
No restrictions 13/84 15.5 1.0 1.0
Slight restrictions 49/378 13.0 0.813 (0.419-1.579) 1.092 (0.341-3.497)
Moderate restrictions 88/408 21.6 1.502 (0.795-2.839) 1.472 (0.409-5.298)
Severe restrictions 104/357 29.1 2.245 (1.191-4.231) 1.539 (0.407-5.820)
Reported encountering COVID-19-related restrictions in their everyday private life in the past 3 months
No restrictions 16/108 14.8 1.0 1.0
Slight restrictions 55/449 12.2 0.803 (0.440-1.464) 0.809 (0.282-2.318)
Moderate restrictions 93/374 24.9 1.903 (1.065-3.400) 1.767 (0.550-5.681)
Severe restrictions 91/296 30.7 2.552 (1.421-4.584) 1.737 (0.509-5.931)
Reported negative consequences of the pandemic to their professional or financial situation in the past 3 months
No negative consequences 42/308 13.6 1.0 1.0
Slight negative consequences 83/472 17.6 1.351 (0.903-2.021) 0.976 (0.566-1.683)
Moderate negative consequences 60/232 25.9 2.209 (1.425-3.425) 1.453 (0.761-2.776)
Severe negative consequences 67/205 32.7 3.075 (1.986-4.761) 2.072 (0.983-4.369)
Reported confirmed SARS-CoV-2 infection in themselves, their family or close friends in the past 3 months
Yes 47/270 17.4 0.772 (0.544-1.098) 0.686 (0.442-1.064)
No 200/933 21.4 1.0 1.0
Reported stress due to the spread of SARS-CoV-2
Yes 168/726 23.1 1.523 (1.116-2.077) 1.265 (0.819-1.952)
No 69/418 16.5 1.0 1.0
Table 4. Associations of sociodemographic factors, typical frequency and volume of alcohol use, consumption of unrecorded alcohol, negative consequences of the COVID-19 pandemic with the increase in the frequency of heavy episodic drinking in the first months of the COVID-19 pandemic, 2020, (OR, 95% CI)*
Variable Respondents who increased the frequency of heavy episodic drinking Unadjusted Adjusted
n / N OR (95% CI) OR (95% CI) OR (95% CI)
Sex
Male 117/411 28.5 1.028 (0.755-1.400) 0.759 (0.497-1.159)
Female 108/387 27.9 1.0 1.0
Age (years)
18-29 50/173 28.9 1.370 (0.831-2.260) 1.732 (0.867-3.462)
30-49 140/472 29.7 1.422 (0.929-2.176) 1.363 (0.762-2.437)
> 50 35/153 22.9 1.0 1.0
Education
Secondary or below 47/171 27.5 1.401 (0.792-2.477) 1.487 (0.700-3.157)
Primary /vocational school or college 23/108 21.3 1.0 1.0
Higher (complete or incomplete) 155/519 29.9 1.574 (0.957-2.588) 1.476 (0.753-2.894)
Settlement size
< 50,000 population 36/153 23.5 0.698 (0.451-1.080) 1.043 (0.567-1.918)
50,000 to 1 million 81/292 27.7 0.871 (0.619-1.226) 1.534 (0.944-2.493)
Over 1 million 108/353 30.6 1.0 1.0
Income per household member (rubles)
< 9,999 53/177 29.9 1.187 (0.688-2.047) 1.458 (0.680-3.130)
10,000-19,999 48/184 26.1 0.980 (0.566-1.698) 1.210 (0.589-2.488)
20,000-39,999 57/195 29.2 1.147 (0.670-1.964) 1.299 (0.650-2.596)
40,000-59,999 40/140 28.6 1.111 (0.627-1.970) 1.218 (0.593-2.501)
> 60,000 27/102 26.5 1.0 1.0
Changes in the average monthly household income since the beginning of the SARS-CoV-2 pandemic
Did not change or increased 90/380 23.7 1.0 1.0
Slightly fell 43/167 25.7 1.117 (0.734-1.700) 1.087 (0.618-1.914)
Moderately fell 41/130 31.5 1.484 (0.957-2.303) 1.246 (0.664-2.337)
Dropped significantly 51/121 42.1 2.348 (1.525-3.614) 1.624 (0.812-3.246)
Typical frequency of alcohol use in the past 12 months before pandemic
Once a month or less frequently 13/142 9.2 1.0 1.0
2-4 times a month 56/277 20.2 2.514 (1.324-4.775) 1.315 (0.566-3.056)
2-3 times a week 64/192 33.3 4.962 (2.605-9.451) 2.756 (1.137-6.679)
More often than 2-3 times a week 92/187 49.2 9.610 (5.076-18.194) 6.581 (2.585-16.749)
Number of standard alcoholic drinks consumed on a typical drinking occasion in the past 12 months before pandemic
1-2 21/171 12.3 1.0 1.0
3-6 122/403 30.3 3.101 (1.874-5.132) 1.583 (0.836-2.999)
7+ 78/184 42.4 5.256 (3.056-9.040) 2.202 (1.014-4.779)
Typical frequency of heavy episodic drinking (6 or more drinks on a single occasion) in the past 12 months before pandemic
Never 38/288 13.2 1.0 1.0
Less than once a month 46/190 24.2 2.102 (1.306-3.383) 2.561 (1.341-4.893)
Once a month 94/228 41.2 4.615 (2.998-7.104) 3.411 (1.746-6.665)
Once a week 47/92 51.1 6.871 (4.034-11.703) 2.647 (1.030-6.803)
Reported consumption of unrecorded alcohol
Yes 127/430 29.5 1.166 (0.851-1.599) 0.897 (0.596-1.349)
No 1.0 1.0
Reported encountering COVID-19-related restrictions in public life in the past 3 months
No restrictions 12/62 19.4 1.0 1.0
Slight restrictions 48/266 18.0 0.917 (0.454-1.854) 0.943 (0.263-3.379)
Moderate restrictions 79/239 33.1 2.057 (1.037-4.082) 1.553 (0.381-6.329)
Severe restrictions 81/224 36.2 2.360 (1.188-4.689) 0.820 (0.187-3.599)
Reported encountering COVID-19-related restrictions in their everyday private life in the past 3 months
No restrictions 12/83 14.5 1.0 1.0
Slight restrictions 57/295 19.3 1.417 (0.720-2.787) 1.513 (0.467-4.899)
Moderate restrictions 78/222 35.1 3.205 (1.638-6.269) 2.690 (0.720-10.055)
Severe restrictions 75/191 39.3 3.825 (1.944-7.530) 3.889 (0.969-15.608)
Reported negative consequences of the pandemic to their professional or financial situation in the past 3 months
No negative consequences 40/195 20.5 1.0 1.0
Slight negative consequences 72/306 23.5 1.192 (0.771-1.845) 0.699 (0.383-1.275)
Moderate negative consequences 54/153 35.3 2.114 (1.307-3.417) 1.280 (0.625-2.621)
Severe negative consequences 57/132 43.2 2.945 (1.805-4.804) 2.329 (1.001-5.428)
Reported confirmed SARS-CoV-2 infection in themselves, their family or friends in the past 3 months)
Yes 48/171 28.1 0.986 (0.676-1.438) 0.893 (0.554-1.439)
No 171/603 28.4 1.0 1.0
Reported stress due to the spread of SARS-CoV-2
Yes 140/423 33.1 1.749 (1.251-2.466) 1.004 (0.628-1.606)
No 69/313 22.0 1.0 1.0
Note: * — respondents who had never drunk 6 or more alcoholic drinks on a single occasion in the past 12 months were excluded from the analysis.
Factors associated with the increase in the frequency of heavy episodic drinking during the first months of the pandemic
Positive statistically significant associations were identified between the increase in the frequency of heavy episodic drinking during the pandemic and the following factors: drinking alcohol 2-3 times a week (OR: 2.756; 95% CI: 1.137-6.679) or more often before the pandemic (OR: 6.581; 95% CI: 2.585-
16.749), having 7 or more drinks on a typical drinking occasion before the pandemic (OR: 2.202; 95% CI: 1.014-4.779) and heavy episodic drinking once a month or more often before the pandemic (from OR: 2.561; 95% CI: 1.341-4.893 to OR: 2.647; 95% CI: 1.030-6.803) (Table 4). The odds of increase in the frequency of heavy episodic drinking were significantly more than two times higher among persons who reported severe negative consequences of the pandemic to their financial or professional situation (OR: 2.329; 95% CI: 1.001-5.428).
DISCUSSION
The associations revealed in our study are corroborated by other research works conducted in various countries during the first months of the pandemic. Specifically, in an Israeli study male sex was associated with increased consumption of beer and strong liquors [16], whereas in another study conducted in Canada male sex, stress, the feelings of isolation and hopelessness were associated with increased frequency of alcohol use in the first months of the pandemic [17]. In a UK study, stress caused by the pandemic was associated with the rise in hazardous drinking [18]. High levels of anxiety and stress caused by the pandemic led to the increase in alcohol use in Australia, France and Canada [17, 19, 20].
A few studies investigated changes in alcohol consumption in the general population unstratified by pandemic-related factors. Thus, a French publication reported an increase in total alcohol consumption during the lockdown [20]; by contrast, alcohol use in Greece and Spain during the lockdown was declining [21, 22]. However, in Greece and Spain the decline was less pronounced among stressed individuals and those with low or middle income. Compared to the prepandemic level, alcohol was purchased in larger quantities during the lockdown by Russian [23, 24] and UK households [25]. During the first months of the pandemic, retail alcohol sales were on the rise in the US [26]. A global study investigating changes in the availability and use of psychoactive drugs and alcohol during the pandemic reported a 71% increase in alcohol consumption across the world [27]. However, according to another large-scale study, alcohol consumption in the general population decreased in most European countries, including Russia, during the first months of the pandemic, mostly due to the reduction in the frequency of heavy episodic drinking [22].
Our study discovered a significant increase in 3 key parameters of alcohol consumption during the first months of the pandemic among those individuals who initially had consumed alcohol in larger quantities and more frequently. These key parameters include the frequency of drinking, the usual consumption (volume) of alcohol on a typical drinking occasion and the frequency of heavy episodic drinking. These findings suggest polarization of alcohol use, i.e. a situation when alcohol consumption grows among those who drink more at baseline and declines among those who typically drink less. This is consistent with the results of another online survey conducted in the general adult population of Russia [28]. The associations established in our study between the increase in the frequency of alcohol use/ heavy episodic drinking and such COVID-19-related factors
as severe restrictions of everyday private life and the negative consequences of the pandemic to professional or financial situation uncover a new aspect or mechanism associated with stress which drives changes in drinking behaviors during the pandemic. Our findings go in line with the stress-associated patterns reported by the studies mentioned above and are consistent with previously reported changes in drinking behavior among Russians determined by certain sociodemographic characteristics, environmental factors and stress in times of socioeconomic and public health crises [29].
A potential limitation of this study might be the insufficient representativeness of the surveyed sample of online social media users in Russia. However, the size of this selection bias is likely small, because the survey was conducted among the users of social networking services highly popular in Russia and because the sociodemographic characteristics of the respondents were generally the same as those of the vast majority of online social media users in Russia. Besides, the consistency of the established patterns and associations with the results of other studies suggests that the probability of our results not being the consequence of selection bias is high. Another limitation of this study is that changes in alcohol consumption were assessed without differentiating between recorded and unrecorded alcohol. Therefore, additional analysis is needed to investigate changes in the consumption of unrecorded alcohol [30], considering its fairly high availability in Russia during the COVID-19 pandemic [31].
CONCLUSIONS
During the first months of the COVID-19 pandemic, over one-third of male and quarter of female online social media users in Russia increased the frequency of drinking. One in four men and one in five women increased their usual consumption (volume) of alcohol on a typical drinking occasion, and about one-third of men and women engaged in heavy episodic drinking more frequently than before the pandemic. Increased alcohol consumption during the first months of the pandemic was associated with male sex, younger age, severe restrictions imposed on everyday private life and severe negative consequences of the pandemic to the professional or financial situation. Further research is needed to investigate the possibility of implementing screening and brief interventions via online social media to prevent problems associated with alcohol use during large-scale epidemics and public health crises.
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Литература
1. РосСтат (Федеральная служба государственной статистики). [процитировано 18.10.2021]. Official Statistics. Доступно по ссылке: https://eng.gks.ru/folder/11335.
2. Артамонов Р. Е., Лаврентьев Н. В. Опрос общественного мнения населения РФ. Изменения, вызванные эпидемией коронавируса и режимом самоизоляции. Аналитический бюллетень НИУ ВШЭ. 2020; (3): 4-24. Доступно по ссылке: https://www.hse.ru/mirror/pubs/share/368507661.pdf.
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