Similar percentages of Canadians increased and decreased their alcohol consumption during the first two waves of the COVID-19 pandemic in 2020, according to a new study.
In a study of nearly 30,000 participants in the Canadian Longitudinal Aging Study (CLSA), 13% reported an increase in alcohol consumption and 13.3% reported a decrease in consumption.
“We found that about 26.3% said they had changed their alcohol intake,” study author Jacqueline McMillan, MD, geriatrician and clinical assistant professor at the University of Calgary, Alberta, told Medscape Medical News. McMillan is site manager for CLSA in Calgary. “We were surprised to find that this was almost equivalent to the number of people who increased their alcohol consumption and the number of people who reduced their alcohol consumption.”
The data was published online July 11 in the Canadian Journal of Public Health.
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The aim of the study was to examine the proportion of changes in alcohol consumption and heavy drinking during the first 10 months (corresponding to the first two waves) of the COVID-19 pandemic among middle-aged and older people. The researchers also sought to identify factors associated with changes in alcohol consumption. Respondents were CLSA participants who agreed to complete a COVID-19 questionnaire covering the first (April-May 2020) and second (September-December 2020) waves of the pandemic.
The researchers found that predictors of increased consumption were female gender, lower age (under 75), higher income, current cannabis smoking, and depression or anxiety. People whose incomes exceeded $150,000 a year were 3.3 times more likely to have increased alcohol consumption. “Many of these were consistent with other studies, but keep in mind that our study is in middle-aged and older Canadians,” McMillan said.
According to McMillan, male gender, higher education, annual income of more than $150,000, and living alone are predictors of declining alcohol consumption.
The researchers also questioned binge drinking (defined as drinking 5+ drinks at a time for men and 4+ drinks for women) since the start of the pandemic. Overall, 11.2% of respondents met the criteria for episodic binge drinking, which was defined as less than once a month, and 16.7% met the criteria for regular binge drinking, which was defined as one or more times a month.
Of those who increased their alcohol consumption since the start of the pandemic, 46.2% met the criteria for regular drinking and 13.6% for occasional drinking. (The remaining 40% did not meet the criteria for drunkenness.)
Previous and current marijuana/cannabis use were associated with 1.4-fold and 1.9-fold increased odds, respectively, of increased use compared to non-use. In addition, previous cannabis use was associated with a 1.5-fold increase in the likelihood of binge drinking, while current cannabis use was associated with a 2.9-fold increase.
Macmillan acknowledged that a shortcoming of this analysis is that consumption reports were received from respondents.
“That’s one of the limitations of the study,” McMillan said. “We ask people to report themselves and, intentionally or unintentionally, there may be some understatements and overstatements, but this is probably more of an understatement.”
Consequences of the risk of falling
Kevin Shield, PhD, an independent researcher at the Center for Addiction and Mental Health in Toronto, Canada, noted the liberalization of access to alcohol in Canada during the pandemic. “One strategy to help businesses during the pandemic has been to make alcohol available to order through food delivery apps,” Shield told Medscape. “And if you didn’t take takeaway food, alcohol could come to your door. There was also a huge increase in online sales.”
Shield agreed that self-reporting alcohol consumption could lead to inaccurate reporting of alcohol consumption, which is commonly characterized as an underreporting. “Our memories can be wrong when we try to quantify alcohol consumption,” Shield said.
What Shield considered the strength of this investigation was the narrowing of the age range of the respondents. “Strength [of this study] focuses on people who are slightly older, as opposed to studies that try to capture changes in alcohol consumption across all ages,” he said.
In addition, the way the researchers conducted the study was suggestive as they looked at the number of drinks consumed, asking if there was an increase or decrease, Shield said.
“Usually we only focus on average changes,” Shield said. “In this case, they asked if you increased or decreased your alcohol consumption. They see it as two separate outcomes, which allows us to better understand why people change their drinking.”
Shield noted that the combined use of alcohol and cannabis seen in the study is worrisome because consumption of each affects gait, putting older adults at risk for events such as falls.
“If you combine these two substances, alcohol and cannabis, there is a synergistic effect,” Shield said. “This will increase the risk of falls among these people. It’s really about injuries among the elderly.”
The study, based on the CLSA COVID-19 questionnaire, was funded by the Jurawinski Research Institute, McMaster University, the McMaster Institute for Research on Aging, Public Health Canada and the Government of Nova Scotia. The Canadian Longitudinal Aging Study was funded by the Canadian Institutes of Health Research, the Canadian Innovation Foundation, Newfoundland and Labrador, Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia. McMillan and Shield reported no relevant financial relationship.
May J Public Health. Published online July 11, 2022 Full text
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