Alcohol-related harm in families and alcohol consumption during COVID-19

Content type
Policy and practice paper
Published

July 2021

Researchers

Claire Farrugia

Summary

This paper explores alcohol-related harm within families and the best available evidence on alcohol consumption during the restrictions related to COVID-19 in Australia, from March to July 2020. Drawing on a scoping review of survey data and established evidence, the paper explores what alcohol-related harm looks like, what we know about alcohol consumption and alcohol-related harm during the early stages of COVID-19, and how practitioners can adopt a harm-minimisation approach when working with clients.

This publication is intended to provide the basis for practitioners without specialist alcohol and other drug training to gain a greater understanding of how alcohol consumption changed during COVID-19, to better understand potential alcohol-related harms, and to develop strategies to support clients who may be experiencing harm themselves or in their families.

Key messages

  • Alcohol-related harm in a family can present in a number of ways, from interrupted sleep and difficulty caregiving through to experiencing or perpetrating abuse and violence. While small amounts of alcohol can cause harm, the level of harm can differ according to the circumstances of a family.

  • Evidence shows that there can be changes in alcohol consumption during large-scale disasters and this may increase harm in families.

  • While a large proportion of people maintained their consumption of alcohol at pre-COVID-19 levels during March-July 2020 in Australia, people reporting higher levels of stress and women were more likely to increase their alcohol consumption.

  • During COVID-19, several factors may result in increased alcohol consumption, including greater stress levels, being bored and spending more time at home.

  • A short discussion with clients in the form of a 'brief intervention' can help identify current or potential alcohol-related harms and appropriate referral pathways when significant harm is present.

Introduction

Introduction

Drinking alcohol can be a source of pleasure and social connection (Harrison, Kelly, Lindsay, Advocat, & Hickey, 2011; Keane, 2009). However, even low levels of alcohol consumption can contribute to harm. Alcohol can impact physical and cognitive functioning, impair a sense of caring responsibility, reduce time or money available for basic needs or unsettle the attachments children and parents share with each other and with extended family members (Bergmans, Coughlin, Wilson, & Malecki, 2019; Lander, Howsare, & Byrne, 2013; World Health Organization [WHO], 2006). Harms can be immediate, such as those experienced from alcohol-induced family violence, or longer term, such as impacts on young people's alcohol consumption behaviours.

Alcohol-related harms can include a general disruption to the wellbeing of family members. Family wellbeing includes the mental and physical health of parents or caregivers, the ability of a family to meet its own basic needs in terms of housing, food and support, and the resilience of a family unit to manage conflict or stressful situations in a way that supports the growth of adults and children (Newland, 2015). Families can include a variety of caring relationships between people who are, or are not, biologically related and who live in the same house or live separately. High-quality evidence shows children's adjustment to new and stressful situations is related to the strength and cohesion of relationships in a family. As a result, the current paper is focused on the relationship between the parent/carer and the child in the context of alcohol-related harms (Browne, Plamondon, Prime, Puente-Duran, & Wade, 2015; Daniels & Bryan, 2021).

Alcohol consumption during and after disasters

The last decade has seen a global increase in extreme weather conditions and natural disasters. In Australia, much of the population experienced extreme heat, bushfires, floods or cyclones. These events have adversely affected the health and wellbeing of families (Bryant et al., 2017; Molyneaux et al., 2020; Taylor et al., 2010). Experiencing stressful events can increase a person's alcohol consumption (Keyes, Hatzenbuehler, & Hasin, 2011) to help reduce tension and cope during such times (Blevins, Abrantes, & Stephens, 2016). While there are different aspects to how an infectious disease outbreak and a natural disaster affect wellbeing, they can both involve an abrupt change in daily routine and an increased sense of uncertainty (Esterwood & Saeed, 2020).

However, evidence of how alcohol consumption and alcohol-related harms change after large-scale disasters is limited (Reifels, Mills, Dückers, & O'Donnell, 2019). Evidence from the US points to a reported increase in alcohol consumption after people experience terror events (Boscarino, Adams, & Galea, 2006; Keyes et al., 2011), an increased risk of alcohol use disorder after human-made disasters such as transport accidents, mass shootings or purposely lit fires (Reifels et al., 2019) and higher levels of drinking and more binge drinking following natural disasters (Cerdá, Tracy, & Galea, 2011). Less consistent evidence is available on how long these changes in alcohol consumption last after these events (Keyes et al., 2011).

Changes in alcohol consumption are not uniform across a population exposed to disaster. Pre-existing factors also shape how much people change their alcohol consumption (Collins, 2016; Esterwood & Saeed, 2020). People who experience social and economic adversity, such as those with lower income levels, are likely to experience greater social and financial impact from exposure to natural disasters. This can affect their alcohol use and widen existing health disparities (Cerdá et al., 2011).

Impact of COVID-19

In March 2020, COVID-19 reached the status of global pandemic. Federal and state governments in Australia introduced social distancing measures and 'lockdowns' to slow the spread of the virus. This resulted in substantial changes to living arrangements and conditions for many individuals and families. Many parents were required to work from home while others lost their employment and income. With school restrictions in place, children continued schooling from the family home.

By the end of April 2020, 46% of Australians said that they were working from home and approximately a third of Australians (31%) aged 18 years and over reported that their household finances had worsened due to COVID-19 (Australian Bureau of Statistics [ABS], 2020b). Parents and families experienced multiple stressors that continued into mid-2020, the most widespread of which was loneliness (14% of people Australia-wide) (ABS, 2020d). Mental distress increased during this time with two in five Australians (42%) reporting that they felt restless or fidgety at least some of the time (compared with 24% in the 2017-18 National Health Survey) (ABS, 2020b). One in three Australians (35%) felt nervous at least some of the time (compared with 20% in the 2017-18 National Health Survey).

Alcohol consumption can change in times of mental distress. In the context of COVID-19 and associated lockdowns, assessing the extent of this change and the factors that influence it can help identify potential alcohol-related harms.

This paper presents evidence about alcohol-related harms, alcohol consumption at the beginning of the COVID-19 pandemic in Australia and family health and wellbeing. The aims of the paper are to support non-alcohol specialist practitioners (family violence practitioners, youth workers, child protection caseworkers and so on) who work with families to:

  • understand what alcohol-related harm is in the family and how to identify harm
  • understand how alcohol use changed at the beginning of the COVID-19 pandemic in Australia
  • understand the factors that contributed to changes
  • understand the harm minimisation approach to alcohol consumption
  • work with families to identify and use appropriate strategies to minimise alcohol-related harms.
Methodology

Methodology

A scoping review was undertaken to assess best available evidence on alcohol-related harm, alcohol consumption during the COVID-19 pandemic in Australia and the health and wellbeing of families. The review followed the steps outlined by Arksey and O'Malley (2005):

  1. Identify the research question.
  2. Identify relevant studies with comprehensive search strategies that are documented and can be reproduced.
  3. Based on an understanding of the literature, establish inclusion/exclusion criteria as the basis for deciding on studies that are credible and will contribute to answering the research question.
  4. Analyse the studies to sort and categorise the available evidence and knowledge in a useful way to answer the question.
  5. Collate the various findings of the studies and present the results in various forms depending on the type of studies included.
  6. Consult and engage with stakeholders as means of checking the validity and utility of the analysis.

The primary research question for the review was: Did alcohol consumption change in families during the COVID-19 pandemic in Australia? The secondary question was: What impact does alcohol-related harm have on family wellbeing?

The search strategy was guided by inclusion criteria (see Appendix A). The databases searched were: Web of Science, APA PsycInfo, Medline, Scopus and Google Scholar. Google was also searched for survey material that had not yet been peer-reviewed. An initial search was conducted with a combination of key words including: 'alcohol', 'alcohol consumption', 'drinking behaviour', 'alcohol interventions', 'risky drinking', 'COVID-19 or coronavirus' and 'Australia'.

Empirical studies were included if they recorded the prevalence of alcohol consumption, change in consumption over time and factors associated with alcohol consumption during COVID-19 in Australia. Articles were also required to meet the inclusion criteria in Appendix A and were excluded if they focused on the health impacts of alcohol on someone who has contracted COVID-19 or had a focus on, or were published by, the alcohol industry. The database literature search identified 196 publications. After excluding articles that did not fit the criteria and removing duplicates, 25 articles remained on the topic of alcohol consumption during COVID-19. In those articles, 10 sources of Australian alcohol consumption data were identified that were collected in the period from March to May 2020 and one source of data collected in June-July 2020. These 11 studies became the focus of this review (see Appendix B).

Secondary searches were conducted to target the impact on family health and wellbeing, key words included: 'family', 'family wellbeing' and 'alcohol consumption'. Due to limited results, the search was expanded to include 'disaster', 'natural disaster', 'mental distress' and 'stress' to provide context for changes in alcohol consumption during periods of widespread mental distress. Additional publications were included in the broader discussion in this paper when they provided contextual evidence on alcohol use during and after natural and human disasters.

Further searches were undertaken to identify tools and guidelines that assist practitioners to identify alcohol-related harms and engage in harm minimisation. These searches were conducted in Google. While the included studies on alcohol in Australia were limited to 2020, older literature was included where it provided important context. Publications included peer-reviewed and other publicly available reports from reputable sources.

Of the 11 included surveys, only four were peer-reviewed and the remaining seven were not subject to peer review prior to publication. The sample size ranged from 319 to 14,632. Small sample sizes can limit how much the findings can be generalised to other population groups. While the studies provide useful insights into alcohol consumption during COVID-19, some caution should be exercised in interpreting results as they are limited in their ability to represent changes across the Australian population.

What does the evidence indicate?

What does the evidence indicate?

Limited research data exist on the prevalence and characteristics associated with parental alcohol use in Australia. Data from the 2007 and 2013 Australian National Drug Strategy Household Survey suggest that parents are more likely to report being moderate drinkers, less likely to report being abstainers and less likely to report being risky drinkers than non-parents (Laslett, Jiang, & Room, 2017). Parents are also less likely to exceed alcohol guidelines than people who are not parents (Bowden, Delfabbro, Room, Miller, & Wilson, 2019; Maloney, Hutchinson, Burns, & Mattick, 2010). Therefore, parents may engage in less harmful alcohol consumption behaviours than adults who do not have children.

Some differences between parental roles are also evident. For instance, some data from the 2007 Australian National Drug Strategy Household Survey suggest that single mothers were more likely to report binge drinking, compared to mothers from couple families (Dawe et al., 2007; Maloney et al., 2010). However, mothers are also more likely to report being abstainers than fathers (Laslett et al., 2017) and fathers are more likely to exceed alcohol guidelines than mothers (Bowden et al., 2019). Overall, parents are more likely to report drinking in the home than non-parents (Bowden et al., 2019).

Changes in alcohol consumption during COVID-19

The evidence included in this review suggests that COVID-19 and its associated stressors changed alcohol consumption in Australia for some people (ABS, 2020a; Biddle, Edwards, Gray, & Sollis, 2020; Callinan et al., 2020; Neill et al., 2020). For many, their frequency and quantity of alcohol consumption either stayed the same or declined compared with pre-pandemic levels (ABS, 2020c; Biddle et al., 2020; Callinan et al., 2020). However, for those reporting higher levels of stress and for women aged 36-50 there was an increase in alcohol consumption. This varied pattern of change is similar to changes in alcohol consumption previously reported in international studies exploring alcohol consumption during times of high collective stress (ABS, 2020a; Biddle et al., 2020; Callinan et al., 2020; Neill et al., 2020; Nordløkken, Pape, Wentzel-Larsen, & Heir, 2013).

Decreased alcohol consumption during 
COVID-19
Increased alcohol consumption during 
COVID-19
  • Young people aged between 18-25
  • Young women aged 26-35
  • Men aged 51-65
  • Women aged 36-50
  • People experiencing high levels of stress
  • Men with a decrease in hours worked

Stable alcohol consumption: Eleven sources of data explored the potential effect of COVID-19 in Australia on adult alcohol consumption (see Appendix B). Between 38% (Foundation for Alcohol Research and Education [FARE], 2020a) and 47% (ABS, 2020a) of Australian adults maintained stable alcohol consumption. The ABS reported differences between men and women, with more men (54%) than women (40%) reporting stable alcohol consumption levels (ABS, 2020a).

Decreases in alcohol consumption: The Centre for Alcohol Policy Research at La Trobe University asked 1,684 Australians about how their alcohol intake during May 2020, two months into social distancing, compared to levels before the COVID-19 outbreak (Callinan et al., 2020). All groups of people except men aged 26-35 decreased their risky drinking frequency. Further, the following three groups of adults decreased their overall alcohol consumption (Callinan et al., 2020):

  • young people aged 18-25
  • young women aged 26-35
  • men aged 51-65.

A decrease in alcohol consumption was also reported by the Centre for Social Research Methods at the Australian National University in their 34th ANU Poll of 3,219 people (Biddle et al., 2020). In May 2020, around two months after the introduction of the first COVID-19 lockdown in Australia, 27% of people reported drinking less (Biddle et al., 2020).

The proportion of men (27.5%) and women (26.7%) reporting decreases was similar. A smaller survey of 319 commissioned by Hello Sunday Morning showed that, during the March lockdown, the biggest overall change in drinking patterns was an increase in the number of people drinking less. After the first two weeks of lockdown, 22% of people were drinking less, and this figure rose to 29% after seven weeks in lockdown (Hello Sunday Morning, 2020). Assessing a later period of time, the ABS reported a similar trend with 1,022 adults: 9.5% of those surveyed in April/May 2020 reported decreased alcohol consumption (ABS, 2020a). Overall, Roy Morgan (2020) reported that 66.3% (13,073,000) of Australians aged 18+ in the year to March 2020 had consumed alcohol in an average four-week period, a slight decrease from 67.5% (13,102,000) from 12 months previous.

In June-July, the Gambling in Australia during COVID-19 study conducted by the Australian Gambling Research Centre, Australian Institute of Family Studies, surveyed 2,019 participants and reported decreases in people drinking four or more times a week (Jenkinson, Sakata, Khokhar, Tajin, & Jatkar, 2020). Despite higher levels of alcohol consumption overall, decreases in drinking were also observed among men and young people aged 18-34 years and there was an increase of people reporting that they 'never' consumed alcohol from before COVID-19 to June 2020 (Jenkinson et al., 2020).

Increases in alcohol consumption: Across studies, the proportion of people who reported increasing their alcohol consumption ranged from 14% (ABS, 2020a) through to 20% (Biddle et al., 2020) in May 2020. Some differences between population groups, and different types of drinking behaviours, were also evident.

For instance:

  • Three times more people (14%) reported drinking daily in April-May 2020 compared to January 2020 (5%) (FARE, 2020a).
  • Eighteen per cent of women and 10% of men reported increasing alcohol consumption in May 2020 (ABS, 2020a).
  • Women aged 36-50 reported an increase in both the frequency and quantity of consumption between April and May 2020 (Callinan et al., 2020).
  • People experiencing high levels of stress reported relatively higher levels of consumption than those with lower levels of stress between April and May 2020 (Callinan et al., 2020).

In the FARE poll, one in five (20%) households reported buying more alcohol than usual since the COVID-19 outbreak in Australia. In households where more alcohol was purchased than usual (n = 202), 70% reported drinking more alcohol than usual since the COVID-19 outbreak in Australia (FARE, 2020a). Patterns in alcohol consumption also changed from May 2019 to May 2020. In comparison to previous years (30.3% in 2017-18), 33.8% of men reported drinking on three or more days per week. The increase was more substantial for women, increasing from 16.2% in 2017-18 to 21.9% in the year up to May 2020 (Biddle et al., 2020).

Key factors influencing alcohol consumption

A number of factors may have influenced changes in alcohol consumption during COVID-19. These include gender and carer status, employment status and income, age, mental health, and pre-COVID consumption patterns. However, the selected surveys asked different questions and used different methods to assess what factors were associated with alcohol consumption. Differences between surveys limit the evidence on why these factors are associated with an increase or decrease in alcohol consumption.

Gender and carer status

Women were more likely to have increased, and slightly less likely to report having decreased, their alcohol consumption than men during COVID-19 (ABS, 2020a). Evidence suggests that women, rather than men, increase their alcohol consumption when confronted with conflicting work and family duties (Kuntsche & Kuntsche, 2020). By May 2020, 76% of Australians with children in their household kept them home from school or child care (ABS, 2020a). Women were almost three times as likely as men to look after children full-time and on their own during May 2020 (ABS, 2020a). Of women who were primary carers, 28% reported increased alcohol consumption compared with 21% who were not primary carers (Biddle et al., 2020). This difference is not statistically significant but may represent a trend that could be better accounted for with a larger sample size.

The relationship between hours worked and alcohol consumption appears to be different according to gender. Men who decreased their number of hours worked or lost their job between March and May 2020 increased their alcohol consumption (Biddle et al., 2020). Women reported an increase in alcohol consumption regardless of whether their work hours remained stable or decreased (Biddle et al., 2020).

Employment status and income

Employment status and income do not have a consistent relationship with changes in alcohol consumption. Studies on natural and terror disasters have found lower income is associated with increased drinking (Cerdá et al., 2011). Conversely, studies on public health emergencies, such as exposure to the epidemic severe acute respiratory syndrome (SARS), reported that having higher income levels was associated with increased alcohol use (Wu et al., 2008).

In the COvid-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project of 4,462 adults, an average or higher income was associated with increased alcohol use in May 2020, after the onset of the pandemic (Neill et al., 2020). This finding may suggest that people who were able to afford to drink more alcohol increased their consumption. However, the 34th ANU Poll suggests that a decrease in hours worked is also related to an increase in alcohol consumption.

Among men who worked fewer hours over February-April, 27.2% reported that their alcohol consumption increased, with a similarly large increase (but large standard errors) for those who stopped working between February and April (27.6%). For men whose work hours stayed the same or increased between February and April 2020, there was an increase in alcohol consumption by 15.8% and 16.5 % respectively (Biddle et al., 2020). For women, on the other hand, those who had a decrease in hours worked had roughly the same level of increased alcohol consumption as those whose hours stayed the same (30.0% and 31.1%).

Age

Young Australians aged 18-25 reported a decrease in alcohol consumption during April-May 2020 (Callinan et al., 2021). While Callinan and colleagues (2021) were not drawing on a representative sample of the Australian population, the data provide an insight into a trend that may be related to COVID-19. Several factors may have influenced this change. Under lockdown, parents spent more time at home and may have been able to supervise children and young people in a way that they were not normally able to. Parental supervision has previously been associated with lower levels of alcohol consumption in adolescents (Wood, Read, Mitchell, & Brand, 2004).

Opportunities to consume alcohol outside the home were also limited as alcohol outlets such as pubs and clubs were closed or restricted the number of patrons (Callinan et al., 2021). Additionally, states that experienced severe lockdowns, such as Victoria, restricted young people's opportunity to visit friends and be away from home after enforced curfew times. This would have restricted opportunities to consume alcohol outside the home in social settings.

Older age groups may have found it easier to access alcohol. Women aged 36-50 showed the highest increase in both their frequency and quantity of consumption during mid-April and May 2020 (Callinan et al., 2020).

Mental health

Multiple studies indicated that higher levels of stress during 2020 were associated with reported increases in alcohol use (ABS, 2020a; Callinan et al., 2020; Neill et al., 2020). For those who did increase their alcohol consumption in May 2020, the most common reason for both men (67%) and women (63%) was spending more time at home (Biddle et al., 2020). The next most common reason for women to increase their drinking was increased stress (42%). For men, the second most common reason was boredom (49%) (Biddle et al., 2020).

While reports of being bored began to decrease after the first seven weeks of the April lockdown, reports of anxiety and stress as factors influencing alcohol consumption started to rise (Hello Sunday Morning, 2020). Anxiety was not as closely related to increased alcohol consumption as depression and stress (Neill et al., 2020; Stanton et al., 2020). Drinking to cope with stress was most apparent in the 18-49 age groups (10-13%) and less a concern for those aged over 50 (5%) (FARE, 2020a).

Pre-COVID drinking patterns

While pre-COVID drinking patterns were not a factor reported in all surveys, previous studies on alcohol consumption after large-scale disasters have found that people who drank heavily before the disaster were more likely to increase their drinking following the disaster (Heslin et al., 2013). This includes people who may have had pre-existing alcohol disorders (such as dependence) and were most likely to report increased drinking after such events (North, Ringwalt, Downs, Derzon, & Galvin, 2010).

The June-July Gambling in Australia during COVID-19 survey found that around one in seven participants (15.3%) did not drink alcohol in either period (classified as 'non-drinkers'), while 4.8% drank before COVID-19 but not during, and 2.4% drank during COVID-19 but not before (Jenkinson et al., 2020). On the other hand, people who reported heavy drinking (10 or more standard drinks per week) prior to COVID-19 were more likely than those who were not heavy drinkers to report an increase in alcohol consumption during 2020 (Neill et al., 2020). This may have been context-dependent, however, as Callinan and colleagues (2021) found that high-risk drinkers who had a low level of home-based drinking in 2019 decreased their drinking during the pandemic. This finding suggests that reduced options for consumption outside of the home may change the behaviour of high-risk drinkers.

Drawing conclusions

The available data suggest that a large proportion of the Australian population decreased or maintained their level of alcohol consumption in the early stages of COVID-19. A decrease in alcohol consumption could have been influenced by the lack of social outlets to drink, mental distress or difficulty reaching alcohol outlets (Callinan et al., 2020). For those who maintained previous consumption levels, a rise in stress, loneliness and a decrease in socialising did not contribute to a change in drinking patterns.

For the one in five people who increased their consumption, COVID-19 changes could have played a role. Increases in alcohol consumption may have been driven by gender, older age, employment status or income level, pre-COVID-19 drinking patterns and mental health. There could also be factors at play that were not asked about in the current surveys. For example, housing and household composition such as living alone or living in a share house, cultural norms around drinking, the location where people drank alcohol and so on. There is a significant gap in the data relating to Aboriginal and Torres Strait Islander people's experiences of alcohol consumption during COVID-19. A gap in data also exists for the experiences of culturally and linguistically diverse communities and LGBTIQA+ communities.

Regardless of which factors have contributed to potential increases in alcohol consumption, or the level of consumption, harm may be experienced by people and their families. There can be alcohol-related harm from even low levels of alcohol consumption, regardless of whether consumption occurs during stable times or those of disaster. The following section explores the types of harms that may result from alcohol consumption.

Conclusion

Conclusion

This publication is intended to provide the basis for non-specialist alcohol and drug practitioners to gain a greater understanding of how alcohol consumption changed during COVID-19. The results of this review show that some groups of Australians experienced increased levels of stress, loneliness and isolation during COVID-19, which may have resulted in higher levels of alcohol consumption. Further, some groups, such as women with carer responsibilities, are at greater risk of increasing alcohol consumption and alcohol-related harm. Practitioners can use this evidence to prepare for those groups of people experiencing harm and requiring support.

Although evidence is available about changes in alcohol consumption due to COVID-19 in Australia, there is, as yet, no evidence about harms to parents or children specifically as a consequence of these changes. However, this review highlights evidence about the nature of alcohol-related harms that may be experienced by families and individuals. Strategies that raise awareness of the risk and nature of alcohol-related harm or referral in higher risk situations can form part of a response. Other strategies could involve assisting families in addressing factors that may lead to increased alcohol consumption.

Further resources

Further resources

  • Parental Substance Use and Child-Aware Practice: podcast. This Emerging Minds podcast supports practitioners to develop an understanding of the importance of a trauma-informed approach, about child-focused and other practices in the alcohol and other drug sector, and the challenge of strengthening parent-child relationship when shame and stigma are present.
  • Working with Mothers Affected by Substance Use: Keeping Children in Mind: online resource. This written resource by Emerging Minds highlights how mothers often experience co-existing issues besides alcohol consumption and showcases engagement strategies that support mothers and their children.
  • Turning Point is Australia's leading national addiction treatment, training and research centre focusing on alcohol and other drugs. It hosts a number of online learning modules to help practitioners use standard adult alcohol and drug screening and assessment tools.
  • The power of words is a resource to support health and other practitioners to identify potential instances of stigma-inducing language and behaviour. It provides information about alternative language and behaviour to help minimise the impact of stigma on people who use alcohol and other drugs.
  • CFCA has produced a resource that includes case studies aimed at prompting readers to consider options when responding to client needs and what quality practice looks like when working with clients who use alcohol and other drugs, and/or their children. The case studies are available here: Working together to support families where a parent uses alcohol and/or other drugs
  • Drug and Alcohol Clinical Advisory Service (DACAS) offers a free 24/7 telephone advisory service that assists health and welfare professionals in Victoria, Tasmania and the Northern Territory to respond effectively to individuals with alcohol or other drug use problems.
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Appendix A: Study inclusion criteria
ParametersInclusion criteria
LocationAustralia
LanguageEnglish
Publication dateMarch 2020-October 2020
Publication typeJournal article, report, media release of findings
Study primary focusOriginal research or secondary data analysis of quantitative and/or qualitative findings
Appendix B: Included empirical studies

The table can also be viewed on page 21 of the PDF.

First Author (Year)Publication typeStudy design*AimCollection datesSample characteristicsFindings
PrevalenceChangeAssociation
ABS (2020)Data release (not peer-reviewed)Longitudinal survey using telephone InterviewInsights into the prevalence and nature of impacts from COVID-19 on households in AustraliaLate April-early May 20201,022 adults 18+N/R3

Stable alcohol consumption (47.1%), usually abstained (28.9%), increase consumption (14.4%; 18% females; 10.8% males), decreased consumption (9.5%). 

18% of females, and 10.8% of males, increased consumption.

N/R
Biddle et al. (2020)Report (not peer-reviewed)Survey comparison of 34th ANU Poll, NDSHS 2016, Standardised NHS 2017/18Analyse changes in alcohol consumption since the spread of the COVID-19 pandemic2017/18; May 2020

34th ANU Poll: 3,219 aged 18+ 

NHS (2017/18): 21,315 aged 18+ including selected 15-17

NDSHS (2016): 
23,772 aged 12+

N/A

NHS and NDSHS benchmark: Alcohol consumption frequency increased 3.5% overall (5.5% females and by 3.5% for males). 

NHS benchmark: Females who drank less than once a month (including never) decreased from 44.8% to 37.7%. Males decreased from 25.9% to 25.1%. Self-reported changes since the spread of COVID-19: 20.2% increased consumption; 27% decreased consumption.

Reasons for changes in alcohol consumption 

Person is spending more time at home (67.3% for males and 63.7% for females).

Boredom: males 49.0%; females 38.4% (p-value = 0.10).

Increased stress: males 28.5%; females 41.9% (p-value = 0.041).

28.3% of females with caring role increased consumption; 21.4% of females with no caring responsibilities increased (p-value = 0.07).

20.7% of male carers increased consumption; 17.8% of males with no caring responsibilities increased (difference not statistically significant).

Employment

Males: increased or stable work hours led to 16.5% and 15.8% of males increasing alcohol consumption, respectively; decreased work hours led to 27.2% increasing alcohol consumption.

Females: decreased hours resulted in 31.1% increasing alcohol consumption; no change in work hours resulted in 30.0% increasing consumption.

In other groups of women alcohol consumption increased by: 19.5% with increased work hours, 18.1% with unemployment, and 20.8% for those who lost their job Feb-April 2020.

Callinan et al. (2020)Peer-reviewed journal articleOnline survey and audit and stress subscaleProvide early estimates of how stress and demographics interact with shifts in harmful alcohol consumption from before the COVID-19 outbreak to 2 months into social distancingMid-April-mid-May 20201,684 adults 18-65 years old who drink at least monthlyN/A

Decrease in harmful drinking [2019 score = 8.2, 95% confidence interval (CI) = 7.9, 8.4; during the pandemic = 7.3, 95% CI = 7.1, 7.6]. 

Women aged 36-50 increased both their frequency and quantity of consumption.

Those experiencing high levels of stress had relatively higher shifts in scores than those who reported low levels of stress.

 

However, the estimated marginal means for those in the high stress group (-0.77, 95% CI = -1.06, -0.49) were still significantly below zero, indicating an overall decrease.

Callinan et al. (2021)Peer-reviewed journal articleSurveyProvide insight into shifts in alcohol consumption and associated factors during the epidemic2019; April-May 20202,307 adults 18+N/A

Reports of average consumption before (3.53 drinks per day [3.36, 3.71 95% confidence interval]) and during (3.52 [3.34, 3.69]) the pandemic were stable. 

15.4% became lower risk; 15.0% higher risk.

Decreased consumption in young men; those who drank more outside the home in 2019. Increase in consumption associated with high levels of stress and bulk-bought alcohol.
Hall & Partners reported by Hello Sunday (2020)Media release (not peer-reviewed)Telephone surveyAssess alcohol consumption during COVID-19April 2020319 adults aged 18+N/R

Reports of drinking less increased from 22% (2nd week of lockdown) to 29% (7th week of lockdown). 

Reports of drinking more increased from 17% (2nd week of lockdown) to 20% (7th week of lockdown).

Reasons for increased alcohol consumption: boredom (53% at 2nd week of lockdown down to 39% at 7th week); anxiety and stress (41% for 30-59 year olds at 2nd week of lockdown and 57% at 7th week).
Jenkinson et al. (2020)Report (not peer reviewed)SurveyTo learn more about how people's gambling participation, alcohol consumption and health and wellbeing were affected during COVID-19 pandemicJune-July 20202,019 adults 18+ who had gambled in the last 12 months15.3% (n = 309) no consumption during COVID-19, 4.8% (n = 97) drank before COVID-19 but not during, and 2.4% (n = 49) drank during COVID-19 but not before. Consumption stable between the two time periods (mean AUDIT-C score 5.91 before and 5.86 during COVID-19); consumption higher for males compared to females (mean AUDIT-C scores around 6.2 compared to 4.6) and young people aged 18-34 years compared to older age groups (mean AUDIT-C scores around 6.4 compared to 5.3 among those aged 35-54 years and 4.8 among those aged 55+ years).Significant decreases in drinking were observed among men and young people aged 18-34 years.N/R
Neill et al. (2020)Peer-reviewed journal articleLongitudinal surveyExamine what predisposing (distal) and pandemic-related (proximal) factors were associated with increased drinking in the wake of the COVID-19 pandemicApril 20204,462 adults 18+Non-drinkers prior to COVID-19 (28%); drinking >10 standard drinks a week (10.5%), <10 standard drinks a week (61.3).Reported reduced or no change to alcohol (69.2%); drinking a lot more than usual (30.8%).Increased drinking associated with higher levels of depression and stress; heavy drinking pre-pandemic; higher income; gender, with females overrepresented in the sample drinking a lot more than usual; age, with those aged 25-49 years drinking more.
Roy Morgan (2020)Media release (not peer-reviewed)Telephone interviewsOverview of alcohol consumption in AustraliaMarch 2020Apr 2018-Mar 2019, n = 16,276. Apr 2019-Mar 2020, = 14,632 adults aged 18+N/RA total of 66.3% (13,073,000) of Australians aged 18+ in the year to March 2020 consumed alcohol in an average four-week period, down from 67.5% (13,102,000) 12 months previous.N/R
Stanton et al. (2020)Peer-reviewed journal articleOnline surveyExamine the associations between psychological distress and changes in selected health behaviours since the onset of COVID-19 in AustraliaApril 20201,491 adults 18+22.3% (n = 332) consumed alcohol on four or more occasions per week.Just over half (n = 825, 55.3%) reported no change in alcohol consumption.Negative change in alcohol associated with higher depression (adjusted OR = 1.07, 95% CI = 1.04, 1.10), anxiety (adjusted OR = 1.08, 95% CI = 1.04, 1.12), and stress (adjusted OR = 1.10, 95% CI = 1.07, 1.13) symptoms
YouGov Galaxy (commissioned by FARE) (2020)ReportTelephone poll April 20201,04514% report they have been drinking daily, a near threefold increase when compared to a January 2020 YouGov survey (5% drinking daily).Drinking more alcohol during COVID-19 (18%); drinking less (17%).

Drinking on their own more (12%); drinking to cope with anxiety and stress (11%). 

Drinking to cope with anxiety and stress (10% for 18-24 years, 13% for 25-34 years and 10% for 35-49 years). Aged over 50 (5%).

YouGov Galaxy (commissioned by the Alcohol and Drug Foundation) (2020)Media releaseTelephone Poll May 20201,007 parents of school-aged childrenn/a

29% report increased alcohol consumption during COVID-19 lockdowns. 

1 in 10 parents with children aged 9-12 report drinking a 'lot more'. 1 in 3 parents working full-time report consuming 'more alcohol' (31% part-time and 19% not working).

Reasons for increased alcohol consumption: feelings of anxiety and stress (38%); stress of home schooling (25%); extra video socialising (1 in 5 for all parents and 1 in 3 for parents aged 18-34).

3 Not directly reported

Acknowledgements

All authors are employed by the Australian Institute of Family Studies. Dr Claire Farrugia is a Senior Research Officer and Dr Trina Hinkley is a Research Fellow in the Knowledge Translation and Impact Lab. The authors wish to thank Dr Nerida Joss for her guidance in producing this paper and thank Dr Brendan Quinn, Australian Institute of Family Studies and Dr Michael Savic, Monash University, for their review and feedback on the paper.


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978-1-76016-227-6

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