Changes in self-reported alcohol use post absolute alcohol sales bans: the case of Botswana during COVID pandemic.

Background
Alcohol control policies like alcohol sales bans during the COVID-19 pandemic provided a rare quasi-experiment on responses to reductions in alcohol availability. Botswana implemented four separate alcohol sales bans covering 225 days from March 2020 to September 2021. We studied changes in alcohol use among adults in Botswana following two sales bans (second ban: 5th August to September 2020; and fourth ban: 28th June to 5th September 2021).
Method
Two online, cross-sectional surveys comprising convenience samples of adults (1318 and 1326) were completed following the second and fourth alcohol sales ban in Botswana. Both surveys required participants to retrospectively recall their alcohol use through a modified AUDIT-C enquiring on alcohol use pre, during and post the respective alcohol sales bans. 
Results
In both surveys, there was a statistically significant decrease in self-reported alcohol use and hazardous drinking (AUDIT-C score of 3 or 4 for females and males, respectively) during both alcohol sales bans. However, the survey following the second ban had a greater self-reported reduction in alcohol use during the related sales ban compared to the latter sales ban in 2021. 
Conclusions
Measures reducing the availability of alcohol during the COVID-19 pandemic were associated with significant reductions in self-reported alcohol use in Botswana. However, such measures may have a reduced effect over time as users and suppliers of alcohol find alternatives to maintain alcohol use. Nevertheless, these findings caution against the Botswana Government’s previous proposals to increase alcohol availability through allowance of alcohol sales in petrol stations and supermarkets.