Temporal Shifts in Alcohol Consumption: A Prospective Cohort Study Investigating Patterns During and Post the COVID-19

Background and Aims. The lockdowns imposed by the government during COVID-19 pandemic have had a significant impact on the Italian population habits. In this study we evaluate changes in alcohol consumption during and after the pandemic.
Design and setting. LOckdown and lifeSTyles in Italy and in Tuscany studies collected data on an online representative sample of the Italian adult population in April-May 2020 (n=6,003) followed up to April 2023 through four additional representative surveys (3,000<n<6,600).
Participants. Considering the cohort of individuals who took part to the first and at least one other wave (n=5,378), a multilevel logistic model was used to derive the odds ratios and corresponding 95% confidence intervals of being at-risk drinkers. 
Measurements. An online self-administered questionnaire collected data on socio-demographics and individual characteristics. The Alcohol Use Disorders Identification Test-Concise was used to identify at-risk drinkers.
Findings. The prevalence of at-risk drinkers was 26.4% before, 23.4% during the first (and strictest) lockdown, and stabilized around 30.0% thereafter. Being at-risk alcohol consumers decreased with decreasing economic status (p for trend<0.001), was less frequent among middle aged compared to younger adults (OR=0.73; 95% CI: 0.60-0.89) and among divorced/separated (OR=0.77; 95% CI: 0.60-0.99) or single (OR=0.75; 95% CI: 0.64-0.89) compared to married individuals. It was more frequent among individuals with anxiety or depressive symptoms (OR=1.24; 95% CI: 1.12-1.37), those using psychotropic drugs  (OR=1.99; 95% CI: 1.69-2.35) and users of conventional cigarettes, e-cigarettes or heated tobacco products (OR=3.67; 95% CI: 3.00-4.48).
Conclusions. The long-term trends in alcohol consumption after the COVID-19 pandemic are unfavourable in Italy. The results point to an increased vulnerability for at-risk alcohol consumption among a number of groups, including younger individuals, women with higher economic status and married individuals. At-risk drinking is strongly related to mental health symptoms and nicotine consumption.