New research has found that heavy episodic drinkers consumed more alcohol than usual during both increased and decreased lockdown restrictions and reported drinking more alcohol because they felt stressed, felt a need to relax, and felt bored.

The researchers conducted a survey on Facebook from July to November 2020. A total of 798 participants took part in the survey, of which 68,4% were female.

Published in the International Journal of Environmental Research and Public Health, the research found that fewer people categorised as heavy episodic drinkers thought that the alcohol restrictions were a good incentive to reduce their alcohol intake. The majority reported buying alcohol illegally during bans on alcohol sales.

The research found the odds of being classified as a heavy episodic drinker were increased for people younger than 65, males, people who drink more frequently than monthly, people who bought alcohol illegally during the alcohol sales restrictions, and those who reported that reducing drinking was more difficult during the restrictions.

“We found that heavy episodic drinkers were prone to consuming more alcohol during restrictions, while moderate drinkers drank the same as usual or less. Nearly half of the 798 participants who completed the Facebook survey were classified as heavy episodic drinkers (HED), with more than 60% of males and 43% of females falling in the HED category,” says Associate Professor Nadine Harker of the School of Public Health and Family Medicine at the University of Cape Town (UCT) and specialist scientist in the Alcohol, Tobacco and other Drug Research Unit at the South African Medical Research (SAMRC).

Harker notes that increased lockdown restrictions were especially relevant to increased stress and anxiety compared to decreased lockdown restrictions when wanting to relax was mentioned before stress.

“During decreased restrictions, the reasons heavy episodic drinkers gave for drinking more alcohol that were significantly more frequent than for moderate drinkers were ‘wanting to relax/switch off’, ‘feeling stressed out’, and ‘celebrating when Covid-19 restrictions were lifted/relaxed’. Interestingly, we see that ‘being bored’ moved from third to fifth most frequently mentioned,” she says.

Reasons given for drinking less alcohol were similar during increased and decreased lockdown restrictions, says Harker.

Dr Petal Petersen-Williams of the Department of Psychiatry and Mental Health at UCT and specialist scientist in the Alcohol, Tobacco and other Drug Research Unit at SAMRC, says more moderate drinkers stated that they drank less alcohol because ‘it is more difficult to get alcohol with restrictions on going out and shops being closed’ and ‘I haven’t been able to socialise or go out to the pub’.

“Importantly, ‘money or cost’ reasons, the third most frequent, did not differ significantly between HED and moderate drinkers,” she says.

According to Petersen-Williams, moderate drinkers stated that the ‘restrictions were a good time to reduce alcohol intake’ significantly more frequently than the HED group during increased restrictions; it was the fourth most frequent reason given for drinking less.

This research, says Petersen-Williams, shows that limiting alcohol sales or imposing alcohol sales restrictions are not proven to be effective in reducing alcohol intake in people who are classified as heavy episodic drinkers.

“Moderate alcohol consumers may benefit from these restrictions by using them as incentive to reduce their alcohol intake,” she says.

She adds that policies intended to increase the pricing of alcohol, such as the World Health Organization’s strategy of increasing excise taxes and minimum unit pricing, may have the potential to reduce alcohol intake in a time of crisis.