Background: Rates of heavy drinking and alcohol-specific deaths increased at the start of the COVID-19 pandemic in many countries. In England, deaths reached record levels in 2022, likely due to higher levels of drinking since 2020. However, it is unclear whether alcohol consumption is now falling. We therefore investigated whether increases in alcohol consumption in England have returned to pre-pandemic levels.
Methods: Data came from a monthly representative survey of adults conducted from March-2014 to January-2024 (N=190,746). Outcomes were mean weekly alcohol consumption (in UK units), prevalence of increasing and higher risk drinking (AUDIT-C≥5) and possible dependence (AUDIT-C≥11). Trend and step changes were assessed using generalised additive models and stratified by age, gender and social grade.
Findings: All outcomes increased immediately in April-2020: prevalence of increasing and higher risk drinking by 29·4% (95%CI: 25·7, 33·2), prevalence of possible dependence by 85·5% (95%CI: 57·0, 119·2), and mean weekly alcohol consumption by 33·3% (95%CI: 29·6, 37·1). The post-pandemic trend declined more quickly than the pre-pandemic trend for the prevalence of increasing and higher risk drinking (Difference: -1·0%/year, 95%CI: -2·1, 0·1) and mean weekly alcohol consumption (Difference: -1·9%/year, 95%CI: -3·0, -0·8), indicating a slow but incomplete return to pre-pandemic levels. The trend in prevalence of possible dependence was similarly stable before and after the pandemic (Difference: 0·1%/year 95%CI: -5·8, 6·5), indicating no return to pre-pandemic levels. In April-2020, alcohol consumption increased more and then declined more slowly among people from less compared with more disadvantaged social grades, resulting in similar levels over time.
Interpretation: Dependent drinking in England remains at elevated levels following sharp increases at the start of the pandemic. Alcohol-related inequalities may also be widening due to comparatively larger increases in consumption and a slower return to pre-pandemic levels among disadvantaged drinkers.
Funding: Cancer Research UK, UK Prevention Research Partnership.
Declaration of Interest: JB has received unrestricted research funding from Pfizer and J&J, who manufacture smoking cessation medications. LS has received honoraria for talks, unrestricted research grants and travel expenses to attend meetings and workshops from manufactures of smoking cessation medications (Pfizer; J&J) and has acted as paid reviewer for grant awarding bodies and as a paid consultant for health care companies. All authors declare no financial links with the alcohol industry or their representatives.
Ethical Approval: The University College London Ethics Committee granted ethical approval for the Smoking and Alcohol Toolkit Study (ID 0498/001).
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)