Future of surveys in the alcohol field

Smoking, and to a lesser extent non-combustible nicotine use, is associated with higher levels of alcohol consumption and risky drinking

This study aimed to estimate differences in alcohol consumption, receipt of alcohol brief intervention, and alcohol reduction attempts by smoking status and use of non-combustible nicotine (including e-cigarettes, nicotine replacement therapy, heated tobacco products, or nicotine pouches). Data were from a representative household survey of adults in England (n = 188,878). Participants who reported former or current smoking scored approximately 1 point higher, on average, on the AUDIT-C (which measures alcohol consumption) than those who had never regularly smoked (Badj=0.97 [95%CI 0.93-1.00] and 0.92 [0.87-0.96], respectively) and had double the odds of risky drinking (AUDIT-C ≥ 5: ORadj=2.04 [1.98-2.10] and 2.03 [1.97-2.10], respectively), while differences for those who did versus did not use non-combustible nicotine use were less pronounced (AUDIT-C: Badj=0.14 [0.08-0.21]; AUDIT-C ≥ 5: ORadj=1.09 [1.04-1.13]). Among participants who engaged in risky drinking, those who smoked (vs. not) were more likely to report receiving alcohol brief interventions, and those attempting to quit smoking (vs. not) were more likely to report alcohol reduction attempts. Overall, combustible and - less so - non-combustible nicotine use is associated with higher levels of alcohol consumption and risky drinking.

Designing and implementing an experimental survey on knowledge and perceptions about alcohol warning labels

OBJECTIVES

This paper describes the design and implementation of an online survey experiment to investigate the effects of alcohol warning labels on alcohol-related knowledge, risk perceptions and intentions.

METHOD

The survey collected self-reported data from 14 European countries through two waves of data collection with different recruitment strategies: dissemination via social media and public health agencies was followed by paid-for Facebook ads. The latter strategy was adopted to achieve broader population representation. Post-stratification weighting was used to match the sample to population demographics.

RESULTS

The survey received over 34,000 visits and resulted in a sample size of 19,601 participants with complete data on key sociodemographic characteristics. The responses in the first wave were over-representing females and higher educated people, thus the dissemination was complemented by the paid-for Facebook ads targeting more diverse populations but had higher attrition rate.

CONCLUSION

Experiments can be integrated into general population surveys. Pan-European results can be achieved with limited resources and a combination of sampling methods to compensate for different biases, and statistical adjustments.

Exploring changes in temporary abstinence in increasing and higher risk drinkers in England and Dry January participation in users of the Try Dry app in the UK between 2020 and 2021

BACKGROUND

We looked at changes in the prevalence of increasing and higher risk drinkers reporting a reduction attempt motivated by temporary abstinence and changes in prevalence of use of the official app accompanying Dry January between 2020 vs 2021, following the onset of the COVID-19 pandemic. We also explored potential shifts in the sociodemographic composition of both groups.

METHODS

We analysed data from: i) 1863 increasing and higher risk drinkers (defined as ≥ 8 on the AUDIT) responding to a nationally representative survey of adults in England in January and February 2020 and 2021, and ii) 104,598 users of the 'Try Dry' app, the official aid to those participating in Dry January 2020 and 2021 in the UK. We used logistic regression to examine shifts in the prevalence of increasing and higher risk drinkers reporting a reduction attempt motivated by temporary abstinence and explored whether there were shifts in the characteristics of this group in terms of AUDIT score, number of last year reduction attempts, smoking status, living alone, living with children, reducing alcohol consumption due to future health motives, age, sex, and occupational social grade between 2020 and 2021. We used t-tests and chi-squared tests to compare the prevalence of users of the 'Try Dry' app in 2020 and 2021 and examine whether the two groups differed in terms of age and sex.

RESULTS

The proportion of increasing and higher risk drinkers reporting a reduction attempt motivated by temporary abstinence increased from 4% in 2020 to 8% in 2021 (OR = 2.07, 95% CI = 1.38-3.11, p < .001) with no changes detected in sociodemographic composition. The number of Try Dry app users in 2021 increased by 34.8% relative to 2020. App users in 2021 were two years older on average [p < .001, d = .02], with a 2% increase in the proportion of female app users [p < .001, vs. < .01].

CONCLUSIONS

Higher participation in Dry January 2021 relative to 2020 indicates increased engagement with a period of temporary abstinence following the COVID-19 related lockdowns in England and the UK, which is positive in the wider context of increasing alcohol consumption throughout the pandemic.

Differential impact of minimum unit pricing on alcohol consumption between Scottish men and women: controlled interrupted time series analysis

OBJECTIVE

To assess the immediate impact of the introduction of minimum unit pricing (MUP) in Scotland on alcohol consumption and whether the impact differed by sex, level of alcohol consumption, age, social grade and level of residential deprivation of respondents.

DESIGN

Primary controlled interrupted time series analysis and secondary before-and-after analysis of the impact of introducing MUP in Scotland using alcohol consumption data for England as control.

SETTING

Data from Kantar Worldpanel's Alcovision survey, a continuous retrospective online timeline follow-back diary survey of the previous week's alcohol consumption.

PARTICIPANTS

53 347 women and 53 143 men.

INTERVENTIONS

Introduction of a minimum price of 50 pence per UK unit (6.25 pence/g) for the sale of alcohol in Scotland on 1 May 2018.

MAIN OUTCOME MEASURES

Number of grams of alcohol consumed per week, in total, in off-trade (eg, at home) and in on-trade (eg, in pubs, restaurants).

RESULTS

Primary interrupted time series analyses found that the introduction of MUP was associated with a drop in reported weekly total alcohol consumption of 5.94 g (95% CI 1.29 to 10.60), a drop in off-trade consumption of 3.27 g (95% CI -0.01 to 6.56) and a drop in on-trade consumption of 2.67 g (95% CI -1.48 to 6.82). Associated reductions were larger for women than for men and were greater among heavier drinkers than for lighter drinkers, except for the 5% of heaviest drinking men for whom an associated increase in consumption was found. Secondary before-and-after analyses found that reductions in consumption were greater among older respondents and those living in less deprived areas. The introduction of MUP was not associated with a reduction in consumption among younger men and men living in more deprived areas.

CONCLUSIONS

Greater policy attention needs to be addressed to the heaviest drinking men, to younger men and to men who live in more deprived areas.

Changes in Alcohol Consumption and Determinants of Excessive Drinking During the COVID-19 Lockdown in the Slovak Republic

As a result of the coronavirus disease 2019 (COVID-19) pandemic, countries have been forced to adopt strong restrictions, such as lockdown, which can lead to serious consequences for public health, including the problematic use of addictive substances. The aim of this cross-sectional study was to examine changes in alcohol consumption and to identify determinants against the background of excessive drinking during the COVID-19 lockdown in the Slovak Republic. The research included 445 respondents (33% males and 67% females), and the data collection through the questionnaire took place from April 29, 2020 to July 1, 2020. Measures such as drinking frequency, amount of alcohol and excessive drinking were used to examine alcohol consumption. Descriptive analysis and binary logistic regression were used to meet the main aim. The findings provide a closer look at the situation in the Slovak Republic and contribute to comprehensive international knowledge. The frequency of excessive drinking did not change in about half of respondents (53% of males and 69% of females). More respondents decreased their excessive drinking than increased, both among males (31 and 16%, respectively) and females (25 and 6%, respectively). Similar results were found for drinking frequency and amount of alcohol. Amongst Slovak respondents, an increase in excessive drinking was more common among males, younger people, smokers, and smokers who increased smoking during the lockdown. Especially in the case of vulnerable populations, public policies should consider a response to impending problems. The findings of this study encourage the implementation of effective and evidence-based prevention programs, which are more than necessary in the Slovak Republic.

Conducting a multi-country online alcohol survey in the time of the COVID-19 pandemic: Opportunities and challenges

OBJECTIVES

This contribution provides insights into the methodology of a pan-European population-based online survey, performed without external funding during the COVID-19 pandemic. We present the impact of different dissemination strategies to collect data from a non-probabilistic convenience sample and outline post-stratification weighting schemes, to provide guidance for future multi-country survey studies.

METHODS

Description and comparison of dissemination strategies for five exemplary countries (Czechia, Germany, Lithuania, Norway, Spain) participating in the Alcohol Use and COVID-19 Survey. Comparison of the sample distribution with the country's actual population distribution according to sociodemographics, and development of weighting schemes.

RESULTS

The dissemination of online surveys through national newspapers, paid social media adverts and dissemination with the support of national health ministries turned out to be the most effective strategies. Monitoring the responses and adapting dissemination strategies to reach under-represented groups, and the application of sample weights were helpful to achieve an analytic sample matching the respective general population profiles.

CONCLUSION

Reaching a large pan-European convenience sample, including most European countries, in a short time was feasible, with the support of a broad scientific network.

Use of alcohol, tobacco, cannabis, and other substances during the first wave of the SARS-CoV-2 pandemic in Europe: a survey on 36,000 European substance users

BACKGROUND

SARS-CoV-2 reached Europe in early 2020 and disrupted the private and public life of its citizens, with potential implications for substance use. The objective of this study was to describe possible changes in substance use in the first months of the SARS-CoV-2 pandemic in Europe.

METHODS

Data were obtained from a cross-sectional online survey of 36,538 adult substance users from 21 European countries conducted between April 24 and July 22 of 2020. Self-perceived changes in substance use were measured by asking respondents whether their use had decreased (slightly or substantially), increased (slightly or substantially), or not changed during the past month. The survey covered alcohol (frequency, quantity, and heavy episodic drinking occasions), tobacco, cannabis, and other illicit drug use. Sample weighted data were descriptively analysed and compared across substances.

RESULTS

Across all countries, use of all substances remained unchanged for around half of the respondents, while the remainder reported either a decrease or increase in their substance use. For alcohol use, overall, a larger proportion of respondents indicated a decrease than those reporting an increase. In contrast, more respondents reported increases in their tobacco and cannabis use during the previous month compared to those reporting decreased use. No distinct direction of change was reported for other substance use.

CONCLUSIONS

Our findings suggest changes in use of alcohol, tobacco and cannabis during the initial months of the pandemic in several European countries. This study offers initial insights into changes in substance use. Other data sources, such as sales statistics, should be used to corroborate these preliminary findings.