Alcohol Sales and Adverse Events during the Covid-19 Pandemic

Alcohol sales increased at the onset of the coronavirus disease 2019 (Covid-19) pandemic, while alcohol-related emergency department (ED) visits decreased. It is unknown whether these patterns of alcohol use persisted or led to delayed effects on health.

We conducted a cross-sectional time series analysis of alcohol sales and alcohol-related adverse events in Ontario, Canada. We obtained 6 years of alcohol sales data from the largest regional alcohol distributor. We obtained monthly counts of alcohol-related ED visits, hospital admissions, and toxicity deaths. We defined our exposure as the start of the Covid-19 pandemic (March 1, 2020). We used linear mixed models to compare mean monthly alcohol sales and adverse events during prepandemic and pandemic periods. We used univariate Poisson regression models to generate incident rate ratios for alcohol-related adverse events comparing the prepandemic (February 28, 2016, to February 29, 2020) and pandemic (March 1, 2020, to February 26, 2022) periods.

Alcohol sales increased, on average, by CA$43.5 million per month (95% confidence interval [CI], CA$26.1 million to CA$60.9 million; P<0.01) during the pandemic years compared with the prepandemic period. We observed a 7% increase (95% CI, 5 to 8) in the proportion of alcohol-related ED visits during the pandemic years, due to a modest decrease in alcohol-related ED visits and a larger decrease in all-cause ED visits. Overall, an average increase of 191 alcohol-related admissions occurred per month (95% CI, 101 to 282). We also observed an average increase of eight toxicity deaths per month (95% CI, 4 to 12).

Alcohol sales and alcohol-related adverse events increased during the Covid-19 pandemic.