Changes in Alcohol Use During COVID-19 and Associations With Contextual and Individual Difference Variables: A Systematic Review and Meta-Analysis

Public Health Significance Statement Throughout the early months of the first wave of COVID-19, about one-fourth of study samples reported increases in alcohol consumption, and one-fourth reported decreases in consumption. The review suggested that the pandemic differentially affected drinking based on multiple individual and contextual variables. In light of the emergence of mutant strains and the prediction of similar future pandemics, these results provide an empirical basis for a behavioral health pandemic preparedness plan that could reduce the likelihood of pandemic-related drinking increases. Objective: The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes. Method: Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized. Results: One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen's d = -0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression). Conclusions: The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards.