Restrictive and permissive alcohol policies during the COVID-19 pandemic and their association with alcohol consumption in the United States
Bibliographic record
Abstract
• Analysis integrates BRFSS survey data with data on alcohol policy measures to disentangle the distinct effects of restrictive and permissive policies on alcohol consumption in 2020 and 2021. • Cross-sectional results support a polarization of alcohol consumption patterns during COVID-19, with varied effects across demographic groups and drinking behaviors. • Restrictive alcohol policies linked to lower overall drinking prevalence, especially among younger adults, but increased daily consumption and heavy episodic drinking (HED) among drinkers. • Permissive alcohol policies linked to higher drinking rates among people with high education. • Women reported a higher relative increase in the frequency of HED compared to men when experiencing additional psychological distress, highlighting possible gendered impacts of the pandemic. Early in the COVID-19 pandemic, alcohol researchers anticipated that psychological distress and changes in alcohol availability would impact alcohol consumption patterns. While psychological distress was expected to increase alcohol use, particularly among vulnerable groups, restrictive alcohol policies might have led to reduced consumption. This study examined the complex relationship between psychological distress, alcohol policies, alcohol consumption, and their interactions with sociodemographic factors during the COVID-19 pandemic in the US. We used 2020–21 US Behavioral Risk Factor Surveillance System Survey (BRFSS, N = 726,962 adults) data to analyze associations between psychological distress, alcohol policy scores, and alcohol consumption, considering age, sex, education, race and ethnicity, and COVID-19 government response as covariates in a zero-inflated multi-level regression. State-level monthly alcohol policy scores derived from Alcohol Policy Information System data reflect the restrictiveness and permissiveness of alcohol policies implemented during the COVID-19 pandemic. Psychological distress and exposure to restrictive policies increased the likelihood of abstaining from alcohol in the past month, although the observed effects were small. Among past-month drinkers, distress and restrictive policies were associated with slightly higher average daily consumption in pure alcohol grams/day. Younger respondents were more likely to abstain from alcohol when exposed to restrictive policies, while permissive policies correlated with higher drinking prevalence and heavy episodic drinking occurrence among those with higher education. Alcohol policies and psychological distress during the COVID-19 pandemic were linked to both lower and higher alcohol consumption in different population subgroups. Restrictive and permissive policies had diverging associations with consumption patterns across subgroups. While effect sizes were modest, they could translate into meaningful changes in alcohol consumption at the population level, especially during prolonged times of crisis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".