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Rebecca Williams, PhD, MHS

Rebecca Williams, PhD, MHS, has received approximately $600,000 in funding to study changes in alcohol consumption and related harms in relation to the wider availability of online and delivery alcohol sales during the COVID-19 pandemic.

During the spring of 2020, near the beginning of the pandemic in the U.S., participants in one study reported a 14% increase in the number of days they drank, compared to what they reported in 2019. The change in alcohol use affected women more than men, with women reporting a 17% increase in days where they drank and a 41% increase in episodes of heavy drinking.

With the onset of the pandemic, some states increased direct-to-consumer alcohol access, allowing shipping from online vendors and delivery from grocery stores, liquor stores, restaurants, and bars. Other states decreased access by restricting these types of sales. Many states that expanded access made delivery sales even easier by permitting apps, such as Drizly, DoorDash, Uber Eats, GrubHub, and Instacart, to deliver alcohol directly to customers.

These policy changes, some temporary and some permanent, may have an impact on how much people drink. Sales from both online vendors and delivery apps saw a measurable boom in popularity in 2020. At the end of March, alcohol delivery app Drizly reported a fourfold increase in sales compared to earlier in the year, and, in general, online alcohol sales over a period in March and April more than tripled compared to the same period the previous year.

Dr. Williams’ research, funded by a grant from the Centers for Disease Control and Prevention, will help her better understand how U.S. alcohol consumption has changed during the pandemic, how online availability of alcohol impacts drinking behaviors, and how different policy approaches to allowing or restricting delivery sales of alcohol can promote safer alcohol consumption.

“During the pandemic, states made rapid alcohol policy changes to support struggling restaurants, bars, and retailers, and to give people who were unable to go out and purchase or consume alcohol more options for having it delivered to them at home,” said Dr. Williams.

Even prior to the pandemic, alcohol use was on the rise in the U.S., with previous years seeing increases in the number of people who drank, the amount they drank and how often, and the number of times they drank heavily. And alcohol remains the third leading preventable cause of death in the United States: almost 100,000 people die each year due to alcohol-related incidents, including motor vehicle accidents, injuries, and liver disease.

According to Dr. Williams, underage access to alcohol also remains a concern, especially during the pandemic when contactless deliveries are the norm for health and safety reasons. In her previous research on internet alcohol vendors, she found that alcohol sold online had very inexpensive prices and poor age verification, enabling easy alcohol access for underage teens and young adults. In states where policies around shipping and delivery are relaxed, access may be further increased. While underage access isn’t the primary focus of the study, it will collect data from underage drinkers ages 18 to 20.

“My prior research has focused on the delivery sellers of alcohol, but very little is known about how alcohol consumption and related impacts on drinkers are affected by increasing access to alcohol via online and other delivery sales,” noted Dr. Williams. “This study will help us better understand how this increase in alcohol access, particularly during times of isolation, impacts problematic drinking behaviors and other alcohol-related harms.”

A research team led by Dr. Williams will survey 7,500 adults ages 18 and up in states with different alcohol policy situations. Participants will report the same information for three time periods: pre-pandemic, early pandemic, and current. Researchers will compare their responses about sources of alcohol consumed, negative outcomes associated with alcohol use, and drinking behavior with the evolving alcohol policies where they live.

The team will also pull data from Google search trends on topics related to alcohol and website traffic for internet alcohol vendors. Putting this data alongside state alcohol policies and how both change over time, they will look for patterns that reveal how policies may be affecting consumer interest in alcohol and concerns about drinking behavior, addiction, and alcohol-related health concerns.

Dr. Williams plans to distribute the findings to advocacy organizations and policymakers with the goal of helping create safer alcohol policies in state and local governments nationwide.

Rebecca Williams, PhD, MHS, is a researcher at UNC’s Lineberger Comprehensive Cancer Center and the UNC Center for Health Promotion and Disease Prevention (HPDP).

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