Evaluating the impact of COVID-19 public health measures on alcohol-related harms

项目摘要 在2019冠状病毒病（COVID-19）大流行期间，世界各国实施了各种措施， 公共卫生措施（例如，完全封锁、占用限制和旅行限制），以努力 限制病毒的传播。这些措施本身就影响了酒精的使用，因此， 对酒精危害的影响。拟议补充协议将评估COVID-19对公众的影响 关于酒精消费和某些酒精所致疾病和死亡结果的健康措施 立陶宛是欧盟的高收入成员国。我们假定， 相关的公共卫生措施影响了酒精消费和酒精引起的危害， 以下方式：消费被假设为消费-即，以前酗酒的人 大流行（大量饮酒将被定义为女性每天40克以上纯酒精，女性每天60克以上纯酒精， 平均而言，男性每天纯酒精的摄入量会增加，而其他人则会增加他们的酒精摄入量。 平均而言，人们的消费量会减少。我们还将测试 可用性和负担能力下降，压力增加。在酒精引起的伤害方面，我们 选择了以下饮酒的关键后果，并从理论上推导出几个假设 受隔离、社交距离和其他公共卫生措施的影响， 降低感染风险：自杀未遂和自杀死亡、家庭暴力、非家庭暴力、交通 碰撞和受伤，还有肝硬化简而言之，我们假设自杀未遂和自杀， 在封锁期间，暴力和肝硬化住院和死亡率增加，部分原因是 饮酒的两极分化，而交通碰撞和伤害以及非家庭暴力减少;后者 第二个原因是总体上交通流量减少，通常发生这种暴力的情况减少。然而，在这方面， 我们还假设，酒精引起的交通碰撞和伤害在所有此类碰撞和伤害中所占的比例， 伤害会增加。如果我们的假设得到支持，我们将能够改进未来的酒精计算- 归因负担和疾病及死亡率，进一步摆脱简单的归因分数模型 根据接触水平和结果（世界卫生组织和 全球疾病负担研究）转向更复杂的模型，具体说明具体国家的边界 条件但如上文所述，计划对本补编进行的分析不仅将改善 酒精流行病学的理论知识，但也规定了必要的边界条件，酒精 控制政策的执行，不仅在未来的流行病时期，而且在经济和其他危机时期， 好.立陶宛提供了一个独特的机会，以测试这些假设，由于其丰富的数据（例如，五 2019- 2021年全国大规模人口普查）。

PROJECT SUMMARY During the coronavirus disease 2019 (COVID-19) pandemic, countries all over the world implemented various public health measures (e.g., complete lockdowns, occupancy limitations, and travel restrictions) in an effort to limit the spread of the virus. Such measures inherently impacted alcohol use, and, as such, likely had an impact on alcohol-attributable harms. The proposed Supplement will evaluate the effects of COVID-19 public health measures on alcohol consumption and on select alcohol-attributable disease and mortality outcomes in Lithuania, a high-income member state of the European Union. We postulate that the pandemic and its associated public health measures impacted alcohol consumption and alcohol-attributable harms in the following ways: consumption is hypothesized to polarize – i.e., people who had been drinking heavily before the pandemic (heavy drinking will be defined a 40+ grams of pure alcohol per day for women, and 60+ g of pure alcohol per day for men) will have, on average, increased their alcohol consumption, whereas the rest of the population will have, on average, decreased their consumption. We will also test mediating mechanisms of availability and affordability for decreases, and stress for increases. In terms of alcohol-attributable harm, we selected the following key consequences of alcohol consumption and theoretically derived several hypotheses impacted by confinement, social distancing and other public health measures taken during the pandemic to reduce infection risk: suicide attempts and deaths by suicide, domestic violence, non-domestic violence, traffic collisions and injuries, and liver cirrhosis. In short, we postulate that suicide attempts and suicide, domestic violence and liver cirrhosis hospitalizations and mortality increased during lockdowns, in part fueled by the polarization of drinking, while traffic collisions and injury as well as non-domestic violence decreased; the latter two because of less traffic and fewer situations where such violence would typically occur, overall. However, we also postulate that the proportion of alcohol-attributable traffic collisions and injury to all such collisions and injury will increase. If our hypotheses are supported, we will be able to improve future calculations of alcohol- attributable burden and disease and mortality, further moving away from simple attributable-fraction models based on level of exposure and outcome (as currently practiced by the World Health Organization and the Global Burden of Disease study) towards more complex models which specify country-specific boundary conditions. But as indicated above, the analyses planned for this Supplement will not only improve the theoretical knowledge in alcohol epidemiology, but also specify necessary boundary conditions for alcohol control policy implementation, not only during times of future pandemics, but economic and other crises as well. Lithuania offers a unique opportunity to test these hypotheses due to the richness of its data (e.g., five large-scale national general population surveys from 2019-21).