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

项目总结 在冠状病毒病2019年(新冠肺炎)大流行期间，世界各国实施了各种 公共卫生措施(例如，完全封锁、居住限制和旅行限制)，以努力 限制病毒的传播。这样的措施本身就会影响饮酒，因此，很可能会对 对酒精造成的危害的影响。建议的补编将评估新冠肺炎对公众的影响 年关于饮酒和选定的酒精可归因性疾病和死亡结果的卫生措施 立陶宛，欧盟的一个高收入成员国。我们假设这次大流行及其 相关公共卫生措施影响饮酒和饮酒可归因性危害 以下方式：消费被假设为两极分化--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，60克以上酒精 男性平均每天饮酒)会增加他们的饮酒量，而其余的 平均而言，人们的消费将会减少。我们还将测试调解机制， 减少的可获得性和可负担性，增加的压力。在酒精造成的伤害方面，我们 选择了以下饮酒的主要后果，并从理论上推导了几个假设 受到大流行期间采取的禁闭、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，以及肝硬变。简而言之，我们假设自杀未遂和自杀在国内 在封锁期间，暴力和肝硬变住院人数和死亡率增加，部分原因是 饮酒两极分化，而交通碰撞和伤害以及非家庭暴力事件减少；后者 二是因为总体上交通流量较少，此类暴力事件通常发生的情况也较少。然而， 我们还假设，由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 伤害将会增加。如果我们的假设得到支持，我们将能够改进未来对酒精的计算- 归因负担与疾病和死亡率，进一步远离简单的归因分数模型 根据接触水平和结果(目前世界卫生组织和 全球疾病负担研究)转向更复杂的模型，以确定特定国家的边界 条件。但如上所述，本补编计划进行的分析不仅将改善 酒精流行病学的理论知识，但也规定了酒精的必要边界条件 控制政策执行，不仅在未来大流行病期间，而且在经济和其他危机期间，如 井。立陶宛提供了一个独特的机会来检验这些假设，因为它的数据丰富(例如，五个 2019-21年大规模的全国人口普查)。

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).