Problem drinkers and high risk-taking behaviors under the stay-at-home policy of the COVID-19 emergency declaration.

Background: To the best of the authors' knowledge, this is the first study to examine whether problem drinkers have had high risk-taking behaviors during the stay-at-home policy (e.g., dining out at a bar) under the COVID-19 emergency declaration.

Methods: We investigated data from Japan COVID-19 and Society Internet Survey(JACSIS)study-a web-based nationwide survey, conducted from August to September 2020. From a total of 12,076 current drinkers, problem drinkers were detected by Cut, Annoyed, Guilty, and Eye-opener (CAGE) questions. A CAGE score of 4 showed potential alcohol use disorder and scores of 2 to3 showed potential alcohol abuse; individuals with these scores were regarded as problem drinkers compared to light-or-no-risk drinkers, with a CAGE score of 0 to 1. The outcome assessed the presence of 18 behaviors against the stay-at-home policy, such as dining out at a bar, meeting people, or going to crowded places. All these behaviors were limited in Japan during the first declaration of emergency between April and May 2020.

Results: Based on the multivariable logistic regression, the participants with potential alcohol use disorder demonstrated 16 out of the 18 risk-taking behaviors, such as dining out at a bar (adjusted odds ratio (aOR): 2.08; 95% confidence interval (CI): 1.56-2.79), dining out at a restaurant (aOR: 1.79; 95% CI:1.37-2.35), visiting friends (aOR: 1.81; 95% CI: 1.34-2.44), going to karaoke (1.97; 95% CI: 1.26-3.10), and riding on a crowded train (aOR: 1.46; 95% CI: 1.07-1.99), compared to light-or-no risk drinkers with a CAGE score of 0 to 1. Additionally, participants with potential alcohol abuse (CAGE score of 2 to 3) had 10 out of 18 behaviors against the stay-at-home policy: the corresponding aORs for the aforementioned behaviors were 1.45 (95% CI: 1.25-1.67), 1.27 (95% CI: 1.12-1.44), 1.17 (95% CI: 1.01-1.36), 1.49 (95% CI: 1.17-1.90), and 1.19 (95% CI: 1.03-1.38), respectively. Problem drinkers had a significant association with being men, a higher income and job position, smoking, sleep deprivation, depression, and other mental diseases.

Conclusions: Overall, problem drinkers were more likely to have higher risk-taking behaviors against the stay-at-home policy, compared to light-or-no-risk drinkers.