ABSTRACT
OBJECTIVE: A substantial number of people reduce their consumption of alcohol in the absence of formal treatment; however, less is known about the mechanisms of change. The aim of this study is to explore whether constructs derived from behavioral economics and computational decision-modeling characterize the moderation of alcohol consumption that many heavy drinkers experience without treatment. METHOD: Between-subject, preregistered design. People who reside in the United Kingdom and who drink heavily (n = 60) or used to drink heavily but now consume alcohol in moderation (n = 60) were recruited. Participants completed self-report behavioral economic measures (alcohol demand and alcohol-related and alcohol-free reinforcement) and a two-alternative forced choice task in which they chose between two alcoholic (in one block) or two soft drink images (in a different block). A drift-diffusion model was fitted to responses from this task to yield the underlying parameters of value-based choice. RESULTS: Compared to heavy drinkers, moderated drinkers had significantly lower alcohol demand, Omax, p = .03, Cohen's d = .36; elasticity, p = .03, rank-biserial correlation (rrb) = .21, and higher proportionate alcohol-free reinforcement (p < .001, Cohen's d = .75). However, contrary to hypotheses, there were no robust between-group differences in value-based decision-making (VBDM) parameters. CONCLUSIONS: Self-report behavioral economic measures demonstrate that alcohol moderation without treatment is characterized by lowered alcohol demand and greater behavioral allocation to alcohol-free reinforcement, in line with behavioral economic theory. However, a computerized VBDM measure yielded inconclusive findings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
ABSTRACT
AIM: To estimate changes in smoking, drinking and quitting behaviour from before to during the first COVID-19 lockdown in England, and whether changes differed by age, sex or social grade. DESIGN: Representative cross-sectional surveys of adults, collected monthly between August 2018 and July 2020. SETTING: England. PARTICIPANTS: A total of 36 980 adults (≥ 18 years). MEASUREMENTS: Independent variables were survey month (pre-lockdown: August-February versus lockdown months: April-July) and year (pandemic: 2019/20 versus comparator: 2018/19). Smoking outcomes were smoking prevalence, cessation, quit attempts, quit success and use of evidence-based or remote cessation support. Drinking outcomes were high-risk drinking prevalence, alcohol reduction attempts and use of evidence-based or remote support. Moderators were age, sex and occupational social grade (ABC1 = more advantaged/C2DE = less advantaged). FINDINGS: Relative to changes during the same time period in 2018/19, lockdown was associated with significant increases in smoking prevalence [+24.7% in 2019/20 versus 0.0% in 2018/19, adjusted odds ratio (aOR) = 1.35, 95% confidence interval (CI) = 1.12-1.63] and quit attempts (+39.9 versus -22.2%, aOR = 2.48, 95% CI = 1.76-3.50) among 18-34-year-olds, but not older groups. Increases in cessation (+156.4 versus -12.5%, aOR = 3.08, 95% CI = 1.86-5.09) and the success rate of quit attempts (+99.2 versus +0.8%, aOR = 2.29, 95% CI = 1.31-3.98) were also observed, and did not differ significantly by age, sex or social grade. Lockdown was associated with a significant increase in high-risk drinking prevalence among all socio-demographic groups (+39.5 versus -7.8%, aOR = 1.80, 95% CI = 1.64-1.98), with particularly high increases among women (aOR = 2.17, 95% CI = 1.87-2.53) and social grades C2DE (aOR = 2.34, 95% CI = 2.00-2.74). Alcohol reduction attempts increased significantly among high-risk drinkers from social grades ABC1 (aOR = 2.31, 95% CI = 1.78-3.00) but not C2DE (aOR = 1.25, 95% CI = 0.83-1.88). There were few significant changes in use of support for smoking cessation or alcohol reduction, although samples were small. CONCLUSIONS: In England, the first COVID-19 lockdown was associated with increased smoking prevalence among younger adults and increased high-risk drinking prevalence among all adults. Smoking cessation activity also increased: more younger smokers made quit attempts during lockdown and more smokers quit successfully. Socio-economic disparities in drinking behaviour were evident: high-risk drinking increased by more among women and those from less advantaged social grades (C2DE), but the rate of reduction attempts increased only among the more advantaged social grades (ABC1).