ABSTRACT
BACKGROUND: In 2020, the COVID-19 pandemic and control measures changed alcohol consumption in the United States (US) and globally. Before the pandemic, alcohol-impaired crashes contributed to approximately one-third of all road traffic crash injuries and fatalities nationally. We examined the impact of the COVID-19 pandemic on crashes and examined differences in alcohol-involved crashes across various subgroups. METHODS: The University of California Berkeley Transportation Injury Mapping Systems provided information on all crashes reported to the California Highway Patrol from January 1, 2016 through December 31, 2021. Using autoregressive integrated moving average (ARIMA) models applied to weekly time series data, we estimated the effect of California's first mandatory statewide shelter-in-place order (March 19, 2020) on crashes per 100,000 population. We also examined crash subgroups according to crash severity, sex, race/ethnicity, age, and alcohol involvement. RESULTS: In California, the mean crash rate per week before the pandemic (January 1, 2016-March 18, 2020) was 9.5 crashes per 100,000 population, and 10.3% of those were alcohol-involved. After the initiation of the COVID-19 stay-at-home order, the percentage of crashes that were alcohol-involved rose to 12.7%. Overall, the crash rate across California decreased significantly (-4.6 crashes per 100,000; 95% CI: -5.3, -3.9), including across all examined subgroups, with the greatest decrease among the least severe crashes. However, there was a 2.3% absolute increase in the proportion of crashes that were alcohol-involved (0.02 crashes per 100,000; 95% CI: 0.02, 0.03). CONCLUSIONS: The initiation of a COVID-19 stay-at-home ordinance in California was associated with a substantial decrease in overall crash rates. While crashes have returned to pre-pandemic levels, alcohol-involved crashes remain elevated. The initiation of the stay-at-home order significantly increased alcohol-impaired driving, which has remained elevated.
ABSTRACT
BACKGROUND: The COVID-19 pandemic and associated public health prevention measures (e.g., "stay at home" orders) may impact tobacco supply and demand among consumers. This qualitative study identified multi-level drivers of shifts in inhaled tobacco product use and access patterns during the initial COVID-19 "lockdown" period in the United States. METHODS: Between April and May 2020, we conducted semi-structured telephone interviews (n = 44) with adults who use cigarettes and/or electronic nicotine delivery systems (ENDS). Transcripts were thematically analyzed using a socioecological framework. RESULTS: Nearly all participants reported changes in their product use during lockdown, though patterns varied. Increased use was most common and was predominantly driven by individual-level factors: pandemic-related anxiety, boredom, and irregular routines. Decreased use was common among social users who cited fewer interpersonal interactions and fear of sharing products. At the community level, retail access impacted cigarette and ENDS use differently. While cigarettes were universally accessible, ENDS access was more limited, driving some to purchase products online. Delayed deliveries led some ENDS users to compensate with readily-available cigarettes. CONCLUSION: To mitigate ways that the COVID-19 pandemic may exacerbate an existing public health crisis, multi-level policy strategies, such as expanded virtual cessation services and implementation and enforcement of smoke-free home rules, can better support population health during this critical period. Policies that facilitate access to lower risk products can help minimize harm among those who cannot or do not want to quit smoking.