{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:36:50Z","timestamp":1769269010380,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Alcohol Abuse and Alcoholism at the National Institutes of Health","award":["R01AA029921"],"award-info":[{"award-number":["R01AA029921"]}]},{"name":"National Institute of Alcohol Abuse and Alcoholism at the National Institutes of Health","award":["T32AA007240"],"award-info":[{"award-number":["T32AA007240"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Although alcohol use increased overall in the US during the COVID-19 pandemic, approximately 16% of people decreased their drinking. Understanding reasons for decreasing or discontinuing alcohol use during a time of crisis could inform alcohol messaging during future crises. (2) Methods: We conducted hour-long interviews with 26 participants who reported drinking above NIAAA guidelines at the second wave of the National Alcohol Survey COVID Cohort (a longitudinal study of alcohol use during the COVID-19 pandemic). Data were analyzed using codebook thematic analysis. (3) Results: Many participants reported decreasing use after a period of heavy drinking. Four themes emerged as reasons for doing so: (1) health conditions attributed to or worsened by drinking, (2) concerns about developing the same alcohol problems as a family member, (3) life demands and transitions that limited drinking opportunities, and (4) disliking the side- and after-effects of drinking (e.g., hangovers). (4) Conclusions: Concerns about negative health consequences from heavy alcohol use and limited opportunities to use alcohol due to competing life demands were salient reasons for reducing or abstaining from alcohol use during COVID-19. Incorporating themes about health and life obligations into messaging to reduce alcohol use during crises may improve message relevance.<\/jats:p>","DOI":"10.3390\/ijerph22020224","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T10:09:52Z","timestamp":1738750192000},"page":"224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cMy Health Is More Important than Drinking\u201d: A Qualitative Analysis of Alcohol Use During COVID-19"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6950-7200","authenticated-orcid":false,"given":"Cat","family":"Munroe","sequence":"first","affiliation":[{"name":"Department of Psychology, Purchase College SUNY, Purchase, NY 10577, USA"},{"name":"Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3965-7432","authenticated-orcid":false,"given":"Anthony","family":"Surace","sequence":"additional","affiliation":[{"name":"Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA"},{"name":"School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla","family":"Martinez","sequence":"additional","affiliation":[{"name":"Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tran, A., Jiang, H., Lange, S., \u0160telem\u0117kas, M., Stumbrys, D., Tamutien\u0117, I., and Rehm, J. (2024). Changes in self-reported alcohol consumption at high and low consumption in the wake of the COVID-19 pandemic: A test of the polarization hypothesis. Medrxiv.","DOI":"10.1101\/2024.07.31.24311291"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rossow, I., Bartak, M., Bloomfield, K., Braddick, F., Bye, E.K., Kilian, C., L\u00f3pez-Pelayo, H., M\u00e4kel\u00e4, P., Moan, I.S., and Moskalewicz, J. (2021). Changes in alcohol consumption during the COVID-19 pandemic are dependent on initial consumption level: Findings from eight European countries. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph181910547"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Grossman, E.R., Benjamin-Neelon, S.E., and Sonnenschein, S. (2020). Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17249189"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s41687-022-00516-0","article-title":"Alcohol consumption and health-related quality of life in the US during the COVID-19 pandemic: A US national survey","volume":"6","author":"Wittenberg","year":"2022","journal-title":"J. Patient-Rep. Outcomes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/acer.14792","article-title":"Changes in alcohol use during the COVID-19 pandemic and previous pandemics: A systematic review","volume":"46","author":"Sohi","year":"2022","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1111\/acer.14839","article-title":"Longitudinal assessment of drinking changes during the pandemic: The 2021 COVID-19 follow-up study to the 2019 to 2020 National Alcohol Survey","volume":"46","author":"Kerr","year":"2022","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_7","unstructured":"Slater, M.E., and Alpert, H.R. (2023). Surveillance Report #120. Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977\u20132021."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"106854","DOI":"10.1016\/j.ypmed.2021.106854","article-title":"Mental health and economic stressors associated with high-risk drinking and increased alcohol consumption early in the COVID-19 pandemic in the United States","volume":"153","author":"Nesoff","year":"2021","journal-title":"Prev. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105090","DOI":"10.1016\/j.chiabu.2021.105090","article-title":"Stress, alcohol use, and punitive parenting during the COVID-19 pandemic","volume":"117","author":"Wolf","year":"2021","journal-title":"Child Abuse Negl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s002130100917","article-title":"How does stress increase risk of drug abuse and relapse?","volume":"158","author":"Sinha","year":"2001","journal-title":"Psychopharmacology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"107247","DOI":"10.1016\/j.addbeh.2022.107247","article-title":"Mental health and drinking to cope in the early COVID period: Data from the 2019-2020 US National Alcohol Survey","volume":"128","author":"Martinez","year":"2022","journal-title":"Addict. Behav."},{"key":"ref_12","first-page":"e11","article-title":"Alcohol Consumption During the First Year of the COVID-19 Pandemic in the United States: Results From a Nationally Representative Longitudinal Survey","volume":"17","author":"Barbosa","year":"2023","journal-title":"J. Addict. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"106532","DOI":"10.1016\/j.addbeh.2020.106532","article-title":"Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women","volume":"110","author":"Rodriguez","year":"2020","journal-title":"Addict. Behav."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1080\/10826084.2021.1928210","article-title":"Early impact of the U.S. COVID-19 pandemic on drinking motives and alcohol use","volume":"56","author":"Prestigiacomo","year":"2021","journal-title":"Subst. Use Misuse"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"McPhee, M.D., Keough, M.T., Rundle, S., Heath, L.M., Wardell, J.D., and Hendershot, C.S. (2020). Depression, environmental reward, coping motives and alcohol consumption during the COVID-19 pandemic. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.574676"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1111\/acer.14574","article-title":"Changes in alcohol use and drinking context due to the COVID-19 pandemic: A multimethod study of college student drinkers","volume":"45","author":"Jackson","year":"2021","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1080\/07853890410018862","article-title":"Stress and alcohol drinking","volume":"36","author":"Sillaber","year":"2004","journal-title":"Ann. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.jadohealth.2021.01.008","article-title":"Changes in young adults\u2019 alcohol and marijuana use, norms, and motives from before to during the COVID-19 pandemic","volume":"68","author":"Graupensperger","year":"2021","journal-title":"J. Adol. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1177\/21676968211004679","article-title":"Young Adults\u2019 Physical Distancing Behaviors During the Initial Months of the COVID-19 Pandemic: Adherence to Guidelines and Associations With Alcohol Use Behavior","volume":"9","author":"Einberger","year":"2021","journal-title":"Emerg. Adulthood"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1080\/00918369.2020.1868187","article-title":"Understanding Alcohol and Marijuana Use among Sexual Minority Women during the COVID-19 Pandemic: A Descriptive Phenomenological Study","volume":"68","author":"Bochicchio","year":"2021","journal-title":"J. Homosex"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/00220426211052673","article-title":"COVID-19\u2019s Impact on Substance Use and Well-Being of Younger Adult Cannabis Users in California: A Mixed Methods Inquiry","volume":"52","author":"Fedorova","year":"2022","journal-title":"J. Drug Issues"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3369","DOI":"10.1111\/add.15530","article-title":"Alcohol consumption during the COVID-19 pandemic in Europe: A large-scale cross-sectional study in 21 countries","volume":"116","author":"Kilian","year":"2021","journal-title":"Addiction"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5, American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_24","unstructured":"Coffey, A., and Atkinson, P. (1996). Making Sense of Qualitative Data: Complementary Research Strategies, Sage Publications, Inc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.trf.2024.06.016","article-title":"A qualitative study of the first COVID-19 pandemic lockdown: The impact on alcohol consumption and driving behaviours","volume":"104","author":"Nicolls","year":"2024","journal-title":"Transp. Res. Part F Traffic Psychol. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1080\/08897077.2022.2060432","article-title":"Alcohol consumption and alcohol home delivery laws during the COVID-19 pandemic","volume":"43","author":"Grossman","year":"2022","journal-title":"Subst. Abus."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1037\/0003-066X.32.7.513","article-title":"Toward an experimental ecology of human development","volume":"32","author":"Bronfenbrenner","year":"1977","journal-title":"Am. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/dar.13610","article-title":"Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: Material ubiquity, automatic routines and embodied states","volume":"42","author":"Lyons","year":"2023","journal-title":"Drug Alcohol Rev."},{"key":"ref_29","first-page":"1","article-title":"Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors","volume":"57","author":"Schwarzer","year":"2008","journal-title":"Appl. Psychol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1111\/add.15295","article-title":"Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: An analysis of 2019\u20132020 data","volume":"116","author":"Jackson","year":"2021","journal-title":"Addiction"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/add.15656","article-title":"Moderators of changes in smoking, drinking and quitting behaviour associated with the first COVID-19 lockdown in England","volume":"117","author":"Jackson","year":"2022","journal-title":"Addiction"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1111\/dar.13868","article-title":"The impact of the COVID-19 pandemic on calls to an alcohol and drug helpline in Victoria, Australia, for alcohol, methamphetamine and cannabis use concerns","volume":"43","author":"Peart","year":"2024","journal-title":"Drug Alcohol Rev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Oldham, M., Kersbergen, I., Cox, S., Brown, J., Piper, R., and Garnett, C. (2022). Exploring changes in temporary abstinence in increasing and higher risk drinkers in England and Dry January participation in users of the Try Dry app in the UK between 2020 and 2021. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14188-4"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1111\/add.13890","article-title":"Familial association of abstinent remission from alcohol use disorder in first-degree relatives of alcohol-dependent treatment-seeking probands","volume":"112","author":"McCutcheon","year":"2017","journal-title":"Addiction"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"11782218231153843","DOI":"10.1177\/11782218231153843","article-title":"Habits and routines of adults in early recovery from substance use disorder: Clinical and research implications from a mixed methodology exploratory study","volume":"17","author":"Kitzinger","year":"2023","journal-title":"Subst. Abus. Res. Treat."},{"key":"ref_36","unstructured":"Surace, A., Munroe, C., and Martinez, P. \u201cMy drinking was way worse during the pandemic\u201d: A Qualitative Analysis of Contextual and Individual Factors Impacting Alcohol Use During the COVID-19 Pandemic, PLoS ONE, under review."},{"key":"ref_37","unstructured":"McFarland, S., Ison, K., Kissel, H., and Brumback, T. (2024, December 05). \u201cAlcohol Is Not Fun Anymore!\u201d: A Study of Alcohol Expectancies During COVID-19. Available online: https:\/\/digitalcommons.murraystate.edu\/postersatthecapitol\/2023\/NKU\/5\/."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/2\/224\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:27:28Z","timestamp":1760027248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/2\/224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,5]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["ijerph22020224"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22020224","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,5]]}}}