Alcohol consumption patterns, suppliers and online alcohol marketing: Before and during COVID-19 alcohol bans

COVID-19-related alcohol sales bans and stay-at-home orders prompted the alcohol industry in South Africa to increase their online alcohol sales promotions. We investigated changes in alcohol-related behaviour and the drivers of illegal alcohol sales through a self-reported Facebook survey that ran from July to November 2020. Questions included socio-demographics and comparison of alcohol purchasing behaviour and intake during 2019 and 2020. Statistical tests were applied to find associations between illegal alcohol purchasing and alcohol-related behaviours. A total of 792 participants took part in the survey, 69.7% of whom were female. During lockdown periods, most participants (55.3%) bought alcohol illegally from illegal outlets or friends. Online alcohol-delivery marketing increased by 20 percentage points from 2019 to 2020, with participants stating that they saw a lot of advertisements per day and 80% of persons under 25 years were not asked to verify their age in 2020 upon delivery. Home-brewed beer and vodka intake increased in 2020 during the alcohol sales bans. Men from the Western Cape who engaged in daily or weekly heavy episodic drinking were more prone to purchase alcohol illegally. The Western Cape, which is South Africa's most prolific wine-producing region, had the highest odds of people buying alcohol illegally, with wine being found to be the most frequently bought alcohol online and consumed by these participants. There is a need for further research into the differences in alcohol-related behaviour affecting illegal alcohol purchasing according to income group, proximity to alcohol producers and underage alcohol sales and marketing through online applications.