Changes in alcohol-consumption frequency and factors associated with the magnitude of decreases during the COVID-19 pandemic: a nationally representative cross-sectional survey in Thailand

We described changes in alcohol-consumption frequency among current drinkers in Thailand during the COVID-19 pandemic and examined factors associated with a larger decrease among those who reduced their drinking frequency. We analysed a nationally representative face-to-face cross-sectional survey conducted in 2021. Unweighted counts describe actual respondents; percentages, means, and regression estimates were weighted. Frequency change was calculated for current drinkers with paired pre-pandemic and past-30-day responses. The 0–10 reason items were asked only of reducers. A weighted binary logistic model compared a decrease of at least two levels with a one-level decrease among reducers, using robust standard errors. The survey included 7,731 respondents; 2,573 current drinkers had paired frequency data. Weighted estimates indicated that 57.7% maintained their frequency, 36.7% decreased it, and 5.5% increased it. Of 941 reducers, 932 completed all reason items. The highest weighted mean ratings were infection risk (7.5/10), reduced income or the need to save money (6.7/10), and fewer social gatherings (6.7/10). The regression included 915 reducers. Higher endorsement of infection risk (aOR 2.50, 95% CI 1.15–5.45) and family considerations (aOR 1.72, 95% CI 1.04–2.86) was associated with higher odds of a decrease of at least two levels rather than one level. Difficulty purchasing alcohol was inversely associated with that contrast (aOR 0.50, 95% CI 0.33–0.76). More than one third of current drinkers reported decreased frequency. Infection risk, financial constraints, and fewer gatherings were salient reasons among reducers. Associations with the magnitude of decrease, including the inverse association for purchasing difficulty, are conditional, non-causal comparisons within reducers and should be interpreted cautiously.