Risky health behaviors during the COVID-19 pandemic: Evidence from the expenditures on alcohol, non-alcoholic beverages, and tobacco products

Background: The COVID-19 pandemic has increased mental stress among the population and, at the same time, has lowered consumer income. Alcohol, non-alcoholic beverages, and tobacco consumption are associated with multiple health conditions but the information on how the consumption pattern of these goods shifted during the pandemic remains limited. Objective: To examine the consumer spending on alcohol, non-alcoholic beverages, and tobacco products during the COVID-19 pandemic compared to the pre-pandemic period. Design: An observational study utilizing the expenditures data on alcohol, non-alcoholic beverages, and tobacco between 2017 and 2020 obtained from the US Consumer Expenditure Diary Survey. Participants: 18,808 respondents aged ≥ 21 years who answered the Consumer Expenditure Diary Survey. Analysis: Multivariable linear regression models. Results: A total of 18,808 respondents (mean [SD] age = 52.5[16.9] years; 53.8% females) were included. Compared to the pre-pandemic levels, household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased during the pandemic period by 28.6%, 7.9%, and 15.5%, respectively, after controlling for the state-, individual-, and household-level characteristics. Individual age, race/ethnicity, income, and education were significant predictors of spending. Heterogeneities in expenditures were evident across subgroups, with less educated and low-income households cutting their alcohol expenses while the wealthy and more educated consumers spent more during the pandemic. Conclusions and implications: Household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased. The results might be beneficial in understanding consumer spending habits concerning risky health behaviors during the period of economic disruption.