This study, based on an anonymous on-line survey of 546 women fielded between June 3 and June 30, 2020, examines changes in women’s alcohol use since the coronavirus pandemic (COVID-19). Nearly two-thirds of women reported drinking more since the beginning of the pandemic, including increases in daily drinking, drinking earlier in the day, and binge drinking. Higher scores on coronavirus-related anxiety were associated with significantly greater odds of drinking more. Changes in alcohol consumption varied for different demographics of women. These findings can be considered a first step toward understanding how COVID-19 may be affecting women’s alcohol use.
The coronavirus pandemic (COVID-19) has altered the way we live in fundamental ways: the way we work, interact with others, perform our daily routines, and engage in behaviors related to our health and well-being. Several studies suggest a surge in alcohol use since the outbreak. In a survey of 2,094 U.S. adults conducted in mid-April of 2020, 17% of respondents reported drinking more in the last few weeks compared to 11% who said they drank less . Alcohol sales were 25% higher during the week ending April 4, 2020 compared to that same week in 2019, and liquor stores in large cities are reporting substantial increases in sales [1,2]. Nationally, estimates indicate a 55% increase in retail alcohol sales between the second and third week of March 2020 . At the same time, economic constraints as a result of the pandemic mean families have less discretionary income, and bar and restaurant closures and cancellation of sporting events provide fewer opportunities to drink outside the home.
The Centers for Disease Control (CDC) has suggested that people are using alcohol to cope with stress brought on by the pandemic . In mid-April 2020, life satisfaction among Americans reached a 12-year low . Potential stressors include unemployment, lost wages, inability to pay bills, and overall economic uncertainty . People who have retained their jobs have had to adjust to working from home, and/or new social distancing and cleanliness standards at the workplace. Other contributing factors thought to be related to increased alcohol use are loneliness and social isolation, inability to exercise or take part in hobbies, and changes in work responsibilities. Parents, and women, are often juggling work and childcare in addition to caring for family members at high risk of COVID-19, with no clear idea of how long the situation will go on . Such chronic ambiguity with respect to roles, relationships, and responsibilities is especially damaging to people’s emotional and physical health . A study of Australian women found drinking intentions and/or behavior were related to “having a stressful week” and because it “makes me feel relaxed” .
Women also make up half the American workforce and are disproportionately employed in occupations deemed essential, and it is widely recognized that essential workers are under an extreme amount of stress [10,11]. Stress, and work-family spillover, is associated with greater alcohol consumption among women [12,13]. Female workers in occupations not deemed essential are more likely than men to have experienced massive layoffs as a result of the pandemic . Unemployment is associated with greater alcohol use and abuse [15-17]. Moreover, a study of 775 U.S. adults in mid-March of 2020 found anxiety specifically related to COVID-19 to be associated with greater alcohol use , and a study of women and men in Spain found that women experienced higher levels of depression, anxiety, PTSD, loneliness, and less spiritual well-being than did men during the COVID-19 lockdown .
Alcohol use had already been on the rise before COVID-19. In 2019, the average number of drinks consumed by Americans in the past week was 4.0, compared to 2.8 in 1996, a 43% increase . Meanwhile, so-called “deaths of despair,” deaths due to alcohol, suicide, or drugs, are responsible for increased death rates and the notable 2015 reversion in U.S. life expectancy [21,22]. Alcohol-related deaths kill roughly 88,000 Americans each year and are the third leading preventable cause of death [23,24]. Alcohol
increases the risk of cancer, liver disease, dementia, depression,
and suicide and the Global Burden of Disease suggests that no
amount of alcohol is healthy [25-29]. Researchers are anticipating
an increase in deaths of despair as a result of the coronavirus
Although women drink less alcohol than do men [31-33],
numerous studies show a convergence of women’s and men’s
alcohol use in terms of prevalence, amount, and frequency,
as well as alcohol-related problems and harms [34-37]. This
convergence is being driven mainly by increases in alcohol use
among women as opposed to declines among men . Analysis
of the National Epidemiological Survey on Alcohol and Related
Conditions indicated that women experienced a 16% increase in
past year alcohol use, a 58% increase in high-risk drinking, and
an 84% increase in alcohol use disorder between 2002 and 2013
. A meta-analysis of six U.S. surveys indicated a 10% increase
in prevalence of alcohol use and 23% increase in binge drinking
among women between 2000 and 2016, with no corresponding
increase for men .
Women are more susceptible to alcohol-related health
conditions than are men, as well as infertility, reproductive
problems, and breast cancer [39-41]. Women have experienced
the same plateau in life expectancy as men partly a result of
increases in alcohol-related deaths and liver disease [42-44]. An
analysis of U.S. death certificates filed between 1999 and 2017
showed an 85% increase in deaths due to alcohol among women
compared to an increase of only 35% for men .
There have been recent calls for research on the effect of
COVID-19 on alcohol consumption, harms, and policies [45,46].
The use and overuse of alcohol has increased substantially among
women with negative effects on their health and emotional wellbeing.
As the main caretakers of children, aging parents, and
extended family members, women’s use of alcohol can reverberate
across the family system and between generations. One in ten
children live with a parent who has an Alcohol Use Disorder
(AUD); 1.4 million of those live with a single parent, most often
with their mothers . Alcohol is associated with child abuse,
neglect, and interpersonal violence [48,49]. There is growing
alarm as to how COVID-19 is affecting women with children, who
are widely viewed as being under particularly stressful conditions
since the pandemic. Jokes and memes about mothers’ increased
reliance on alcohol to cope with work, childcare, and managing
their children’s on-line education, have exploded on social media
since the pandemic.
A developmental perspective on alcohol use stresses that
“variability in drinking patterns is not constant across the lifespan,
and that pressures to drink-or not to drink-are concentrated
at certain stages in the course of a person’s life” . Indeed, a
woman’s use of alcohol over her lifetime or her drinking trajectory,
is particularly sensitive to life course transitions. Some transitions
are protective against alcohol use, including steady employment
[51,52], marriage [53-57], and parenthood [54,58-60]. Others,
such as attending college and divorce, are associated with the
greater use of alcohol (Chilcoat & Breslau 1996; . Drinking
tends to decline with age [55,61,62], although more recent studies
suggest increase drinking among people in midlife and older,
especially among women [37,38,63]. White, college-educated,
and higher income women experienced the greatest increase
in alcohol consumption in recent years and drink significantly
more than do other women [34,64-66]. Religiosity and organized
religion are inversely related to alcohol use and alcohol-related
The aim of this study is to assess changes in women’s alcohol
consumption since COVID-19, and to understand the role of
coronavirus-related anxiety, and women’s social and demographic
characteristics. There is only one other similar study available
currently. In a national study, Australian researchers found an
increase in self-reported alcohol consumption among women and
men during the pandemic (May 2020) than 2 to 3 years prior, but
that the increase was substantially higher among women, and that
having a child caring role was a strong predictor of an increase
in alcohol consumption . They did not examine the role of
anxiety related to COVID-19.
Given large variation in rates of positive cases of COVID-19
and COVID-19-related hospitalizations and deaths across U.S.
states, this study explores regional differences in these patterns.
The survey contains a series alcohol use questions adapted
from the National Institutes on Alcoholism and Alcohol Abuse
adapted to capture drinking pre- and post-COVID-19, including
frequency, number of drinks, and frequency of binge drinking
, as well as the time-of-day alcohol is consumed and type of
drink, and contains a broad range of sociodemographic variables.
A coronavirus anxiety scale was designed by the researcher.
The study is based on an anonymous on-line Qualtrics survey
of 546 women age 25 and older who reported drinking alcohol
at least occasionally. Women under the age of 25 were excluded
because they demonstrate a temporary upswing in drinking and
binge drinking. Participants were recruited primarily through
social media (Facebook, Twitter, etc.), but also by email, listserves,
and newsletters. The survey was fielded between June 3 and June
30, 2020. Participants were directed to a website containing a
consent form and a Qualtrics survey which they could access
through their smartphones, computer, or other electronic device.
Participants were encouraged to share the link to the study with
others in their social network.
The main objective of the survey was to measure women’s
alcohol consumption pre- and post-COVID-19. Respondents were
first asked about their current level of alcohol consumption. Since
COVID-19 and social distancing measures began in your area, about how often do you have any kind of drink containing alcohol?
By a drink, we mean half an ounce of absolute alcohol (e.g. a
12-ounce can or glass of beer or cooler, a 5-ounce glass of wine,
or a drink containing 1 shot of liquor)? Responses ranged from 1
(every day) to 10 (less than a few times a year). About how many
alcoholic drinks would you say you have on a typical day when you
drink alcohol? Responses ranged from 1 (one drink) to 7 (12 or
more drinks). Respondents were then asked about their frequency
of binge drinking. About how often would you say you have 4 or
more drinks containing any kind of alcohol in within a two-hour
period? That would be the equivalent of at least 4 - 12-ounce
cans or bottles of beer, 4 - 5-ounce glasses of wine, 4 drinks each
containing one shot of liquor or spirits. Responses ranged from 1
(never) to 9 (every day). Respondents were also asked about their
typical pattern of alcohol consumption: On days you drink, when
do you usually have your first drink? Potential responses included
before lunchtime, around lunchtime, mid-afternoon, before dinner,
with dinner, and after dinner or evening. Then, On days you drink,
what type of drink do you have most often? Respondents could
select from beer, wine, cocktails or mixed drinks, liquor or spirits
(straight), and other. Finally, the women were asked, on days you
drink, do you tend to switch from one kind of drink to another?
Response categories were yes, I tend to switch from drinks with
less alcohol to drinks with more, such as from beer to wine; yes, I
tend to switch from drinks with more alcohol to drinks with less,
such as from wine to beer; and, no, I tend to drink the same kind
of drink all day.
Respondents were then asked about their pre-COVID-19 level
of drinking. Before COVID-19 and social distancing measures
began in your area, would you say you drank quite a bit less than
I do now, somewhat less than I do now, the same amount as I do
now, somewhat more than I do now, or quite a bit more than I do
now? Respondents who reported drinking “the same amount”
were asked, if you drank the same amount as now, were there ever
periods of time during COVID-19 and social distancing measures
began in your area when you drank more or less alcohol than
you did? Potential responses were yes, there were times when I
drank more; yes, there were times when I drank less; and, no, I’ve
been drinking about the same amount throughout the pandemic.
Respondents who reported a change in their alcohol consumption
answered the same series of alcohol consumption questions in
relation to before COVID-19.
The Coronavirus Anxiety Scale, designed for this study,
contains 9 items designed to capture anxiety about COVID-19
(Stewart, 2020). Respondents were asked, since COVID-19 and
social distancing measures began in your area, on a scale from
1 (never) to 5 (often), how often have you thought about the
following: (a) me or a family member contracting the coronavirus,
(b) me or a family member getting seriously ill or dying from the
coronavirus, (c) others getting sick or dying from the coronavirus,
(d) my personal finances and providing for my family, (e) the
economy in general, (f) not being able to see friends and family,
(g) the mental health and emotional well-being of friends and
family, (h) my mental health and emotional well-being, and (i) the
future of the country. The scale has a high level of reliability with
a Cronbach’s alpha of .83. The women in the sample exhibited a
moderate to high level of anxiety with an average level of 3.6.
Respondents provided information on their social and
economic characteristics. Age was recorded in years and is
grouped in terms of the following: 25 to 29, 30 to 39, 40 to 49, 50 to
59, and 60 and older. Racial and ethnic identity is coded as White,
Black/African American, Hispanic, Asian/Asian Indian, and other
or more than one race. Due to small cell sizes, the latter categories
were coded as non-White. Relationship status was coded as
single, cohabiting, and married. Educational attainment is a
three-category measure: less than a bachelor’s degree, bachelor’s
degree, to graduate or professional degree. Respondents were
asked whether and how their employment situation has been
affected by the pandemic: yes, I lost my job or was furloughed;
yes, I work fewer hours; yes, I work more hours; yes, I work from
home some or all of the time; and, no, my work life has stayed the
same. Respondent’s reporting having lost their job, having been
furloughed, or worked fewer or more hours were combined in the
multivariate analysis. Whether or not respondents had children
was coded as a dichotomous variable (yes, no). Categories of
religious affiliation included Catholic, Protestant, Jewish, Muslim,
other religion, and no affiliation. Respondents recorded the
region where they live: Northeast, Midwest, South, or West. Yearly
gross household income in 2019 ranged from less than $25,000,
$25,000 to $49,999, $50,000 to $74,999, $75,000 to $99,999,
$100,000 to $149,000, $150,000 to $199,999, and $200,000 or
more. Respondents with household incomes less than $75,000
were combined. The distribution of these variables can be found
in Table 1.
Table 2 describes women’s perceptions of changes in their
alcohol consumption since COVID-19. Results in Panel 1 indicate
that women’s alcohol consumption has increased since the
beginning of the pandemic. Nearly two-thirds (64%) of women
reported drinking quite a bit less (22%) or somewhat less (43%)
before the pandemic than after. Only 13% of women reported
drinking somewhat more or quite a bit more before COVID-19,
and 23% reported drinking the same amount. Among those who
reported drinking the same amount, 29% reported there were
times since COVID-19 when they drank more, and 9.4% said there
were times when they drank less. Panel 3 combines information
from these two questions. Compared to pre-COVID-19, 15.2%
of women reported ever drinking quite a bit less or somewhat
less, 70% of women reported ever drinking quite a bit more or
somewhat more, and 14.5% of women say they consistently drank
the same amount pre- and post-COVID-19.
Table 3 examines changes in women’s drinking in greater
detail. First, there was a three-fold increase in daily drinking,
from 4.6% pre-COVID-19 to 15.6% post-COVID-19. The volume
of drinks consumed remained relatively consistent across time,
although there was a slight decline in the percent of women who
drank just one drink, from 32.4% to 26.9%. Women’s frequency
of binge drinking (drinking 4 or more drinks within a two-hour
period) showed an interesting pattern with an increase in never
(from 37.0% to 42.5%) and an increase in weekly (15.4% to
23.1%). There was also a shift in drinking from later in the day
to earlier in the day. Pre-COVID-19, 4.4% of women reported
having their first drink by mid-afternoon compared to 16.1%
post-COVID-19. The type of alcohol consumed remained relatively
consistent, with a slight increase in drinking cocktails, liquor,
and beverages other than beer and wine. At both time points,
most women drank beverages with the same amount of alcohol
throughout the day (90.0% and 88.1%) as opposed to switching
from one kind of drink to another.
Table 4 describes the bivariate relationship between
coronavirus-related anxiety, women’s sociodemographic
characteristics, and changes in alcohol consumption since
COVID-19. Significant differences across categories are noted.
First, women who reported drinking more after the pandemic
reported a significantly higher level of COVID-19-related anxiety
(3.8) than did women who reported drinking the same amount
(3.5) or less (3.6), although the difference in magnitude between
groups is small. A higher percentage of younger women than older
women reported drinking more since the pandemic. Women age
60 and older demonstrated the most stability in drinking; 53.6%
reported drinking the same amount before and after COVID-19.
A slightly higher percentage of non-White women reported
drinking more. A significantly lower percentage of women
with graduate or professional degrees reported drinking more
(63.9%) compared to women with a bachelor’s degree (74.9%)
or less than a bachelor’s degree (76.5%). Changes in employment
were associated with changes in alcohol consumption. Women
who lost their job, were furloughed, or who worked hours than
before the pandemic exhibited significantly less stable alcohol
consumption before and after COVID-19 than did women whose
work life remained the same. For example, only 7.0% in those categories drank the same amount at both time points compared
to 23% of women whose work life did not change after COVID-19.
Relationship status, particularly marriage, was also important.
Three-fourths of married women (74.6%) reported drinking more
since the pandemic, compared to 62.5% of cohabiting women and
59.6% of single women. Less than half the percentage of married
women reported drinking less (10.9%) than cohabiting or single
women (26.6% and 24.0%, respectfully). A significantly lower
percentage of Catholic women reported drinking more (57.9%)
or the same amount (25.3%) since the pandemic than women of
other religious affiliations. There were no significant regional or
income differences in changes in women’s alcohol consumption.
Note: Cells may not total to 100% due to rounding.
Note: Cells may not total to 100% due to rounding.
*Significant differences between groups at p < 05.
Table 5 provides the results of a logistic regression, in the
form of odds ratios, that assesses the independent effects of
women’s coronavirus-related anxiety and their sociodemographic
characteristics on changes in women’s alcohol consumption preand
post-COVID-19. A test of the proportional odds assumption
suggests that binary logistic regression (more versus same/
less) is preferred over a three-category ordered or multinomial
logit model . Model 1 indicates that women with higher
coronavirus-related anxiety have higher odds of drinking more
post-COVID-19 than pre-COVID-19. Every one-unit increase in
anxiety is associated with 32.6% higher odds of drinking more
after the pandemic as opposed to the same amount or less.
Older women, namely women age 50 to 59 and sixty and older,
have significantly lower odds (55.0% and 78.0%, respectively)
of increasing their alcohol consumption compared to women in
their twenties. Compared to women with less than a bachelor’s
degree, women with advanced degrees have 57.5% lower odds of
increasing their alcohol consumption than women with less than
a bachelor’s degree and 48.5% lower odds compared to women
with a bachelor’s degree (data not shown). Catholic women have
62.4% lower odds of increased alcohol use compared to Protestant
women. On the other hand, married women are over twice as
likely to have increased their alcohol consumption compared to
single women and cohabiting women (data not shown). Women’s
characteristics not associated with changes in alcohol use include
race and ethnicity, changes in employment situation, region, and
income. Additional analysis did not find a statistically significant
relationship between employment status (full-time, part-time,
and not employed), religious service attendance, and changes in
women’s alcohol use (results not shown).
*p < 05; **p<.01; ***p < .001.
At baseline, having children was not associated with changes
in drinking since the pandemic. However, the effect of children may
be dependent upon women’s relationships status. For example,
the presumed stress of having a child could be compounded by
traditional role responsibilities associated with marriage. Model
2 includes an interaction between relationship status and any
children. However, result indicate having children reduces the
odds of increased alcohol consumption among married women
by 69.3%. Children are not associated with changes in alcohol
consumption among cohabiting or single women.
Although women drink less alcohol than do men [31,32],
numerous studies show that women’s use of alcohol is catching
up to that of men’s in terms of prevalence, amount, and frequency,
as well as alcohol-related illnesses and deaths . The U.S.
Department of Health and Human Services estimates there are 5.3
million women in the U.S. who are heavy drinkers or who “drink
in a way that threatens their health, safety, and general wellbeing”
(2018, p. 6). Alcohol-related cirrhosis increased 50% in
women between 2009 and 2015 . In an analysis of data from
the Centers for Disease Control (CDC), nearly a third of women
surveyed (23%) reported previous levels of alcohol use consistent
with an alcohol use disorder, with 10% showing symptoms of an
AUD in the past 12 months .
The results of this survey are consistent with studies suggesting
a rise in alcohol use since COVID-19 (e.g.,  and that anxiety
about the pandemic playx a role, supporting anecdotal evidence
and widespread media reports. Results regarding women’s
sociodemographic characteristics are for the most part in line
with previous research. A lower proportion of older women than
younger women increased their alcohol consumption. Although
religiosity and organized religion are generally associated with
less alcohol use and alcohol-related problems [67,68], results
indicate lower odds of increased drinking among only Catholic
women. Although women with advanced degrees had lower odds
of drinking more since the pandemic, they also had a higher level
of alcohol consumption pre-COVID-19 (43% drank at least three to
four times a week versus 28% of women with a bachelor’s degree
or less), consistent with prior work showing greater alcohol use
among more educated women [55,65,72]. As noted above, race
and ethnicity, changes in employment situation, employment
status, region, and income, religious service attendance, were
not associated with changes in women’s alcohol use, in contrast
to previous research indicating these are important variables to
consider. However, previous research assessed these relationships
with respect to current levels of drinking as opposed to this study
which examines change over time.
The positive effect of marriage on increased alcohol
consumption is interesting given that marriage has long been considered a protective factor against substance use [37,53,54].
However, married women have been found to have higher rates
of alcohol consumption than unpartnered women, at least among
Whites . Reczek et al.  examined the marital biographies
of men and women from the Health and Retirement Study and
found that marriage and remarriage reduced men’s heavy alcohol
use (3+ drinks at least one day each week) but increased women’s
and that divorce increased men’s drinking but reduced women’s.
This work suggests that married women may be under greater
stress since the pandemic, perhaps a result of having a husband at
home more of the time. Gender roles and gender role attitudes are
more traditional among married women than among cohabiting
and single women, and married women may feel particularly
responsible for “keeping things together” on the home front, even
if working full time. The results may also be related to increased
drinking among husbands since the pandemic, as women’s
drinking is highly sensitive to that of their spouse . The effect
of the pandemic on men’s alcohol use is currently unknown, but
financial strain and increased stress post-COVID-19 is certainly
not exclusive to women. Results are also consistent with research
showing lower levels of alcohol consumption among mothers,
despite anecdotal evidence to the contrary [53, 54] Hayden et al.
It is important to reemphasize that these results are not
representative of the national population and are based on the
experiences of a largely White, college-educated sample of women
recruited through social media. Nevertheless, this sample reflects
women who have the highest levels of alcohol consumption relative
to other women and who have experienced the greatest increase
in alcohol use in recent years [34,64, 66]. Women’s reports are
retrospective, and respondents may not accurately recall their
behaviors and feelings before the pandemic, although the survey
was constructed to minimize over-inflation of alcohol use since
the pandemic by asking about their current usage prior to asking
about previous levels. It is hoped that, in the absence of national
studies, this study contributes to our understanding of changes in
women’s alcohol use as it relates to COVID-19. Studies conducted
at the national level are needed, as are longitudinal assessments
of women’s alcohol use over time, and especially studies focusing
on women of color, and less educated and lower income women.
Women’s increased alcohol use since the pandemic is especially
troubling given their level of alcohol use had already been on the
increase. There are already many barriers for women getting
treatment for alcohol overuse that prolong women’s alcohol
dependency and health risks. Guilt, shame, being perceived as a
“bad mom,” lack of childcare, the cost of treatment, and familial
opposition, the lack of gender-specific treatment, physicians
being slow to recognize AUDs in women, and for single mothers,
the potential loss of custody [73-76]. Since the pandemic, many
women have lost access to mental health services, substance use
resources, and have been cut off from family and friends .
These findings suggest the importance of continued study of how
COVID-19 is impacting women’s alcohol use, factors underlying
increased consumption, and the effect of drinking on women’s
social and emotional health and on the well-being of their families
Susan D. Stewart is a Professor of Sociology at Iowa State
University. She received her Doctorate in Sociology from Bowling
Green State University. Dr. Stewart is a family demographer
whose research focuses on gender, parenting, family diversity,
and children and adults’ physical, social, and emotional health.
Stewart is the author or co-author of several books including,
Multicultural Stepfamilies; Brave New Stepfamilies: Diverse Paths
Toward Stepfamily Living; Marriages, Families, and Relationships;
and Co-Sleeping: Parents, Children and Musical Beds. Her research
has been supported by grants from the NICHD, USDA, Joint Center
for Poverty Research, and the Annie E. Casey Foundation. She has
conducted research on a diverse array of topics, including divorce,
stepfamilies, women’s alcohol use, family stress, childhood obesity,
adoption, and women’s financial literacy.
Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, et al. (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet 392: 1015-1035.
Stewart SD, Jones-Johnson G, Dorius C (2019) Women and Alcohol Use over the Lifecourse: An Intersectional Approach. Paper presented at the annual meeting of the American Sociological Association, New York, USA.