If They'd Said You Should Only Drink Five Units I'd Have Listened: A Mixed Methods Study of Alcohol Consumption Following a Diagnosis of Breast Cancer.

OBJECTIVES: As part of a wider study describing the impact of a breast cancer diagnosis on lifestyle behaviours, this paper describes the impact of a breast cancer diagnosis on alcohol consumption and factors influencing consumption. METHODS: Cross-sectional online survey of 140 people (138 women) and interviews with 21 women diagnosed with breast cancer in the last 10 years. RESULTS: Of the 100 survey participants who drank alcohol 25% were drinking at increasing or higher risk levels and 17% strongly wanted to change their drinking behaviour. The habitual aspects of alcohol consumption were the strongest predictor of current alcohol consumption behaviours. Social norms and perceptions about conflicting information were substantial barriers to change. CONCLUSIONS: Breast cancer survivors need accurate information about the risks of alcohol consumption and guidelines in order to make informed decisions about making changes to their behaviour. Interventions to support breast cancer survivors to reduce alcohol consumption need to focus on the development of healthy habits and may benefit from a focus which includes partners and friends.

From chaos to kaleidoscope: Exploring factors in psychedelic self-treatment for mental health conditions.

INTRODUCTION: This study explores how individuals self-treat psychiatric conditions with psychedelics outside medical guidance bridging the gap in understanding unregulated therapeutic use. AIMS: The primary objective was to extract specific factors underlying the effects of psychedelics, exploring their relationship with the need for medication, particularly for mental health conditions like depression and anxiety. Additionally, we aimed to understand how the likelihood of being prescribed pharmacological medication varies based on mental health diagnoses and demographic factors. METHODS: This research utilised the Global Drug Survey 2020, an annual online survey focused on substance use patterns and demographics, incorporating modules addressing mental health and psychedelic use. The study employed Exploratory Factor Analysis to discern latent factors underlying the self-reported effects of psychedelics. Bivariable and multivariable logistic regressions were conducted to investigate the association between identified factors and the likelihood of current prescribed medication usage. RESULTS: In all, 2552 respondents reported using psychedelics for self-treatment of mental health conditions. Three significant factors were identified: Improved Mental Health, Improved Self-Awareness and Neuro-Sensory Changes. The majority of the sample reported a history of depression (80%) or anxiety (65.6%), with a significant association observed between reported factors of psychedelics' effects and current medication usage for mental health, especially notable in cases of depression or comorbid depression and anxiety. CONCLUSIONS: Perceived symptom improvement following psychedelic self-treatment may reduce the need for medically supervised pharmacological interventions. These findings highlight the potential of psychedelics to positively influence mental health and self-awareness, paving the way for further research into their therapeutic application.

Prospective Assessment of Adjuvant Netarsudil Use in Patients Undergoing Descemet Stripping Only.

PURPOSE: We sought to determine whether adjuvant use of netarsudil improves corneal clearance rate and regeneration of corneal endothelial cells in patients undergoing Descemet stripping only (DSO). METHODS: We conducted a prospective assessment on the use of adjuvant netarsudil in 50 eyes from 25 patients undergoing DSO at Massachusetts Eye and Ear between May 2021 and May 2023. Our comparison group was a retrospective cohort of patients (23 eyes from 15 patients) who previously underwent DSO without the use of a postoperative rho-kinase inhibitor between September 2014 and March 2020. RESULTS: Use of netarsudil after DSO statistically significantly reduced time to corneal clearance, improved best corrected visual acuity, reduced pachymetric thickness, and increased central endothelial cell count (ECC) at 6 months postoperatively. Importantly, central ECC continued to increase beyond 12 months after DSO with central ECC still statistically significantly greater in eyes that received netarsudil than in eyes that received no netarsudil. CONCLUSIONS: A rho-kinase inhibitor, such as netarsudil, after DSO should be used if available to achieve the best corneal clearance, best corrected visual acuity, and ECC after surgery.

Tripping into the unknown: Exploring the experiences of first-time LSD users through global drug survey insights.

BACKGROUND: The recreational use of LSD, a synthetic psychedelic drug, has surged in recent years, coinciding with a renewed research focus on its potential psychotherapeutic properties. AIM: This study aims to describe the experiences and perceptions of individuals engaging in LSD use for the first time, derived from a large international sample. METHODS: This study utilised 2018 Global Drug Survey data collected from 6 November 2017 to 10 January 2018. Participants who initiated LSD use in the preceding 12 months answered questions on their experiences, social settings, harm-reduction behaviours, and demographics. Descriptive statistics were employed, and characteristics of those seeking emergency medical treatment (EMT) and those not planning further LSD use were compared with other respondents. RESULTS: Among 3340 respondents who used LSD in the past year, their first-time experiences generally exceeded expectations, with 97.7% expressing excitement. Adverse and unwanted side effects were rarely reported, and only 17 individuals needed EMT. Feelings of fear were reported by most (64.1%), but only very mildly and not enough to put them off from wanting to use LSD again. DISCUSSION: Although the occurrence of unwanted side effects seems low and the LSD experience is generally pleasurable, vigilance amid the rising illicit use of LSD through harm-reduction education is still important in preventing possible risks.

Sweating for Sobriety: Exploring the Relationship Between Exercise Engagement and Substance Use Disorders.

Despite various interventions available for substance use disorders, relapse rates remain substantial and, therefore, alternative strategies for attenuating dependence are needed. This study examined the associations between exercise frequency, illicit substance use, and dependence severity among a large sample of people who use drugs. The study utilized data from the Global Drug Survey 2018 (N = 57,110) to investigate the relationship between exercise frequency, illicit substance use, and substance dependence severity. Binomial regressions were employed to examine the relationship between exercise and SDS scores for 9 drugs. Greater exercise frequency correlated with reduced severity of substance dependence for specific drugs: cannabis (χ2 = 14.75, p < .001), MDMA (χ2 = 4.73, p = .029), cocaine (χ2 = 8.37, p = .015), amphetamine powder (χ2 = 6.39, p = .041), and methamphetamine (χ2 = 15.17, p < .001). These findings suggest a potential link between exercise and reduced substance use dependency. Further research is needed to understand the complex dynamics between exercise and substance use, considering potential bidirectional relationships and concurrent factors.

Drinking and mental health in middle adulthood: exploring the impact of wellbeing, mental health literacy, and drinking motives on risk of alcohol dependence.

OBJECTIVES: Risky drinking is a concern among UK-based middle-aged adults. We aimed to explore the relationship between risky drinking, drinking motives, wellbeing, and mental health literacy (MHL). METHOD: Cross-sectional analysis of online survey data completed by 193 UK-based adults aged 40-65 who drank alcohol, incorporating the Alcohol Use Disorders Identification Test (AUDIT); Drinking Motives Questionnaire-Revised (DMQ-R); Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); Mental Health Literacy Scale (MHLS) and demographic questions. RESULTS: Coping, enhancement and conformity motives and gender significantly predicted higher AUDIT scores (measuring risky drinking). Enhancement motives were found to mediate the relationship between the self-help component of MHL and AUDIT scores, while coping motives mediated the association between wellbeing and AUDIT scores. CONCLUSION: Findings support research emphasising the influence of drinking motives on risky drinking and highlights how low wellbeing may interact with coping motives to explain risky drinking among middle-aged adults, particularly men. Interventions supporting individuals to understand the relationship between drinking motives and risky drinking, develop adaptive coping strategies, and address the causes of low wellbeing, may be beneficial. However, as the sample was 84% ethnically White, 64% women, 85% educated to at least undergraduate level, and reported a relatively high mean socioeconomic status (6.98 out of 10), the results may not generalise beyond these groups. Future research should use stratified sampling to increase generalisability, as well as exploring whether alcohol-specific, component-specific, or disorder-specific MHL is associated with risky drinking and wellbeing.

Evaluation of a custom designed hybridisation assay for whole genome sequencing of human adenoviruses direct from clinical samples.

BACKGROUND: Human Adenoviruses are a common cause of disease and can cause significant morbidity and mortality in immunocompromised patients. Nosocomial transmission events can occur with whole genome sequencing playing a crucial role. This study evaluates the performance of a custom designed SureSelectXT target enrichment assay based on 14 adenovirus genomes for sequencing direct from clinical samples. METHODS: Modifications were made to the SureSelectXT low input protocol to enhance performance for viral targets. Consensus sequences were generated using an in-house designed three stage bioinformatics pipeline. We assessed, percentage of on target reads, average depth of coverage and percentage genome coverage to determine assay performance across a range of sample matrices. RESULTS: Whole genome sequences were successfully generated for 91.6 % of samples assessed. Adenovirus DNA concentration was a good indicator of enrichment success. Highly specific enrichment was observed with only 6 % of samples showing < 50 % on target reads. Respiratory and faecal samples performed well where bloods showed higher levels of non-specific enrichment likely confounded by low adenovirus DNA concentrations. Protocol performance did not appear impacted by Adenovirus type or species. CONCLUSION: Overall performance of this modified SureSelectXT protocol appears in line with previously published works although there are some confounding factors requiring further investigation. The use of a small RNA bait set has the potential to reduce associated costs which can be prohibitive.

Regrets, I've Had a Few: Exploring Factors Associated with Getting Drunk and Regret in an International Study of People Who Drink Alcohol.

BACKGROUND: Excessive alcohol consumption is often followed by feelings of regret. This study aimed to explore country differences in experiences of drunkenness and regrets and predictors of experiencing a greater number of regrettable drinking occasions. METHODS: This study draws on a sample of 82,821 respondents from 31 countries who completed the 2020 Global Drug Survey. Respondents were asked to report how many times in the last year they had been drunk, how many of those times they felt regret afterwards and to complete a range of sociodemographic measures. RESULTS: In the last 12 months, the median times drunk was 6 and the median number of regretted occasions was 2. There was an inverse relationship between times drunk and regret. Respondents who got drunk more often regretted it a smaller percentage of the time than those who got drunk less often. Respondents from Argentina and Colombia regretted being drunk the most and Denmark the least. Being younger, in higher AUDIT categories were associated with more times drunk. Being a woman, having mental health conditions were associated with more regretted occasions.Discussion and conclusions: Country variations may reflect relative acceptability of being drunk. Those who drink more, per occasion, may become accustomed to the consequences and feel fewer regrets. Interventions promoting reduced alcohol consumption may benefit from encouraging people to consider their future regret following a drinking occasion but should account for lower levels of regret in those who get drunk more often.

Discrimination, gender dysphoria, drinking to cope, and alcohol harms in the UK trans and non-binary community.

Transgender (trans) and non-binary people may be at increased risk of alcohol harms, but little is known about motives for drinking in this community. This study explored the relationship between risk of alcohol dependence, experience of alcohol harms, drinking motives, dysphoria, and discrimination within a United Kingdom sample of trans and non-binary people with a lifetime history of alcohol use. A cross-sectional survey was co-produced with community stakeholders and administered to a purposive sample of trans and non-binary people from 1 February until 31 March 2022. A total of 462 respondents were included-159 identified as non-binary and/or genderqueer (identities outside the man/woman binary), 135 solely as women, 63 solely as men, 15 as another gender identity, 90 selected multiple identities. Higher levels of reported discrimination were associated with higher risk of dependence and more reported harms from drinking. Coping motives, enhancement motives, and drinking to manage dysphoria were associated with higher Alcohol Use Disorders Identification Test scores. Social, coping, and enhancement motives alongside discrimination and drinking to have sex were associated with harms. The relationship between discrimination and risk of dependence was mediated by coping motives and drinking to manage dysphoria. Further to these associations, we suggest that reducing discrimination against trans and non-binary communities might reduce alcohol harms in this population. Interventions should target enhancement motives, coping motives and gender dysphoria. Social and enhancement functions of alcohol could be replaced by alcohol free supportive social spaces.

Investigating the impact of 'dark nudges' on drinking intentions: A between groups, randomized and online experimental study.

OBJECTIVES: This study explored how 'dark nudges' (tactics used in alcohol industry-funded responsible drinking campaigns) affect drinking intentions, perceived source credibility and whether individual differences in perceptions of prototypical drinkers moderated these effects. DESIGN: Two 2 × 2 between-groups online experimental studies. METHODS: Study 1 (N = 164) presented three alcohol health messages per condition, comprising social norm (healthy/unhealthy ("dark nudge")) by frame (loss/gain). Study 2 (N = 229) presented one message per condition, comprising cancer causality (single cause/multiple causes (dark nudge)) by funding disclosure (disclosure/non-disclosure (dark nudge)). Outcomes were drinking intentions and perceived source credibility. Exploratory analyses considered prototype perceptions as a between-subjects moderator. RESULTS: No significant effects of message frame, social norm, fundi or multiple cancer causality arguments on drinking intentions were found. In Study 2, in the dark nudge multiple cancer causality conditions, perceived source credibility was high when funding was undisclosed, but significantly lower when it was disclosed. Exploratory analyses suggested effects were moderated by prototype similarity. In Study 1, higher perceived similarity to a heavy drinker and lower perceived similarity to a responsible drinker were associated with higher drinking intentions in the unhealthy norm/gain frame condition, but lower drinking intentions in the other conditions. CONCLUSIONS: Framing, social norm, funding disclosure and multiple causality manipulations as tested in this study did not exert a dark nudge effect on drinking intentions. However, the exploratory analyses suggest it could be hypothesised that the types of messages used in alcohol industry-funded responsible drinking campaigns may result in greater drinking intentions among those who identify more as heavy drinkers and less as responsible drinkers. Perceived prototype similarity may be an important moderator of the impact of alcohol health messages that warrants further research. Study 2 suggests disclosure of industry funding guides judgements of the credibility of sources of misleading messages about alcohol and cancer.

Transgender and non-binary people's experiences with alcohol reduction in the UK: A cross-sectional study.

INTRODUCTION: Transgender (trans) and non-binary people experience disproportionate harm from alcohol use, have a greater likelihood of developing dependence, and experience exclusion from both clinical and peer-based support systems. This study aimed to understand experiences with and preferences for alcohol reduction support among UK-based transgender and non-binary people. METHODS: The study team and community stakeholders co-produced a cross-sectional survey and administered it to a purposive sample of trans and non-binary people from 1st February to 31st March 2022. The study recruited participants through social media, mailing lists, blog posts, and news articles. Participants (n = 565) had a lifetime history of alcohol use, were in one of five gender categories, and were classified as people who drink or formerly drank alcohol. Open- and closed-ended questions measured motivations for alcohol reduction and views surrounding various support modalities. RESULTS: More than 15 % of the sample no longer drink alcohol and reported long-term abstinence, achieved without support, and were motivated by a loss of control over drinking behaviour and a desire to improve both physical and mental health. Mental illness, gender dysphoria, and a culture of alcohol excess were common antecedents of alcohol use. Thirty percent of participants who drink alcohol wanted to reduce their consumption. They suggested that this could be achieved with self-help tools, specialist trans and non-binary or LGBT+ services, access to both gender-affirming medical services, and sober queer social spaces. CONCLUSIONS: UK-based trans and non-binary people face unique gender minority-related stressors which contribute to patterns of alcohol use that are perceived to be out of control and harmful to health. While many wanted access to self-help tools, there was interest in the availability of specialist alcohol reduction services and more inclusive general services. Conducting needs assessments to inform Needs assessments should inform the development of such services and trans-affirmative training should be mandated for all who provide support with alcohol reduction.

Resurrection of 2'-5'-oligoadenylate synthetase 1 (OAS1) from the ancestor of modern horseshoe bats blocks SARS-CoV-2 replication.

The prenylated form of the human 2'-5'-oligoadenylate synthetase 1 (OAS1) protein has been shown to potently inhibit the replication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for the Coronavirus Disease 2019 (COVID-19) pandemic. However, the OAS1 orthologue in the horseshoe bats (superfamily Rhinolophoidea), the reservoir host of SARS-related coronaviruses (SARSr-CoVs), has lost the prenylation signal required for this antiviral activity. Herein, we used an ancestral state reconstruction approach to predict and reconstitute in vitro, the most likely OAS1 protein sequence expressed by the Rhinolophoidea common ancestor prior to its prenylation loss (RhinoCA OAS1). We exogenously expressed the ancient bat protein in vitro to show that, unlike its non-prenylated horseshoe bat descendants, RhinoCA OAS1 successfully blocks SARS-CoV-2 replication. Using protein structure predictions in combination with evolutionary hypothesis testing methods, we highlight sites under unique diversifying selection specific to OAS1's evolution in the Rhinolophoidea. These sites are located near the RNA-binding region and the C-terminal end of the protein where the prenylation signal would have been. Our results confirm that OAS1 prenylation loss at the base of the Rhinolophoidea clade ablated the ability of OAS1 to restrict SARSr-CoV replication and that subsequent evolution of the gene in these bats likely favoured an alternative function. These findings can advance our understanding of the tightly linked association between SARSr-CoVs and horseshoe bats.

Anxiety and Depression in British Horseracing Stud and Stable Staff Following Occupational Injury.

Horseracing has identified several factors influencing staff wellbeing; however, the relationship between injury, anxiety, and depression is yet to be established. This study investigated anxiety and depression scores and their association to pain management, coping, and help-seeking behaviour in injured British horseracing staff. An online retrospective survey was completed by 175 participants, identifying injury prevalence, coping strategies, occupational risk factors, and Hospital Anxiety and Depression Scale (HADS) scores. Analysis identified 65.14% (n = 114) of staff reported anxiety scores above the threshold (≥8) and 59.52% (n = 104) of staff reported depression scores ≥8. Median anxiety and depression scores were higher for staff who viewed their employer as unhelpful (anxiety p = 0.001; depression p = 0.020). Heightened anxiety and depression were associated with an increased likelihood to use pain medication to manage at work, including non-steroidal anti-inflammatory drugs (NSAID's), alcohol, nicotine, and prescription drugs (p < 0.05). Implications for staff wellbeing is evident; anxiety and depression risks are high following injury, which may influence help-seeking behaviour, perceived job security, and coping mechanisms. This paper suggests it is vital to continue to investigate poor mental health and injury in racing staff and the implications for equine welfare.

Nosocomial outbreak in a respiratory ward caused by the SARS-CoV-2 Omicron BA 5.2.1 subvariant associated with non-severe illness in vaccinated patients.

In this short report, we describe an outbreak of COVID-19 caused by Omicron subvariant BA.5.2.1 in highly vaccinated patients in a respiratory ward in a large acute general hospital in North West London, United Kingdom. The attack rate was high (14/33 (42%)) but the clinical impact was relatively non-severe including in patients who were at high risk of severe COVID-19. Twelve of fourteen patients had COVID-19 vaccinations. There was only one death due to COVID-19 pneumonitis. The findings of this outbreak investigation suggest that while the transmissibility of Omicron BA.5.2.1 subvariant is high, infections caused by this strain are non-severe in vaccinated patients, even if they are at high risk of severe COVID-19 infection.

Paediatric acute hepatitis of unknown aetiology: a national investigation and adenoviraemia case-control study in the UK.

BACKGROUND: An increase in acute severe hepatitis of unknown aetiology in previously healthy children in the UK in March, 2022, triggered global case-finding. We aimed to describe UK epidemiological investigations of cases and their possible causes. METHODS: We actively surveilled unexplained paediatric acute hepatitis (transaminase >500 international units per litre) in children younger than 16 years presenting since Jan 1, 2022, through notifications from paediatricians, microbiologists, and paediatric liver units; we collected demographic, clinical, and exposure information. Then, we did a case-control study to investigate the association between adenoviraemia and other viruses and case-status using multivariable Firth penalised logistic regression. Cases aged 1-10 years and tested for adenovirus were included and compared with controls (ie, children admitted to hospital with an acute non-hepatitis illness who had residual blood samples collected between Jan 1 and May 28, 2022, and without known laboratory-confirmed diagnosis or previous adenovirus testing). Controls were frequency-matched on sex, age band, sample months, and nation or supra-region with randomised selection. We explored temporal associations between frequency of circulating viruses identified through routine laboratory pathogen surveillance and occurrence of cases by linear regression. SARS-CoV-2 seropositivity of cases was examined against residual serum from age-matched clinical comparison groups. FINDINGS: Between Jan 1 and July 4, 2022, 274 cases were identified (median age 3 years [IQR 2-5]). 131 (48%) participants were male, 142 (52%) were female, and one (<1%) participant had sex data unknown. Jaundice (195 [83%] of 235) and gastrointestinal symptoms (202 [91%] of 222) were common. 15 (5%) children required liver transplantation and none died. Adenovirus was detected in 172 (68%) of 252 participants tested, regardless of sample type; 137 (63%) of 218 samples were positive for adenovirus in the blood. For cases that were successfully genotyped, 58 (81%) of 72 had Ad41F, and 57 were identified as positive via blood samples (six of these were among participants who had undergone a transplant). In the case-control analysis, adenoviraemia was associated with hepatitis case-status (adjusted OR 37·4 [95% CI 15·5-90·3]). Increases in the detection of adenovirus from faecal samples, but not other infectious agents, in routine laboratory pathogen surveillance correlated with hepatitis cases 4 weeks later, which independently suggested an association (ß 0·06 [95% CI 0·02-0·11]). No association was identified for SARS-CoV-2 antibody seropositivity. INTERPRETATION: We observed an association between adenovirus 41F viraemia and paediatric acute hepatitis. These results can inform diagnostic testing recommendations, clinical management, and exploratory in vitro or clinical studies of paediatric acute hepatitis of unknown aetiology. The role of potential co-factors, including other viruses and host susceptibility, requires further investigation. FUNDING: None.

Shouldn't We Know This Already? UK Women's Views About Communicating the Link Between Alcohol Consumption and Risk of Breast Cancer.

Alcohol is a causal factor in about 10% of breast cancer (BCa) cases, but awareness of this link is low. This study explored how to raise awareness and inform the development of an intervention using the COM-B model (capability, opportunity, motivation, behavior) framework. Eight online focus groups were conducted with 36 participants (6 expert stakeholders,and 30 women aged 40-65). Participants reflected on a package of information about alcohol and BCa and discussed how to impart this information and encourage women to reduce drinking. Thematic analysis of focus group transcripts was undertaken. Three themes were identified: understanding ineffective messaging; transitions and challenges; and message acceptability. Current health information about alcohol was perceived as judgmental and BCa was put down to chance. Mid-life consisted of many challenges that could lead to increased consumption, but menopause transition may be a key moment for alcohol reduction. Barriers and enablers to communicating risk information and encouraging alcohol reduction were mapped onto the COM-B model. Psychological capability (relating to knowledge), social opportunity (in the form of social pressure) and automatic motivation (relating to drinking to cope) were barriers to behavior change.  These will be targeted in an alcohol reduction intervention. It is important to tailor information to women's experiences, taking into account the social benefits of drinking, and encourage the development of healthy coping strategies. Acceptable intervention messages may include personal stories, clear statistics, and suggest healthy alternatives to drinking. It is vital that messaging does not appear judgmental or patronizing.

Variation in response rates to isolated limb perfusion in different soft-tissue tumour subtypes: an international multi-centre study.

OBJECTIVE: The aim of this study was to investigate the response rates of different extremity soft-tissue sarcoma subtypes (eSTS) after isolated limb perfusion (ILP), based on an international multi-centre study. MATERIALS AND METHODS: The retrospective cohort comprised eSTS patients from 17 specialised ILP centres that underwent melphalan-based ILP, with or without recombinant human tumour necrosis factor (rhTNFα) (TM-ILP and M-ILP, respectively). Response was measured on imaging (magnetic resonance imaging) and/or clinical response, for which M-ILPs were excluded. RESULTS: A total of 1109 eSTS patients were included. The three most common histological subtypes were undifferentiated pleomorphic sarcoma (17%, n = 184), synovial sarcoma (16%, n = 175) and myxofibrosarcoma (8%, n = 87). rhTNFα was used in 93% (TM-ILP) and resulted in a significantly better overall response rate (ORR, p = 0.031) and complete responses (CR, p < 0.001) in comparison to M-ILP, without significant differences among histological subgroups. The ORR of TM-ILP was 68%, including 17% CR. Also, 80% showed progressive disease. Significantly higher response rates were shown for Kaposi sarcoma (KS) with 42% CR and 96% ORR (both p < 0.001), and significantly higher CR rates for angiosarcoma (AS, 45%, p < 0.001) and clear cell sarcoma (CCS, 31%, p = 0.049). ILP was followed by resection ≤ 6 months in 80% of the patients. The overall limb salvage rate was 88%, without significant differences among histological subgroups, but was significantly higher for ILP responders compared to non-responders (93% versus 76%, p < 0.001). CONCLUSION: ILP resulted in high response and LRS among all eSTS subtypes, however, with significant differences between subtypes with most promising results for KS, AS and CCS.

Not all home drinking is equal: A latent class analysis of drinking patterns and alcohol consumption levels following initial COVID-19 restrictions in Australia, New Zealand and the United Kingdom.

INTRODUCTION: Initial COVID-19 restrictions forced changes in the contexts (e.g., with who and where) within which individuals consumed alcohol. We aimed to explore different profiles of drinking contexts during initial COVID-19 restrictions and their association with alcohol consumption. METHOD: We used latent class analysis (LCA) to explore subgroups of drinking contexts among 4891 respondents of the Global Drug Survey from the United Kingdom, New Zealand and Australia who reported drinking alcohol in the month prior to data collection (3 May-21 June 2020). Ten binary LCA indicator variables were generated from a survey question about last month alcohol settings. Negative binomial regression was used to explore the association between the latent classes and respondents' total number of drinks consumed in the last 30 days (i.e., alcohol consumption). RESULTS: The LCA found six distinct classes of individuals who reported drinking in the following contexts: household (36.0%); alone (32.3%); alone and household (17.9%); gatherings and household (9.5%); party (3.2%); and everywhere (1.1%), with the last group associated with the highest probability of increased alcohol consumption during this time. Male respondents and those aged 35 or older were most likely to report increased alcohol consumption. DISCUSSION AND CONCLUSIONS: Our findings suggest that drinking contexts, sex and age influenced alcohol consumption during the early stages of the COVID-19 pandemic. These findings highlight a need for improved policy targeting risky drinking in home settings. Further research should explore whether COVID-19-induced shifts in alcohol use persist as restrictions are lifted.