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Background: Absolute alcohol sales bans instituted in countries like Botswana provide a rare opportunity for a quasi-natural experiment on how such strict policies influence users' behaviours during the COVID pandemic and beyond. From March 2020 to September 2021, Botswana banned the sales of alcohol on four separate occasions spanning a cumulative 225 days. We studied changes in retrospectively recalled hazardous drinking following the longest and last alcohol sales ban in Botswana., Methods: This online cross-sectional study, carried out following a 70-day alcohol sales ban in 2021, comprised a convenience sample of 1326 adults who completed the AUDIT-C and had to recall their alcohol use during three points: pre alcohol sale ban (before 28th June 2021), during alcohol sales ban (28th June 2021 to 5th September 2021), and post alcohol sales ban (after 5th September 2021)., Results: The prevalence of hazardous drinking (defined by an AUDIT-C score of 3 or 4 for females and males, respectively) prior, during and post the alcohol sales ban was 52.6% (95%CI=49.8-55.3), 33.9% (95%CI=31.3-36.5), and 43.1% (95%CI=40.4-45.8), respectively., Conclusion: The findings from this study showed that reduced alcohol availability by way of the fourth alcohol sales ban was associated with reductions in self-reported hazardous drinking, albeit at a lesser degree compared to during an earlier sales ban., Competing Interests: Declarations of Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: The COVID-19 pandemic has seen the implementation of unprecedented legislation and policy, including drug control measures which in some countries, like Botswana, included a temporary full alcohol sales ban. However, the association of such absolute prohibition of alcohol sales on population drinking, including hazardous drinking, during the COVID-19 period has not yet been determined. This study investigated changes in retrospectively recalled alcohol use and hazardous drinking pre (prior 5th August 2020), during (5th August to 3rd September 2020) and post (after 4th September) the second alcohol sales ban in Botswana. Predictors of hazardous drinking across the three time points were also investigated., Methods: An online cross-sectional study involving a convenience sample of 1318 adults with a past 12 months drinking history in Botswana was conducted in October 2020 following a month long alcohol sales prohibition. Participants completed a modified Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) alongside demographic questions. Participants were expected to retrospectively recall their alcohol use pre, during and post the second alcohol sales ban., Results: The prevalence of alcohol use among participants with a past 12 months drinking history was 91.7% (95%CI= 90.1-93.1) before the second ban, 62.3% (95%CI= 59.7-64.9) during the second ban, and 90.4% (95%CI= 88.7-91.8) after the ban.. Hazardous drinking temporarily decreased by 30% during the second alcohol sales ban, and rose to the pre-ban levels of about 60% after the ban. Significant predictors of hazardous drinking at any of the three time points (pre, during and post the second ban) were being male (AOR ranging from 1.50 to 2.13 for all time points), earning between P3000-P6000 (AOR= 1.69 prior sales ban), being a student (AOR=0.56 during the sales ban), and being employed (AOR= 1.45 post the sales ban)., Conclusion: The alcohol sales ban was associated with short-lived changes in alcohol consumption and hazardous drinking thereby likely contributed in providing the anticipated and much needed temporary relief to the health system sought by COVID-19 pandemic measures., Competing Interests: Declarations of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)