Changes in Alcohol and Cannabis Retail Sales in Canada During the Early Phase of COVID-19

Background: Changes in the use of alcohol and other substances during COVID-19 is of considerable public health interest. This study examined changes in per capita alcohol, cannabis and other essential retail sales across Canada during the early phase of COVID-19, and associations between these changes and different jurisdictional approaches to drug control. Methods: A time series analysis was used to examine trends in monthly per capita alcohol, cannabis, and essential and non-essential retail sales before and during the first three months of COVID-19 for 12 jurisdictions across Canada. We compared observed sales during the first three months of COVID-19 to predicted sales based on model outputs using pre-COVID-19 trends. Next, we used difference in difference models to estimate the associations between different models of alcohol and cannabis retail systems and changes in retail sales during COVID-19. Findings: In Canada, observed per capita sales were significantly greater than predicted for alcohol (+9.6%) and cannabis (+14.1%) during March 2020, and consistent with predicted sales in April and May 2020. Essential retail sales were significantly less than predicted during March to May 2020 (average of -7.4%). During COVID-19, per capita alcohol sales in jurisdictions with a private retail system increased significantly (+$8.5 on average, 95%CIs; 2.1,15.6) after accounting for changes over time. In contrast, the relative change in per capita alcohol sales in jurisdictions with a public retail model prior to and during COVID-19 was, on average, $13.3 lower (95% CIs; -22.6,-4.0) compared to the changes in jurisdictions with a private retail model. Similar trends were observed for cannabis sales with respect to retail model. Interpretation: There was a modest increase in alcohol and cannabis purchasing during the first three months of COVID-19. Changes in sales were influenced by pre-existing policies, and jurisdictions with a private retail model had greater than expected alcohol and cannabis sales compared to jurisdictions with a public model. This study adds to the body of research showing that government-run retail models for alcohol and cannabis provide protection for public health. Funding Statement: There is no funding to disclose for this project. Declaration of Interests: The authors have all completed ICMJE conflict of interest forms. The authors have no conflicts of interest to declare. Ethics Approval Statement: This project was approved by the Public Health Ontario Ethics Review Board file number 2020-038.01.