National Retail Sales of Alcohol and Cannabis During the COVID-19 Pandemic in Canada

This economic evaluation examines national retail sales of alcohol and cannabis before and during the COVID-19 pandemic in Canada.


Introduction
There is concern that the societal consequences of the COVID-19 pandemic will be associated with increased substance use. 1 Data to date have primarily been self-reported changes, but objective sales data may inform this question.Here, we examined national retail sales of alcohol and cannabis prior to and during the pandemic in Canada.

Methods
Where applicable, the report for this economic evaluation is consistent with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting guideline.The Hamilton Integrated Research Ethics Board determined that ethical review board approval and informed consent were not needed because the data were publicly available sales metrics.The data were seasonally adjusted national monthly retail sales (ie, North American Industry Classification System codes 4453, for beer, wine, and liquor stores, and 453993, for cannabis stores) from November 2018 to June 2021 in Canadian dollars. 2 The period was selected to provide a sizable prepandemic window and because of the timing of cannabis legalization (ie, mid-October 2018).Principal analyses were contrasts between intrapandemic sales and a counterfactual intrapandemic linear trend based on prepandemic sales.A subanalysis quantified stockpiling, operationalized as the proportionate change in March 2020, when states of emergency were declared, compared with the counterfactual estimate.Because the data were population level, null hypothesis significance testing was a secondary priority, but overall differences and intrapandemic trends in poststockpiling data were examined statistically using analysis of variance (ANOVA) and segmented regression, respectively.

Discussion
In this economic evaluation, mean monthly national retail sales of alcohol, with notable stockpiling, exhibited a monthly increase of 5.5% vs the counterfactual estimate during the intrapandemic period.For cannabis, although stockpiling was similar, the general intrapandemic increase in mean monthly sales vs the counterfactual estimate was substantially higher, approaching 25%.Interestingly, these results converge with a national study of self-reported pandemic-associated changes that found a similar dissociation between alcohol and cannabis. 3e public health and clinical significance of these changes cannot be directly inferred.National retail sales cannot be directly converted into person-level expenditures, consumption behavior, or, more importantly, the extent to which individuals transition to higher-risk levels of use.Additionally, some subpopulations have reported decreases in alcohol involvement during the pandemic, 4 and aggregate sales necessarily conflate increases, decreases, and stable patterns.A limitation of this study is that these macroeconomic indicators represent large proportions of the market but not its entirety (eg, illegal sales and alcohol sold through ferment-on-premises operations).This is particularly significant for cannabis, for which a large contraband market remains, 5 and it is possible that the pandemic pushed consumers from illegal terrestrial purchasing to legal online purchasing.
These results nonetheless offer one of the first national perspectives on changes in alcohol and cannabis use during the COVID-19 pandemic.Whether similar patterns are present in other nations is an open question, but these findings suggest the value of sales data as a strategy to characterize the pandemic's associations with substance use.
Significance tests used P < .05 and were 2-sided, and analyses were conducted from May to August 2021 using Excel version 2019 (Microsoft), SPSS statistical software version 26.0 (IBM), and R statistical software version 4.1.1(R Project for Statistical Computing).

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Figure 1.National Alcohol Retail Sales 16 Months Prior to and During the First 16 Months of the COVID-19 Pandemic in Canada