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BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1439 (Published 08 April 2020) Cite this as: BMJ 2020;369:m1439

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Nationwide alcohol sales ban during COVID-19 pandemic: unique opportunity for epidemiology and alcohol policy

Dear Editor,

As reported in the news article by Owen Dyer, South Africa has banned sales of alcohol to prevent domestic violence as a part of 21-day lockdown package. Thailand is a recent country putting a nationwide total ban on alcohol sales in attempt to contain COVID-19. Some cities have implemented alcohol sales ban since the beginning of April 2020. On 12th April 2020, the Ministry of Interior declared nationwide alcohol sales ban (1). More than half of the country will lift the ban on 21st April 2020. The measure aims to limit social gatherings during the Thai traditional new year celebration (13th-15th April). Also, it is intended to reduce burden on already tight health system by preventing alcohol-related injuries.

Although with good intention, the ban has entailed unfavourable consequences. For instance, in Bangkok, the ban took effect on 10th April 2020. The governor of Bangkok unprecedentedly issued a ban notification on 9th April 2020; in the evening of that day, news outlets reported a crowd at supermarkets and grocery stores purchasing huge amounts of alcoholic beverages for consuming and stockpiling. Those unnecessary gatherings might offset effect of partial lockdown measure in Bangkok.

Some cities observed deaths in persons with alcohol dependence. Alcohol withdrawal syndrome (AWS) was suspected in some of those deaths. At the time of writing (13th April 2020), a total number of COVID-19 deaths in Thailand is relatively small with 40 fatalities. Excessive deaths related to AWS during the sales ban could well surpass death toll from COVID-19. This alone would make the ban unwarranted. Following the ban notification, the Ministry of Public Health has attempted to mitigate morbidity and mortality from AWS by using information campaign and promoting alcohol quit hotline. Civil society groups advocating for alcohol control use this opportunity to promote alcohol abstinence. Unprecedented nature of the ban notification contributed to the drawbacks.

Nevertheless, nationwide alcohol sales ban in South Africa and Thailand provides a unique opportunity to explore its short- and long-term effects. Cost-benefit analysis of alcohol sales ban as an intervention to contain the epidemic would be a topic of current interest. This is an important lesson for dealing with the next pandemic and perhaps the next wave of current pandemic. Its short- and long-term effects on alcohol consumption at the population level as well as its impacts on alcohol market could have important implications for future alcohol policy-making.

I declare no conflict of interest.

References

1. The Nation. Alcohol sales banned in entire country. 2020.

Competing interests: No competing interests

13 April 2020
Udomsak Saengow
Assistant Professor
Research Institute for Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
Center of Excellence in Health System and Medical Research, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand