PONE-D-24-21093Impact of the COVID-19 pandemic on violence exposure and alcohol use among adults who drink alcoholPLOS ONE

Dear Dr. Gyamerah,

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The analysis presented in the paper adds significant insights on the linkage between violence and alcohol consumption during the COVID-19 pandemic in a selective urban population. The study, however, has significant limitations mainly related to the unmeasured confounders, which shall me discussed in the discussion section and mentioned in the study limitations subsection. Violence is only one among several important causes of pandemic associated distress.

The fact is that violence is just one of several important causes of pandemic-related distress that may have influenced alcohol consumption. Quite a lot of research works has already been published in the scientific literature that show the relationship between other causes of distress during the pandemic that influenced alcohol consumption. They included job loss during the pandemic, decreased income during the pandemic, and the perception of the pandemic itself as a stressful event.

Also, according to the published literature, alcohol consumption and levels of violence were influenced by the strength of the restrictions imposed to reduce spread of COVID-19 and the severity of self-isolation controls during the pandemic. In the discussion, authors are encouraged to provide some details about the severity of restrictions during the pandemic in the community surveyed. The authors should also mention that the study did not ask questions about the respondent’s own perception of the severity of the imposed restrictions on social and everyday life, which, according to the literature, may affect both the level of violence and the level of alcohol consumption.

Several studies reported association between the levels of alcohol consumption before pandemic and increase in alcohol consumption during the pandemic.

For example, one study conducted among users of social media demonstrated a positive association between the increase in the frequency of alcohol consumption and severe restrictions in everyday private life (OR: 3.127; 95% CI: 1.011–9.675), and severe negative professional or financial consequences due to the spread of SARS-CoV-2 (OR: 2.247; 95% CI: 1.131–4.465). In this study, the odds of an increase in the frequency of heavy episodic drinking were more than twice higher (OR: 2.329; 95% CI: 1.001–5.428) among those who had experienced severe negative consequences of the pandemic to their professional and financial situation. Higher typical frequency and usual consumption (volume) of alcohol on a typical drinking occasion and higher typical frequency of heavy episodic drinking before the pandemic were positively significantly associated with the increase in alcohol consumption during the pandemic. (Reference: Gil AU, Demin AK. Factors associated with increase in alcohol consumption during first months of COVID-19 pandemic among online social media users in Russia. Bulletin of Russian State Medical University. 2021. 6:(118-128). DOI 10.24075/brsmu.2021.064.). Authors shall also discuss in the discussion section the literature dedicated to the polarization of alcohol consumption during the pandemic where it was found that heavy drinkers tend to increase consumption of alcohol during the pandemic, while those drinking less tend to increase alcohol consumption less or to decrease their alcohol consumption. Initial (before pandemic) level of alcohol consumption (frequency, one-time volume of drinking, frequency of heavy episodic drinking) is an important unmeasured confounder in analysis presented in the submitted paper.

Among published works on the mentioned above unmeasured confounders, the following are recommended for discussion in the discussion section of the paper:

Rossow I, Bartak M, Bloomfield K, et al. Changes in Alcohol Consumption during the COVID-19 Pandemic Are Dependent on Initial Consumption Level: Findings from Eight European Countries. Int J Environ Res Public Health. 2021;18(19):10547.

Changes in self-reported alcohol consumption at high and low consumption in the wake of the COVID-19 pandemic: A test of the polarization hypothesis

Alexander Tran, et al. https://www.medrxiv.org/content/10.1101/2024.07.31.24311291v1

Kilian, C., Rehm, J., Allebeck, P., Braddick, F., Gual, A., Barták, M., . . . O'Donnell, A. (2021). Alcohol

consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21

countries. Addiction, 116(12), 3369-3380.

Gil AU, Demin AK. Factors associated with increase in alcohol consumption during first months of COVID-19 pandemic among online social media users in Russia. Bulletin of Russian State Medical University. 2021. 6:(118-128). DOI 10.24075/brsmu.2021.064. https://cyberleninka.ru/article/n/factors-associated-with-increase-in-alcohol-consumption-during-first-months-of-covid-19-pandemic-among-online-social-media-users-in/viewer

Gil A., et al. Changes in alcohol consumption in the Russian Federation during the first months of the COVID-19 pandemic. https://cyberleninka.ru/article/n/izmeneniya-osobennostey-potrebleniya-alkogolya-v-rossiyskoy-federatsii-v-pervye-mesyatsy-pandemii-covid-19/viewer

and other studies available in the reference lists of indicated above publications.

Once, the issue of unmeasured confounders is thoroughly discussed in the paper, the revised manuscript can be considered for publication.

Reviewer #2: Thank you for the opportunity to review this article examining the association between violence (and GBV) and alcohol use during the COVID-19 pandemic in the San Francisco Bay Area. The article is well written and provides important insight into this under-researched topic. Building on the findings, the authors also make strong recommendations relevant to this discipline and well-placed within the context of previous literature.

I am of the opinion that this article should be accepted for publication, with only minor revisions required to provide additional clarity for the reader.

Minor revisions:

1. Page 4, Introduction: "Alcohol purchases increased by 54% in the first week of shelter-in-place orders in the US (5)." This seems to reference a journal article that referenced this statistic in the introduction and not the source material. Please ensure all citations cite the appropriate reference and original source material for the reader. Please also provide additional information on what the 54% increase in sales is being compared to (e.g. the previous year) and if the data is based on sales or self-reported purchasing.

2. Page 6, Introduction: "In the United States, a study using 911 calls in Michigan documented a relationship between domestic violence reports and alcohol use (30)" please include a brief description of the nature of the relationship/association.

3. Page 6, Introduction: The first sentence in the aims paragraph took a few reads. Please revise for clarity. Perhaps consider splitting over two sentences, and/or utilise additional commas.

4. Methods and Materials: Please advise how interested participants responded to the recruitment drive (e.g. did they have to call, text, email etc). Would the required method of responding to the recruitment advertisements have affected who responded?

5. Methods and Materials: Please include whether you have followed any reporting guidelines or checklists. If not, please consider applying one like STROBE and ensure you have included all relevant information for reporting. e.g. was there any missing data? How was it managed?

6. Page 10, results: "Nearly one-third (27.9%) of participants" this is closer to a quarter, a third could be considered overstating the results. Consider revising two 'over a quarter' or something similar.

7. Page 12, Discussion: "Overall, we found that the COVID-19 pandemic increased violence exposure and alcohol use among alcohol-using adults." consider revising to more accurately reflect the findings, e.g. "...alcohol-using adults self-reported an increase in violence exposure and alcohol use during the covid-19 pandemic"

8. Discussion: Please consider swapping the order of paragraphs 2 and 3 of the discussion so it flows more naturally from discussing why the rates of violence identified in your study are higher than that of the general population, and that this high prevalence of alcohol use is likely related to the population you are looking at being adults who use alcohol and/or seeking alcohol treatment. As it is written now, it felt like this was an overlooked point in paragraph 2.

Given the length of the discussion, please also consider the use of subheadings if this falls within journal guidelines - perhaps a section for covid-related findings.

9. Page 14, Discussion: "half of participants reported drinking more alcohol than prior to the pandemic, which is higher than national estimates from the same surveillance study of adults who use alcohol (13.4%) in the U.S. (49)." unclear what is meant by 'the same surveillance study' here, please revise to clarify

10. Page 15, Discussion: "The high prevalence of violence during the pandemic in our study along with the finding that many experienced"; please revise to something like 'many of our participants' or something similar for clarity. It would also be beneficial to include the percentage in brackets here to save the reader having to refer back.

11. Page 16, recommendations: "be prepared to provide targeted outreach to support people who are at risk of or experience GBV and elevated violence" please add more clarity here for if you mean people who have an elevated risk of violence and GVB, or describe what you mean by 'elevated violence'.

12. Please also advise when the shelter in place order(s) for the SFBA ceased in comparison to when the recruitment drive stopped, and include any commentary on if you think this may have affected the results.

Minor typographical or grammar suggestions:

- Page 2, Abstract, 6th line from bottom: replace 'thank' with 'than'

- Pandemic and epidemic have been used seemingly interchangeably. Advise all be revised to pandemic if referring to COVID-19, or clearly include why epidemic is being used.

- Page 5, Introduction: "GBV can consist of violence experienced from strangers, that state (i.e., the police, military, etc.)," revise to 'the' state

- Page 5+6, Introduction: IPV acronym introduced twice. Suggest it instead be introduced in sentence "with a few national and local studies reporting significant increases in violence experiences, especially IPV, among cis women and gender minorities" and remove from other instances

- Page 5, Introduction: double opening bracket on reference 19

- Page 5, Introduction: Full stop/period missing from sentence ending "similarly found that the pandemic worsened incidence of domestic violence against women"

- Page 5, Introduction: In sentence following the above, revise tense for "reporting"

- Page 14, Discussion: "While some forms of IPV and sexual violence can be categorized at GBV"; 'as' instead of 'at'

- Page 16, Limitations: Please revise the fourth sentence in this paragraph

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Reviewer #1: Yes: Artyom Gil

Reviewer #2: No

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Impact of the COVID-19 pandemic on violence exposure and alcohol use among adults who drink alcohol

PONE-D-24-21093R1

Dear Dr. Gyamerah,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Claudio Alberto Dávila-Cervantes, Ph.D.

Academic Editor

PLOS ONE

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