Objective: This study examined the effects of direct-to-consumer alcohol home delivery (DTC) policies enacted in response to the COVID-19 pandemic on online searches for alcohol delivery and alcohol-related harms in the United States.
Methods: Google Trends data (2019-2023) were used to assess weekly relative search volume (RSV) for three terms reflecting 1) DTC and 2) potential harms associated with expanded DTC: alcohol delivery, alcohol poisoning, and alcoholic. RSV for each term was extracted for states representing four DTC policy contexts (no DTC [South Carolina], no change in existing DTC policy [Pennsylvania], new DTC policy [Georgia], expanded DTC policy [California]). Interrupted times series analyses evaluated the effect of time and policy implementation on RSV in states introducing or expanding DTC policies, while linear regressions evaluated the effect of time where DTC policies did not change.
Results: There was a significant positive effect of time on RSV for alcohol delivery in the state that introduced a new DTC policy (β = 0.1, p = 0.02), with RSV declining over time following policy implementation (β = -0.1, p = 0.001). In the state that expanded DTC policy, alcohol delivery RSV increased immediately after policy expansion (β = 20.9, p < 0.001) and declined in subsequent months (β = -1.5, p < 0.001). RSV for alcohol-related harms fluctuated across states.
Conclusions: Online search interest related to alcohol delivery and harms varied post-DTC policy implementation. These findings highlight the potential of search trends to provide real-time insights into public health impacts of evolving alcohol policies.
Keywords: Alcohol use; Alcohol-related harms; COVID-19 pandemic; Internet; Public health policy.
© 2025 The Authors. Published by Elsevier Inc.