The impacts of selling alcohol in grocery stores in Ontario, Canada: a before after study

Objective: From 2015-19, the Government of Ontario expanded privatized sales of alcohol, licensing 450 grocery stores to sell beer, cider, and wine. The impacts of a nearby grocery store gaining an alcohol license on adults’ alcohol use in Ontario are examined, including whether impacts differed by gender. Methods: Data from 2015-2019 Canadian Community Health Survey participants in Ontario (age 20+), living within 1000m and 1500m of grocery stores that gained a license to sell alcohol and propensity matched controls were included (1000m n=14,052, 1500m n=30,486). Alcohol use outcomes included past 7-day number of standard drinks consumed, near-daily drinking (4+ days/week), and heavy drinking (5+ drinks in men/4+ in women, ≥once/month). Gender-specific difference-in-differences (DiD) analyses compared changes in alcohol use pre- to post-intervention in intervention and control populations. Results: Decreases in past 7-day drinks, near-daily drinking, and heavy drinking were observed post-intervention in both intervention and control populations. At the 1000m level, adjusted DiD analyses showed past 7-day drinking in women (RR=1.21, 95%CI: 0.88-1.60), and heavy drinking in men (OR=1.38, 95%CI: 0.92-2.08), had effect sizes above one, a relative increase over controls, though confidence intervals crossed one. Findings did not indicate significant differences in alcohol use in intervention relative to controls for other alcohol use measures and at 1500m. Conclusions: Findings suggest no association between a partial alcohol deregulation initiative in Ontario and alcohol use from 2015-19. It is important to monitor the impacts on alcohol use over time as further alcohol deregulation plans in Ontario and other jurisdictions are considered.