Bad Habits and the Pandemic
Dr. Steven Rigatti, Consulting Medical Director to CRL, comments on alcohol and tobacco usage rates from a pre-pandemic period to a pandemic period. Formal studies and new research from CRL indicate trends that affect life insurers and applicant policies.
If the threshold of alcohol positivity is moved from 10 mg/dl to 80 mg/dl, a similar trend holds, with a pre-pandemic positivity rate of 0.8 per thousand, and a pandemic rate of 1.04, also statistically significant (p = 0.0008).
One interesting aspect of this observed difference by period is that the uptick occurred primarily among smokers. Figure 3 shows the rates of positive blood alcohol by period and face amount among the 91,668 tobacco users in the data. Note that these rates are up to 5 times the comparable rates in non-smokers.
The percentage of tobacco users varies widely across the companies in this study, from around 6% to over 16%. During the study, the percentage of individuals from each company changed significantly. Therefore, observed changes in tobacco usage may be due to the change in the mix of insurer populations. Rather than compare raw rates, an average of company rates was utilized. Note that this was not the case for alcohol; the rate of positive blood alcohol was very similar across companies.
As shown in Figure 4, there was a very modest decrease in the percentage of tobacco usage over time. In the pre-pandemic period the inter-company average was 10.1%, which decreased to 9.5% in the pandemic period.
This study demonstrates some interesting trends over the measured time period of the COVID-19 pandemic. Most notably, rates of blood alcohol positivity are up, especially among smokers and those applying for large dollar amounts of life insurance. Tobacco usage rates are down substantially, across the board.
One might speculate that alcohol usage is up because of elevated social stressors and isolation. Peer review literature has corroborated the increase (see Pollard et al. JAMA 2020 ). Sales data also seem to support this point (see CNN report).
The tobacco usage trend is also interesting, and one might speculate that the high cost is more difficult to manage than usual during pandemic. Also, since COVID-19 is a respiratory virus, it may be that smokers are being “scared straight.” The observed trend, though, stands in contrast to tobacco industry trends (see Reuters) which show increases during the pandemic. They speculate that increased time at home provides more opportunity to smoke. Thus, it could be that those who do smoke are smoking more, even if fewer people are smoking.
About the Author
Dr. Steven J. Rigatti is a consulting medical director with Clinical Reference Laboratory, with 12 years’ experience in the life insurance industry. He is the current chair of the Mortality Committee of the American Academy of Life Insurance Medicine.