Enforced sobriety and drinking practices in the context of the war in Ukraine

■ INTRODUCTION

Following the introduction of martial law due to the large-scale Russian invasion in February 2022, Ukraine implemented alcohol access restrictions ranging from time-limited sales to a complete ban for specific social groups like military personnel. These measures are considered one of the key tools for reducing the harmful consequences of alcohol consumption. The World Health Organization (WHO) identifies restricting alcohol access as one of the five core universal strategies to mitigate its destructive effects, including mortality, disability, traffic accidents, violence and social problems [1, 2]. It is logical to assume that reducing or eliminating access to alcohol automatically reduces the risks associated with its consumption. However, historical experience shows that the outcomes of alcohol access restrictions vary significantly depending on their form and the context in which they are implemented [3-9]. In this study, the term “alcohol access restrictions” is used as a general term to describe all measures aimed at reducing the availability or consumption of alcohol.
Cultural, religious, social, socio-economic and situational factors often lead to specific or unpredictable effects and consequences. Distinct patterns of alcohol consumption are deeply rooted in the culture of countries and are difficult to compare due to changing economic conditions and political frameworks [10, 11]. Taking into account the specifics of individual historical situations is important for identifying the specific and non-specific factors of the effectiveness of alcohol access restrictions for developing and implementing programmes of this kind. Therefore it is important to take into consideration 1) the effects of alcohol access restrictions known from previously implemented programmes around the world, taking into account the context of the situation in which they are introduced and 2) the cultural specifics of the history of attitudes to alcohol in a particular country and the actual situation in which these alcohol access restrictions are introduced.
The most well-known and severe example of extremely strict restrictions on public access to alcohol was the US Prohibition (1920-1933). Lesser-known examples include partial restrictions on alcohol access in Sweden (1865-1957), Iceland (1915-1935), Poland (1920-1922), the Soviet Union (1917-1923 and 1985-1988) and Barcelona (2008-2013).
Prohibition (“The Dry Law”) – a ban on the sale, production and transportation of alcohol introduced by the US Congress in 1920-1933 to conserve grain stocks, contributed to a decrease in alcohol consumption, changes in drinking habits during its duration and a decline in per capita consumption even after its cancellation. However, this was accompanied by the intensification of the black market and increased organised crime [4].
The anti-alcohol campaign in the USSR in 1985-1987 was initiated because 32% of deaths and more than 50% of crimes were alcohol-related.
Within a year of the introduction of severe alcohol access restrictions, deaths from accidents, poisoning, and injuries dropped sharply by 22%. However, at the same time, this contributed to the production of surrogates, the development of the shadow economy and the underground production of alcohol [6].
An analysis of the effects of the ban on the sale of alcohol at night in retail outlets in Barcelona in 2008-2013 showed a positive impact on road safety. At the same time, the effectiveness of these alcohol access restrictions required the implementation of educational programmes and non-specific prevention interventions in high-risk areas [12].
A meta-analysis of studies of the effectiveness of alcohol access restrictions in rural areas of the United States, Australia and Canada found that these measures generally reduced crime, injuries and alcohol consumption. However, the effect of such restrictions was short-lived or even negative. In about a third of cases, people were able to obtain alcohol from neighbouring regions without these restrictions [13] or found ways to bypass them through the growth of illegal alcohol importation and home production [14].
In the context of our study, it is important to analyse the experience of introducing alcohol access restrictions in extraordinary situations (strikes, pandemics, military operations, etc.).
The ban on the sale of alcohol, which was imposed for the entire period of the 18-day strike at the Gdańsk Shipyard (Poland) in 1980, demonstrated the feasibility and effectiveness of alcohol access restrictions, as they played an important role in maintaining order and discipline during strikes. However, among their negative consequences was the difficulty in organising traditional family celebrations during this period.
After the ban was cancelled, alcohol consumption returned to its usual level [5].
In the context of the COVID-19 pandemic, many governments have refrained from imposing severe alcohol access restrictions due to concerns about negative reactions from citizens, economic needs and lobbying by the alcohol industry [15]. However, in some countries, this kind of restriction on access to alcohol has been implemented revealing both positive effects and complications. For example, drastic changes from a complete ban to the free sale of alcohol were found to be inappropriate. Instead, a gradual introduction and strengthening of control measures in healthcare systems was recommended [16].
Evidence from different countries confirms that strict alcohol policies can reduce alcohol consumption but also demonstrates the economic and industrial barriers faced by low and middle-income countries [17]. In addition, workarounds have also been found in the context of pandemic restrictions as research in Ukraine found that despite the restrictions on alcohol access in public places (bars and restaurants) during the pandemic, consumption was not significantly reduced due to the possibility of drinking at home or using alternative sources [18].
The prohibition of alcohol consumption for the military as a separate social group, is especially important in the context of active military operations. Participation in combat operations increases the risk of experiencing morally traumatic events that can lead to internal conflict, guilt, shame and spiritual or existential crisis. This stress can contribute to the development of harmful behaviours like excessive alcohol consumption [19]. Researches confirm the existence of similar problems with the growth of alcohol abuse among military personnel and veterans from different countries. For example, this was reported among British veterans who served in Afghanistan or Iraq [20]. Restrictions on alcohol access are more important for active military personnel than for veterans [21]. It is necessary to improve the recruitment of military personnel, strengthen psychological training and introduce stricter rules on alcohol consumption in combat zones [22] although this is difficult to implement in the context of general mobilisation.
Historical experience shows the ambivalence of such alcohol access restrictions. For example, the ban on the sale and consumption of alcoholic beverages in Kyiv during the First World War (1914-1917) was introduced as a situational measure for the duration of the mobilisation.
It changed not only Kyiv residents’ way of life but also influenced their socio-political attitudes.
At the same time, this ban contradicted traditions and led to surrogate-consumption poisonings due to the lack of legal access to strong drinks [23].
Thus, an analysis of the restrictions on access to alcohol during the war in Ukraine requires consideration of the overall cultural context.
Alcohol consumption in Ukrainian society has deep historical roots; in the past, it was widespread but controlled while in the Soviet period, it went beyond legal norms. Traditions of alcohol consumption were so deeply rooted in society that they were considered an established normative tradition, and non-consumption was often perceived as a social anomaly [24].
In the 21^st century, some decrease in alcohol consumption and its negative consequences can be observed in Ukraine. The prevalence of mental and behavioural disorders due to alcohol consumption in Ukraine in 2021 decreased by almost 9% compared to 2014 [25: 66]. A decrease in alcohol-related mortality was recorded in 2005-2013 but it remained at a stable level for between 2014 and 2021 [26]. Total alcohol consumption per capita (litres of pure alcohol, projected estimates, 15+ years of age) in Ukraine in 2019 was 8.7, which roughly corresponded to the average for European countries [1, 2, 27]. Analysis of the differences in the dynamics of mortality due to alcohol consumption in 2008 and 2018 in Poland and Ukraine revealed a decrease in Ukraine from 3.52% to 1.83% as opposed to an increase in Poland from 1.72% to 2.36% [28]. However, there are reasons to believe that the indicators of alcohol consumption in Ukraine do not take into account high levels of unregistered consumption, which makes up approximately half of the total [29]. Ukraine’s illegal alcohol market is recognised as the largest in Europe at 50% of the total [30]. In Ukraine during the period of military conflicts initiated by Russia, an increase in the use of psychoactive substances and alcohol was recorded especially among non-professional soldiers [22]. While at the beginning of the Russian aggression (since 2014), increased alcohol access restrictions were applied only in combat areas and affected certain categories of consumers, including the military; since February 2022, they have been extended to the whole country, although with some differences between regions.
After February 24 2022, from the start of Russia’s full-scale invasion of Ukraine, problems related to alcohol consumption aquired new characteristics. Guided by the Resolution of the Cabinet of Ministers of Ukraine, the military administrations introduced alcohol access restrictions during the period of martial law [31], from a complete ban in the first days and months of the war, to restrictions imposed on the space and time of sale of alcoholic beverages for certain social groups.
It is obvious that drinking alcohol, especially in a situation of uncertainty and experiencing objective danger, can increase the level of aggression and violence. The likelihood of alcohol consumption by servicemen is fraught with additional dangers and negative consequences, so one of the key aspects has been increased control of alcohol and drugs among military personnel. Amendments to the Ukrainian legislation also included increasing the penalties for alcohol and drug intoxication among the military, increasing fines and arrests, granting the Military Service of Law and Order the authority to perform intoxication checks and establishing a procedure for checks with the result documentation [32]. In this situation, the intention of changing the practices of alcohol consumption was above all to minimise its possible harm to public order.
The longest alcohol access restriction, which included a complete ban on alcohol sales, lasted 73 days in frontline Chernihiv. In Kyiv, measures like this were implemented for 31 days in March 2022. The shortest period of restrictions of only 14 days was recorded in Uzhhorod. As of 2024, only partial time restrictions on selling alcoholic beverages to civilians remained in place in Ukraine [33, 34].
The results of studies of changes in alcohol consumption after the start of the full-scale invasion in the context of alcohol access restrictions are contradictory. Some studies show a decrease in consumption [35] while others record an increase [36].
This can be explained by the fact that war increases stress and anxiety while alcohol is often perceived as an available means to reduce it [37].
The data obtained fixes, but does not explain, the specifics of attitudes towards alcohol access restrictions among representatives of different social groups. It does not clarify the real motives for changes in alcohol consumption.
This study aims to analyse how alcohol access restrictions affect drinking practices during Russia’s full-scale invasion of Ukraine. It focuses on the specific context of the implementation of alcohol restriction policies, which helps to identify cultural, situational and general aspects of the impact of these measures.

■ MATERIAL AND METHODS

The research was conducted within a qualitative paradigm using case study tactics that focus on a specific phenomenon’s specific circumstances. Based on the logic of the definition of a case study by Robert Yin [38: 8], we understand a case study as a research tactic applied to study a case that is limited to a certain space and time, which aims to find explanations (answers to the questions “how?” and “why”) in a situation when the focus is on circumstances that cannot be controlled. The case of Ukraine in the conditions of war is quite unique.
At the same time, its spatial and temporal framework is determined historically – Ukrainian realities from the beginning of Russia’s full-scale invasion on February 24 2022, until March 2024 (the time of completion of this study).
Informants were selected based on the principle of theoretical sampling [39] and the criterion for inclusion was potential involvement in the process of alcohol use or abuse in the context of alcohol access restrictions. This involvement included four aspects:
1) decision-making on restricting access to alcohol (by representatives of the government and local self-government bodies) (LSG),
2) implementation of these decisions at retail outlets – sellers (S),
3) the category of potential consumers who are most severely affected by the restrictions – servicemen (SV),
4) people with professional knowledge of the consequences of alcohol consumption – psychosocial support specialists (psychologists, social workers) (Ps).
Participants were selected based on convenience sampling; informants were recruited through personal acquaintances, recommendations and contacts in professional networks, which provided access to people directly involved in alcohol restrictions. As a result, four groups of informants (a total of 19 people aged 21 to 61) were interviewed: four representatives of the government and local authorities, six military personnel, five alcohol sellers and four psychosocial support professionals. These groups could have different opinions on the problem. A detailed description of the informants is provided in the Appendix.

Data collection tools

The study was conducted using semi-structured interviews to assess the informants’ attitudes towards the government’s decision to restrict access to alcohol and their opinions on the consequences and effects of these restrictions. Key topics discussed with all groups of informants included 1) the logic and motivations behind the introduction of alcohol restrictions during martial law, 2) changes in the behaviour of different groups as a result of the restrictions, 3) the effectiveness of the restrictions and their impact on social and economic conditions and 4) the challenges faced in implementing and enforcing the restrictions.
The semi-structured nature of the interviews was ensured by using a guide of the same structure for all groups of informants but included clarifying questions adapted to the context of each group. For example 1) representatives of local authorities were asked questions related to the logic of the restrictions, their effectiveness and implementation challenges, 2) sellers were asked clarifying questions about changes in sales amounts, customer behaviour and compliance with the restrictions, 3) servicemen were asked about the perception of restrictions, behavioural changes among servicemen and alternative methods of stress reduction, 4) social workers and psychologists were asked about the impact of restrictions on family relationships, seeking support and the psychological and social consequences of restricting access to alcohol.
Interviews were conducted in the period from January to March 2024 in various formats – most in a face-to-face format, some on internet platforms, some over the phone and some in the form of written answers. Informed consent was obtained from each informant to conduct and record the interview. On average, the interview lasted from 30 to 45 minutes.

Data analysis and reliability

The audio records of the interviews were transformed into text transcripts. Frame analysis was used to analyse documents [40, 41]. Analysis was carried out in three interrelated phases. In the first phase (data management), a careful selection of data (transcripts) was carried out, then the researchers reviewed the data and initial themes, or thematic structure, was developed. In the second phase (descriptive analysis), the thematic structure was explored to reveal any connection and similarity between the fragments within the frame matrix of an individual group. The third phase (explanatory analysis) involved checking how the level of coincidence between the phenomena was distributed across the entire data set. Five themes were identified using frame analysis to explain the experience of alcohol access restrictions, which were 1) perceptions of alcohol access restrictions during martial law, 2) justification of the logic of introducing such restrictions, 3) the effect of restrictions on alcohol consumption, 4) strategies for circumventing restrictions and 5) assessment of the adequacy of the adopted decision.
While the frame matrices were developed separately for each group of informants, the themes in these frameworks were identical. The themes in the frameworks were discussed and agreed upon at the meetings of the entire research team. The interpretation completed the analysis process, the purpose of which was to attach meaning and gain understanding of the data obtained [41: 117].
The process was outlined in detail to ensure the reliability of the research. In case of ambiguous statements, the consistency of the received data was ensured by paraphrasing the same questions in different ways; members of the research team cross-checked the data obtained from the participants.

■ RESULTS

The topics listed were reflected in virtually all interview texts, but representatives of different groups brought their own emphasis to the interpretation of these topics.

Representatives of the authorities and local self-government bodies

The attitude of the representatives of the authorities and local self-government bodies (LSG) to alcohol access restrictions can be described as a “statement of fact” (In the first three months of the large-scale invasion of 2022, a complete ban on the sale of alcohol was introduced. Over time, the complete ban was left only for people in military uniform. Later, restrictions on the time of sale of alcohol were introduced ) (LSG_2). They simply quote various resolutions (Today, in Lviv, the sale of alcohol of any strength is allowed from 12:00 to 22:00, which means that alcoholic beverages will be sold for an hour longer. This is the order of the Mayor of Lviv dated 21.12.2023 No. 626), naming their numbers and not questioning their legitimacy. This approach follows the traditional bureaucratic logic: “If a decision is made, it must be implemented.”
The justification of the logic behind the introduction of alcohol access restrictions is also in line with the official point of view. Firstly, they confirm the official version of the justification for such a ban through the argument it’s not right – In my opinion, the main reason for the ban/restriction of alcohol sales was that it is not right to drink alcohol when there is a war in the country, and people are dying. Indeed, in this context, alcohol consumption is considered as an element of celebration (LSG_3). Secondly, they consider the argument of security to be the reason for restricting the sale of alcoholic beverages – it was normal for the safety of citizens, for peace in the city (LSG_1), as the sale and consumption of alcoholic beverages could cause conflicts, in particular between local residents, internally displaced persons and collaborators. This was done in order to reduce the amount of alcohol consumption and prevent the occurrence of criminal acts or the formation of criminal intentions (LSG_2). At the same time, however, the authorities recognise that society is not ready for a complete ban even in times of war, as there are many factors when small/infrequent alcohol consumption is an element of adherence to established traditions/norms (for example, weddings, funerals, meetings of comrades outside the frontline).
While they support the total alcohol access restriction, as predicted they note the positive effects of this step: Looking at the economic effect, we believe that the restrictions did not affect our region as sales were only streamlined in time. Speaking about the social aspect, it should be noted that the restriction of alcohol sales in the morning and at night has obviously had a positive impact; namely, the number of people who commit illegal acts because of alcohol (for example, nighttime hooliganism or drunk driving) has decreased, the number of crimes committed, including domestic violence, has decreased, there has been significant relief for people living with addicts and it has become possible to take more effective measures to get families/individuals out of difficult life circumstances related to alcohol use (for example, interventions to persuade addicts to undergo treatment and rehabilitation) (LSG_3). On the other hand, the risk of negative consequences of such a decision is recognised at the level of local communities – Economically, it may have a negative impact on the development of a particular territory, as the excise tax on alcohol is credited to the budget of the administrative-territorial unit where the points of sale of excisable goods are located (LSG_4).
Due to their pro-authority status, representatives of local self-government bodies are reluctant to admit that there are strategies to circumvent and seek loopholes to gain access to alcohol – were there any such violations, or maybe someone was selling from the floor or trying to sell somewhere in the first weeks of the war, no one even tried to do that, at least I don’t know, I don’t hear (...) everyone understood that they had to pause. Later, in the summer, when the war had entered a longer phase, as they say, such things happened, that is, later, somewhere (LSG_1); There are definitely cases of violation of restrictions. But the rather harsh financial sanctions motivate sellers to be disciplined in their attitude to the requirements to sell alcohol at a certain time (LSG_3).
As for assessing the adequacy of the decision, the opinions of local self-government representatives are ambivalent. On the one hand, a decision was made to be implemented while on the other, they stressed that the complete ban on alcohol sales did not have a significant effect, as addicts still found informal sources of alcohol, including low-quality alcohol, and people who intended to drink alcohol once, on occasion, could not buy it at all (LSG_3). As an effective alternative, hourly restrictions on alcohol sales are suggested, since it forms the sales system itself, taking into account the hours of the highest abuse. This, in turn, has a positive impact on public order and safety (LSG_3).
Thus, the attitude of local government representatives can be characterised as something that is mandatory and cannot be questioned, at least in terms of implementation. At the same time, they express doubts about the effectiveness of such a “prohibitive” policy in the long term.

Servicemen

Theoretically, the servicemen group (SV) was the most sensitive to the alcohol access restrictions. In the conditions of martial law due to Russia’s full-scale invasion of Ukraine, the problem of alcohol consumption among the military takes on special importance due to the potential impact on discipline, the effectiveness of combat tasks and general combat readiness.
Servicemen-informants showed quite different attitudes towards the alcohol access restrictions, depending on individual circumstances, personal views and experience from the unambiguously positive – very, very positive – I am absolutely in favour of the ban on drinking alcohol during the war (SV_4; SV_1) to inappropriate – Improper. Well, look, actually (...) these restrictions are just creating a black market. They have no effect. We need to talk about the causes not prohibitions (SV_2) or negative – quite negative because alcohol is still sold, you just need to know where to buy it (...) and they sell it to the military as well. When it is difficult for you to buy something, you go somewhere to such places where they pour something not very good (SV_5).
On the one hand, all informants are aware of and reproduce the logic of such restrictions. Such alcohol access restrictions aim to discipline servicemen so that they are not so unbalanced, especially on rotation (SV_5). A person with weapons must be predictable – security techniques for handling weapons categorically prohibit the use of alcohol or drugs (SV_2). This applies to the civilian population as well because a large number of unregistered weapons are in the hands of the civilian population (SV_1), and in the area of hostilities: access to alcohol for servicemen is something inappropriate – in the case of performing combat tasks, large doses or even normal doses of alcohol reduces reaction, dull vigilance, even reduce physical capabilities (SV_2). And this is due to the fact that alcohol (...) remits consciousness, that is, a person does not make decisions quickly, a person thinks slowly, often a person cannot make a decision at all (SV_4). In the subtext, there was another reason for the restrictions – a financial one – someone wanted to enrich the budget in such a way as to limit the payment to the military (SV_4), with a hint that servicemen who are fined for drinking alcohol are deprived of bonuses and extra payments.
On the other hand, servicemen claim that it is next to inevitable to have alcohol consumption in wartime: alcohol is an attempt to quell fears (SV_1), alcohol is taken as a means for bravery, to relieve fatigue, against illness, for sound sleep, against grieving to wet in celebration when the social status of colleagues and their family members changes, as well as on the occasion of numerous dates, anniversaries, etc. Therefore the effectiveness of alcohol access restrictions for servicemen is estimated as very low. They record the need to consume alcohol and thus quickly relieve stress, there comes the moment when this dose is needed to relieve stress (...) a person cannot be under psychological stress all the time (SV_2). In addition, stress in the military arises not only from the fact that war is nearby but also from the forced restriction of freedom of movement – a lot of people drink because they are not allowed out, as they say, from a certain territory (SV_2), war itself is depression or lack of freedom (...) servicemen cannot go whenever they want (SV_4). In addition to the need to relieve stress, there are also additional opportunities for alcohol consumption: The so-called (thirty thousand hryvnias), which was paid in the Armed Forces until the beginning of 2023, gave military personnel financial independence and opportunities to abuse alcohol, drugs and gambling (SV_1).
There are many “buts” regarding alternative ways of dealing with stress from a serviceman’s point of view.
Firstly, there are not so many alternative ways to relieve stress at the front – a hobby (good, if there is one), sports competitions (chess, football) – the maximum such alternative way that I came to is that we have a gym where you can do sports plus there is a tennis table, and you can play tennis (SV_5). And if sports opportunities are not always availible, the ways to enhance the effect of alcohol are readily at hand – as an anti-stress – drug, smoking (...) light, smoking dope, cannabis, and it is even easier than alcohol, but on the other hand – firstly, they mix alcohol with smoking, secondly – they don’t stop (SV_2). Unfortunately, these “non-alcoholic” alternatives do not unite the military brotherhood as much as alcohol does – if you don’t drink, you are not their man; if you don’t smoke, you don’t belong (...) That’s how it was from the very beginning when I first arrived (...) Well, that’s how I had to get to know everyone, and there were a couple hundred of them (SV_5).
Secondly, alternative methods of stress relief require additional efforts on the part of the person himself – I have a passion and hobby that is more than a dozen years old (collecting, chess, philately, pewter miniatures, fantasy literature). Therefore, it’s easier for me. I go to certain internet resources to replenish my collection. Sometimes, the process of finding is not a week alone. But the satisfaction from the process is not smaller than the purchase itself (SV_1) (…) I’m lucky in life; I practised sports for a long time, I somehow learned to get excited and calm down, so it was a little easier for me to deal with it (SV_3).
Thirdly, the creation of alternatives depends on the efforts of commanders of military units. The great role of commanders: through their own example, training and explanations, that is, believe it or not, an authoritative statement is important when commanders show by their example that it is possible to do without it or establish a certain regime: on the day when you going to the position – not a single gram, or even the day before going (SV_2). The commander should take care that young recruits should have no free time, and then there will be no time for bullshit in their minds (SV_3), Instead, commanders come up with formal excursions or other entertainment activities that are not interesting for servicemen (SV_1).
The overall assessment of the alcohol access restrictions for the military is rather negative. For military professionals, it (the ban) is not required because professional performance of military duties involves understanding the fact that it is impossible to perform such duties in an intoxicated state; this is part of the professional military code – It all starts with the fact that people should be professionals, that’s why. There should be a professional army, and then there would be no need to do this (SV_6).
A positive perception of the alcohol access restrictions can be observed among those aware of the need for a wartime ban. Firstly, some of the military (including the so-called “professional soldiers” or commanders) understand that alcohol consumption can negatively affect their combat effectiveness and the overall safety of the unit and therefore support restrictions, considering it necessary to maintain discipline and efficiency of combat actions. Secondly, some are aware of the importance of a healthy lifestyle and maintaining physical fitness. Thirdly, part of the military believes that the restrictions can also strengthen the team spirit since all military personnel operate in compliance with the same rules and are jointly responsible for maintaining discipline.
Among non-professional conscripted soldiers, we very often come across the best of the worst who carry their old problems of abuse with them (SV_1) and they in real life (...) consumed, keep consuming, maybe a little (...) more carefully because they try not to catch someone’s eye (SV_4). And when people like this, very often not highly motivated, are taken, forcefully or something like that, then here are the consequences. They treat all this carelessly because they really don’t care. It seems so to me. That is, if a person is a school principal or whoever he is, and he will not go to class after drinking, you understand? (SV_6). For them, the ban (...) actually doesn’t work, because there is alcohol, it is consumed and there is more of it now (SV_4) I know that everyone who wanted – everyone will always find it (SV_6), Well for to me (this ban) is absolutely ineffective – if we allowed free sale, it is possible that it would simply come out of the grey and this would be an advantage for the economy (SV_5).
The negative perception of the alcohol access restrictions is based on several arguments. Some servicemen may find that alcohol helps them relax after hard combat or long periods of staying on duty. They perceive restrictions as 1) an additional stress factor, 2) restrictions on their personal rights and freedoms (and anyone treats such restrictions negatively) and 3) a demand to give up their “usual habit”.
The military’s attitude to alcohol access restrictions is differentiated. Awareness of responsibility for their actions when on the line of defence leads to clear support for such restrictions. At the same time, the restriction is perceived negatively as alcohol is seen as a means of quickly getting out of a stressful state.

Sellers (distributors of alcohol)

The third group that can be considered a stakeholder is the sellers (S). Those who sold alcoholic beverages in shops, cafes, bars or restaurants could observe the reaction of those who tried to buy alcohol and could not do it. Certainly, it would be pointless to ask sellers if they were aware of the alcohol access restrictions. But the logic of the restrictions in the sellers’ interpretation varied and was even surprisingly unbusinesslike – The logic is very simple. If you sell alcohol until 12 o’clock, people will be before the curfew, drinking alcohol, there will be some lawlessness, the police will be alarmed. And so until 10 o’clock alcohol is sold, people finish drinking it and safely go home (S_1), Sadovyi [city mayor] said that we will drink after the war. We were afraid of everything then, and if someone got drunk in addition to everything else, we could run into a big trouble (S_3), And what is the logic: the war started and everything is clear (...) Then you had to be sober. And there was nothing to celebrate (S_4) and I think why explain? Everyone knows that everyone is on nerves (...) can you imagine that drunk person, even that military man with weapons? (S_5).
“Sellers” noted changes in the process of selling and consuming alcohol after the introduction of alcohol access restrictions. Changes could be traced:
• in the amount of alcohol purchases – the number of visitors decreased (by 50% – S_1) they began to buy a little less. There are fewer people, they celebrate less, they have less money (S_3), the biggest change is that people stopped celebrating. Because it is not very expensive here and you can get together as a team after work. But who celebrated anything then? It was not the right time for celebration. So, to put it this way in general, it was nothing special: people understood that there was nothing, and that was it (S_4) and regarding the scope of alcohol consumption, people started drinking less, at least in the early days – Well, they started drinking less, but not by much (...) it’s just that now they are somehow more careful about it (S_2). We didn’t sell, so buyers didn’t buy. Zero revenue, and that’s it. Both we and the drunkards were affected, those who wanted to drink (S_3), but later they started drinking more. They started drinking even more, do you understand? Air alert, for example, so what? Instead of going to the shelter, they all came to my store because of what they would go to the shelter with. It looked as if they were going to drink those hundred grams or 50 grams for the last time (S_5),
• in the behaviour of buyers – At first they asked why it was not there, and then they got used to it. No, but regular customers came, those who live nearby. They said that no one would hand me over to anyone, that we had known each other for a long time. But how can I sell if I have a cash register? It will immediately show what I have sold (S_3). At first, you know, they were furious, and then they somehow calmed down (S_5),
• in visitors’ preferences – Before that, people used to drink cocktails, but now they just come and order horilka [vodka]; they want to drown out their emotional pain, they drink everything down with horilka. Now there are very few cocktails, people somehow, and I don’t know (...) they want to get drunk cheaper (S_1) and recently, there have been more small hundred-gram bottles, so people buy them on their way from their workplaces (S_3),
• in the contingent of buyers – In the past, both adults and pensioners came. And they didn’t go that way just once in a while, once a year, to see what was happening there, but they came often, and they liked to walk there. Now, there are a lot of (S_1) and There were a lot of refugees, you know? There were plenty of them – from a doctor to a drug addict. And they all wanted alcohol, you know? Because they came from Kharkiv, they came from the war. I answer – not for sale. And she: Well, I have come from Kharkiv, you know? – I answered – So what? It was horrible (S_5).
Alcohol “sellers” had the opportunity to visually observe the behavioural strategies of “circumventing” the alcohol access restrictions by various types of customers. To buy alcohol at a time when it is prohibited to sell it, potential buyers used both the usual methods of circumventing prohibitions and not quite standard ones.
The usual included:
• to use differences in the alcohol access restrictions according to the territorial principle (city/outside the city): They used to go to Sokilnyky, beyond the limits of the sign, that’s only in Lviv, like in big cities, they prohibit it. Alcohol was sold behind the sign, you know? Then they found a place to take it and everything (S_5),
• “to change clothes”: Yes, it is forbidden to sell to military personnel, but they don’t always wear uniforms. That is, you do not know a person personally, you do not know if he is a serviceman or not, if he comes not in uniform. Of course, if a person came in without a uniform at the time of permitted sale, why not (S_2). Sometimes this “disguise” could take quite dramatic and demonstrative forms. They say – I’m a military man, pour me some. I say- I won’t tell you, you have a chevron on. He goes out into the hall, takes off his jacket there, removes his pants, comes out in underpants and says – I’m not a military man (S_1),
• to make agreements: someone will ask someone else – to go and buy it, and our people will agree to it, our people will do it (S_2); Sometimes they cracked jokes: you pour us from under the counter. But I said that it was not the Soviet Union. And nobody likes the Soviet Union in Lviv (S_3),
• to offer money for the sale of alcohol: Sometimes they came and said that they would pay the triple price (S_3),
• to use old supplies from pre-war times: So I took a couple of flasks from the house. My old stock (S_3).
Among the unconventional, occasional ones was the method of “stirring pity”: we (military) fought for you, we want to drink, rest, we were very angry (S_1); There is this guy, he is very afraid of air alerts if there are also rockets flying, or something else, then he will drink validol, such all kinds of nonsense, he comes, buys himself 100 grams, he drinks one hundred grams on the bench and again takes validol. He comes and says: Natalia, I’m so much afraid, and then wants another one hundred grams, do you understand? (S_5).
To conclude: No ban works for Ukrainians (...) I think it would be useful, it would be a cool ban, but not for Ukrainians who know how to find a way out of any situation (S_2).
Thus, despite a possible negative attitude due to the loss of revenue from the restrictions imposed on the sale of these products, the position of alcohol sellers turned out to be “patriotic” in the sense that they definitely support the restrictions, at least in a wartime situation when everyone is required to be sober and quick to react.

Psychosocial support professionals

Another angle of the alcohol access restrictions problem in wartime was explored with the help of one rather specific group of problem stakeholders – representatives of professions that provide social and psychological support. Psychologists and social workers (Ps) evaluate these restrictions during wartime through the prism of situational war-related factors. We treat this group as experts in situations of stress. They are at a distance to immediate circumstances, but reflect the impact of the alcohol access restrictions on the consumption of psychoactive substances, using their knowledge about stress and various coping strategies.
The main statement is that the war affected people so that they began to drink alcohol more and more often: the amount of alcohol consumption has definitely increased, these restrictions have no effect because, after all, Ukrainians are a nation that can bypass these limitations. In fact, I have seen many times in supermarkets when customers bought alcohol for servicemen. They are in uniform, but they stand aside and give money, which has happened more than once (...) I have seen it many times – people do it out of compassion because they cannot refuse the military, they buy alcohol for them (Ps_4) and unfortunately, this is Ukrainian reality (...) because a lot of entertainment has been taken away, many men do not leave the house, many teenagers do not go to any discos there, their entertainment is still more or less limited (Ps_4).
In the hierarchy of psychological problems we will face after the war, “experts” unequivocally put the problem of alcohol in second place after mental-health-related problems – because mental problems will actually cause this alcohol consumption. Mental problems are post-traumatic consequences after amputations, losses (Ps_4), and this threatens to turn into an all-Ukrainian problem – the most important thing is that if the men who return will not endure it all, their wives may follow them, because they will not endure either, and there are children, and there is the society, it will be possible to so to say pour the grief down with alcohol, so it is very important to talk about psychoeducation right now (...) it’s normal (Ps_4).
The effect of alcohol on the human body and behaviour has certain negative effects – we are under the influence of stress, and alcohol increases its negative effects. The body is constantly in the system of readiness to respond to stress. And this readiness is exactly what alcohol disables completely (Ps_1). In the conditions of war, this can be particularly dangerous because the ability to assess the situation adequately and quickly react decreases – during stress, cognitive functioning is impaired, and during alcohol consumption it becomes even more impaired (Ps_1) and to think soberly is so basic that what we need in wartime are rules that provide a canvas, that provides a framework thanks to which we can function (Ps_1). In a war environment, when people are prone to aggressive behaviour due to stress and trauma, alcohol can further complicate the situation. This action has a cyclical nature, and alcohol turns into a habit the habit of drinking alcohol when you are having fun with friends and you think that now you will drink, you will have fun again, you will feel not so lonely, not so unhappy, abandoned by everyone – God, the state, people, and as if you drink, and everything will be as it used to be before – stable as before, because when everything , alcohol is the only thing which is stable (Ps_2).
Awareness of the social problem of alcohol consumption in wartime often leads experts to the position of an ambivalent assessment of the alcohol access restrictions (yes..., but) during the war for several reasons:
• alcohol access restrictions can make it difficult to get out of stress quickly. During the war, the level of stress and trauma increases; therefore the ban on drinking alcohol, in particular for military personnel, can further worsen their condition in a stressful situation – during war that is acute and such deep stress, that is, stress that has such a traumatic effect. That is, it is stress that disrupts the defence system (Ps_1), and alcohol can be a tempting way to reduce stress, but at the same time it can worsen the psychological state, contributing to the development of depression and anxiety disorders, so alcohol is definitely an ineffective avoidance coping strategy (Ps_1);
• alcohol access restrictions increase the safety of the environment and reduce the risk of violence, but is it possible to solve the problem of aggression with a straightforward total ban on alcohol consumption? Therefore the deep and, at the same time, simple logic that brought these restrictions to life is most likely to scare people so that everyone sits at home and does not go anywhere (Ps_2). This was due to the government’s habit of managing people’s lives in a simple way: now we will tell you what you need to do – stay there and be afraid (Ps_2). Therefore there is a double logic: on the surface – the explanation is such a security argument (to secure people) (Ps_3) so that there are no unauthorised provocations, and an implicit one lies in the habit of directing and indicating what should be done (they thought that the restriction would affect sobriety) (Ps_3) did not work.
• alcohol access restrictions act like any others; that is, they limit a person’s choice, but one must know the national character – we cannot banned from anything at all (Ps_2); after all, we are not Germany, if we are banned from something, we only start doing it more (Ps_2). It sounds anecdotal, but close to the truth. One of the experts tried to explain this by drawing an analogy with smoking. Making a decision in Ukraine about the price of cigarettes, which should reach the level of the price of cigarettes in Europe so that there is no smuggling (...) and every week the price of cigarettes changed by 5 kopecks, but the more expensive cigarettes became, the more they were bought (...) When she asked a man from the village, he explained this: Well, you understand, cigarettes are getting more expensive; I’m getting nervous. And what am I doing? I take out a cigarette and (...) light it. It worked the same way with this law: it is an action that causes a reaction. This is how it worked – action causes counteraction (Ps_4) and People start producing moonshine, start buying it for extra money, find somewhere for bribes and use more than they usually do, in case there suddenly won’t be any tomorrow, so let’s drink three bottles today and so be it. That is, this restriction was so ineffective in terms of consumption – the people from our authorities are some non-Ukrainians, honestly. They do not understand that Ukrainians cannot be banned from anything; as soon as there is a ban, we run there immediately; we need more of everything (Ps_2).
Representatives of professions that provide social and psychological services focused on alternative ways of coping with stress. The restrictions alone will not change anything; a set of measures must accompany them, and these should include separate measures for the military on the frontline and for civilians.
• Control and prohibition measures for the military: this is encouraging to a certain extent because the military does not know when there may be an inspection, how these certified drug testers can be checked (...) servicemen say that it is quite effective. And what was done in 2015 and 2016, when, so to speak, they put them in a cold pit or tied them up (Ps_3) did not have this effect. Today, economic methods of punishing an alcohol dependent person are recognised as effective (depriving of wages and bonuses). In addition, peer pressure – the guys said that (...) these alcohol addicts who are there, they only get in the way, no one likes them, they are stopped, demobilised (...) they don’t want them to return because there is a problem with them, the number of addicts in the war is too high, they are trying to transfer them somewhere there through the command (Ps_3).
• Creating a real rehabilitation system for active military and veterans: We don’t have rehabilitation; we have a large number of people who have gone through military operations and reduce anxiety or stress through alcohol (Ps_3).
• Psychosocial support for active servicemen, veterans, and civilians uniting the efforts of various specialists who assist people in difficult life circumstances by arming them with basic knowledge (Establishment of mental health centres, training of a wide range of specialists, notification of family doctors of mental health – this was a national-level initiative) (Ps_1). For centres like this to work, it is necessary to train agents of influence, which should be done consciously, and then let them work for themselves (Ps_2). Within the framework of this psychosocial support, it is necessary to increase the number of centres, expand available free centres, increase the number of detoxification centres (...) so that I can come to any hospital to simply, as we called it, get a drip, or even stay in an inpatient care facility or just come to the outpatient hospital to make arrangements with my doctor because I feel very bad (Ps_2).
• Within the framework of such psychosocial support, in addition to prohibitions, preventive programmes should also operate – that is, it is not intimidation, with no registration, but some role-play for people, motivational interviews, conducting more of some group discussions, without any intrusiveness like – yes, sit down, guys, now we will be saying that you are not allowed to drink. Such an unobtrusive level involves outreach, that is, everything that can be done in society in some mini-communities, among neighbours (Ps_2), and it also requires training agents of influence.
• Psychoeducation: because a lot of people do not understand and do not know that influence, accordingly, when you do not know, it is as if it does not release you from responsibility, but you think to yourself: I will drink a little and it will be easier for me. But such information about aldehyde, showing that the decomposition product is poisonous, about what happens in the brain, what happens to the body, what the alternative could be – well, what can be done instead. It will definitely improve the situation (...) That is, this is exactly the psychosocial support we mean, and it will definitely improve their situation; that is, they don’t know what to do: Well, well, what, what can I do to make it easier? (Ps_1). Psychoeducation of this kind should include awareness of other safe stress-coping strategies. Alcohol can be considered a way to overcome stress, but this is just temporary relaxation, and these breathing and muscle relaxation techniques work better here (Ps_1). It does not work for everyone – whatever survival strategy you used to have, you will use it. If it has just appeared (a strategy to overcome stress with the help of alcohol), if it is identified and help is provided in time, then the strategy can be replaced, yielding quite good results. Well, this can be substituted by relaxation techniques, senses, social environment, some other coping, some other senses, which were the previous ways of coping. Then the person pays attention to something else (Ps_1).
• Public communicative psychoeducational campaigns should have a specific emphasis: the campaign should be built with an emphasis on the interaction of stress and alcohol. And since we are already in prolonged stress, such a broad campaign would aim to show what other ways there exist for coping with stress, and it could have an effect because the war, in fact, exacerbates this problem (Ps_1).
Thus representatives of the helping professions, when assessing the policy of restrictions and the situation with actual alcohol consumption, focused on the possible long-term consequences of this difficult situation. In fact, they expanded the context of the policy-decision evaluation framework from situational circumstances to the future consequences for the individual and society.

■ DISCUSSION

The analysis of the survey results focuses on the informants’ identification of both positive and negative consequences of alcohol access restrictions. Common positions for all groups of informants regarding these restrictions during the war relate primarily to the support of security motives to reduce conflict, violence and crime and promote public order. For example, representatives of the local authorities emphasised maintaining security and reducing conflict, the military focused on the disciplinary effect, the sellers on improving public order and psychologists on the reduction of the risk of aggression. Almost all studies of alcohol access restrictions in emergency situations have revealed a similar approach [5, 15, 16, 18].
Another common theme across all groups was that alcohol is often used as a way of coping with the stress of war and tension relief. For example, the military noted that alcohol helps combat personnel cope with fear and fatigue, sellers pointed to the increased demand for cheap alcohol as a quick way to relieve tension, and self-government representatives emphasised that alcohol consumption is often perceived as part of traditional social practices that help people to cope with stress. Psychologists stressed its role as an affordable way of reducing tension in times of war, which, according to various studies, is also a common argument [35-37, 42].
However, it is worth noting that research shows there was no majority of respondents actually reporting an increase in alcohol consumption; for example, this was only 16.8% [43]. Therefore alcohol access restrictions cause dissatisfaction among a rather small part of the population. At the same time, the effectiveness of alcohol is not as great as expected [42]. Obviously, the tendency to drink alcohol to relieve stress as well as the effectiveness of its stress-reducing effects differs significantly for individuals depending on their relationship with alcohol. Therefore we consider the evidence of the feasibility and effectiveness of introducing alcohol access restrictions as a preventive measure, especially since there is no particular dissatisfaction.
A common approach to understanding the security and social motivations behind alcohol restrictions allows us to recognise their appropriateness, especially in emergency situations such as war. At the same time, the duration and nature of such restrictions may affect their effectiveness and consequences. The experience of different countries shows that long-term and radical restrictions on access to alcohol are often accompanied by negative effects like the intensification of the black market, growth of organised crime or the distribution of surrogates, which poses a danger to human life and health [4, 6, 23]. In this context, it is important to keep in mind that short-term restrictions, especially those with a clear justification, usually do not raise widespread dissatisfaction among the population [5]; they avoid many of the negative consequences because complex alternative forms of access to alcohol do not have time to develop. These measures can be effective if they consider the local context, communicate clearly with the population and involve communities in planning and implementation [14].
The differences in views between the surveyed groups are actually expected and reflect identified professional activity-related contexts. Representatives of the authorities and local self-government emphasise the positive impact of alcohol access restrictions on public order while acknowledging the existence of “workarounds” and suggesting hourly restrictions as a more effective approach. Alcohol sellers mostly perceive access restrictions as necessary and report significant changes in consumer behaviour, profile and approach to circumventing restrictions. The attitude of the military ranges from positive (support for discipline) to negative (an obstacle to quick stress relief) and concern about the increased risks of consuming low-quality alcohol. Representatives of helping professions most often emphasise the need for comprehensive psychosocial measures, including psychoeducation, rehabilitation and the creation of alternative ways of coping with stress.
Limitations. The study has several limitations that should be considered when interpreting the results. The main limitation is convenience sampling, where participants were recruited based on their accessibility to researchers through personal acquaintances, recommendations and contacts in professional networks. While this approach allowed for quick access to individuals directly involved in the context of alcohol access restrictions, it did not ensure sample randomness or its representative standard. Most informants were from the western regions of Ukraine, limiting the findings’ geographical generalisability. The study also did not take into account the opinions of groups at higher risk of alcohol use. Moreover, the focus of the analysis was on the experience of short-term restrictions, which leaves open questions about the impact of long-term measures, which requires separate research. The findings allow us to identify the main trends and areas for policy improvement. Still, they should be complemented by a more in-depth study of the specific characteristics of individual groups to improve the effectiveness of education programmes and communication campaigns.

■ CONCLUSIONS

Alcohol access restrictions can have a significant impact on reducing alcohol consumption and the negative consequences of its misuse. How¬ever, the results of qualitative research demonstrate the complexity and ambiguity of these measures. Prohibitions and radical restrictions do not always have unambiguously positive effects, especially in the long term, due to the deep-rootedness of alcohol consumption in cultural traditions and its role as an affordable means of relieving tension. The informants’ experience confirms that measures can be effective provided they consider the socio-cultural context and are adapted to the needs of different social groups.
Negative consequences, such as the use of substitutes or the emergence of a black market, remain typical of all known attempts to restrict access to alcohol severely. However, in emergency situations, short-term restrictions may be justified as they contribute to reducing violence and maintaining public order and security. Informants noted that restrictions of this kind were understood by consumers due to their temporary nature although some tried to circumvent the rules.
According to the data obtained, alcohol consumption patterns have undergone certain changes since the beginning of open Russian aggression compared to peacetime. However, these transformations were of a dual and contradictory nature. Society, and even those parts interested in the circulation of alcohol (primarily its legal sellers), treated the complete removal of alcoholic beverages from sale with understanding: they were guided by the belief that alcohol traditionally appears in Ukrainian culture as one of the important components of various kinds of festive events. The absence of events of this kind at the time, which was tragic for the country, automatically meant a ban on alcohol. At the same time, alcoholic beverages, according to the same traditional beliefs, also act as antidepressant drugs and mobilisers and components of recreation [44], playing an important role in practices accompanying certain tragic events like the commemoration of fallen soldiers. In addition, revenues from alcohol sales constitute a significant source of income for the state and local community budgets. Obviously, guided by these motives, radical alcohol access restrictions introduced by the local authorities of various regions within the framework of compliance with martial law were generally accepted with understanding. Still, their liberalisation began quickly, returning them to the framework of the usual restrictions. They were withdrawn after they fulfilled their primary mission to prevent violations of public order during open large-scale aggression. Accordingly, the patterns of alcohol consumption among most consumers also returned to normal and some increases in alcohol consumption [36] can be interpreted as attempts to relieve wartime stress and the tendency to act contrary to the prohibitions imposed by the authorities, which corresponds to the socio-cultural tradition of Ukrainian society. The findings suggest that radical alcohol access restrictions aimed at complete alcohol prohibition are possible and are approved by the public only when they are a response to an extreme situation and are temporary. Therefore a real transformation of patterns of alcohol consumption by the majority of citizens aimed at limiting consumption is possible only due to constant, systemic, and complex action of the main entities engaged in regulating the problem. This will include not only restrictive measures of an administrative nature but also awareness-raising. It is important to developing a comprehensive strategy that includes preventive and psychosocial support, rehabilitation programmes and preventive measures to reduce stress.
Legal regulation of the time of retail sale of alcoholic beverages and establishment of alcohol sales outlets is complicated by how difficult it is to monitor their implementation [30]. The available evidence highlights the need for a comprehensive approach to alcohol policy. To be effective and avoid negative consequences, these policies should address not only alcohol consumers but also the market, supply chain, consumption environment and overall social context [45] and combine the control system with expanded health and social services and the development of educational prevention programmes [46].

■ RECOMMENDATIONS FOR REGULATING ALCOHOL CONSUMPTION IN EMERGENCY SITUATIONS

The research findings confirm that general alcohol access restrictions are not always effective and that adapting regulations to local values and cultural characteristics is critical. A comprehensive approach that combines regulatory, educational and social measures is needed to ensure widespread compliance.
Integration of rules with cultural traditions. Regulation of alcohol sales could consider traditional rituals and socially significant events like weddings, wakes or other similar ceremonies (although the actual rules for implementing this approach are not easy to formulate). This will help to avoid tension among the population during the introduction of restrictions. At the same time, an essential element is to support a culture of “reasonable consumption” through information campaigns that emphasise responsibility and limits on alcohol consumption.
Focus on public health through educational campaigns. Information programmes should explain not only the dangers of alcohol but also the positive aspects of compliance with restrictions like improved public order and social environment. Educating the population on alternative coping strategies like relaxation practices or participation in physical activities is also important.
>Public involvement in policy making. Including local communities in decision-making processes helps to increase trust in the measures implemented. Organising public discussions on alcohol sales rules and establishing local committees with representatives of different groups will help to consider the population’s needs and improve the effectiveness of restrictions.
>Support long-term initiatives through a buy-in policy. From a long-term perspective, it is important to communicate the benefits of changes transparently, considering cultural and social specifics. Creating incentive programmes like “healthy communities” initiatives that provide bonuses (discounts on gyms or cultural events) can help motivate people to follow the rules.
Specific approaches for the military. Ensuring discipline among the military requires specific strategies, including education about the impact of alcohol on combat readiness and safety and fostering a culture of responsible leadership where commanders demonstrate compliance. It is also important to create alternative ways to reduce stress for the military like through the organisation of group activities or access to psychological support.
These recommendations can serve as a basis for effective regulation of alcohol consumption in emergencies, taking into account local characteristics and needs of the population. At the same time, this study offers only a general framework for recommendations as this issue requires further in-depth research, especially on the long-term impact of restrictions on specific groups like the military or internally displaced persons.

Conflict of interest/Konflikt interesów

None declared./Nie występuje.

Financial support/Finansowanie

None declared./Nie zadeklarowano.

Ethics/Etyka

Ethical confirmation and permission to conduct the research were approved by/Potwierdzenie, że badanie będzie przeprowadzone zgodnie z zasadami etycznymi oraz zgoda na jego rozpoczęcie zostały wydane przez: the Department of Social Science and Social Work of Lviv Polytechnic National University (protocol No 8, 25.01.2024).
The work described in this article has been carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) on medical research involving human subjects, Uniform Requirements for manuscripts submitted to biomedical journals and the ethical principles defined in the Farmington Consensus of 1997.
Treści przedstawione w pracy są zgodne z zasadami Deklaracji Helsińskiej odnoszącymi się do badań z udziałem ludzi, ujednoliconymi wymaganiami dla czasopism biomedycznych oraz z zasadami etycznymi określonymi w Porozumieniu z Farmington w 1997 roku.

References/Piśmiennictwo