Alcohol-free and low-alcohol (no/lo) drinks have taken off in recent years and you may have seen headlines suggesting that no/lo drinks are going mainstream. But who is buying no/lo drinks, how much are they buying, and how much alcohol is being bought alongside them?
The government has backed the expansion of no/lo drinks as an opportunity for individuals to cut their alcohol consumption and reduce harm, and alcohol producers and retailers have embraced this framing enthusiastically. However, this growth comes with risks: No/lo drinks may normalise drinking in new contexts, such as lunchtimes or after exercising, by increasing exposure to alcohol-style drinks in otherwise alcohol-free spaces. Shared branding between no/lo and full-strength products may allow companies to advertise in places where alcohol advertising is banned, what researchers call surrogate marketing. And if uptake remains concentrated among lower-risk, higher socio-economic households, no/lo drinks could also widen inequalities in alcohol harm. Finally, a policy focus on no/lo drinks availability risks sidelining approaches with a stronger evidence base – the WHO’s ‘best buys’ of increasing alcohol prices, reducing availability and restricting marketing.
To understand whether no/lo drinks are living up to their public health claims, we need to know more about the people buying them. Regular purchasing by those at highest risk of alcohol harms – heavy drinkers from lower socio-economic backgrounds – has the greatest potential to improve public health. Infrequent purchasing by lighter drinkers, much less so. Our new study in Addiction set out to do exactly this.
Not all no/lo purchasers are the same
Using shopping data from around 30,000 households across Great Britain, we analysed no/lo and alcohol purchasing quantities to identify distinct groups of no/lo buyers in 2023. Rather than treating no/lo purchasers as one homogeneous group, which most previous research has done, we used a clustering method called latent profile analysis to let the data tell us how many meaningfully different types of purchasers there are.
Three groups emerged.
- The largest, comprising over half of no/lo purchasing households, we called no/lo triers. These households bought an average of just over two no/lo servings per adult across the entire year and most bought alcohol at low-risk levels. Rather than incorporating no/lo drinks into their drinking habits, these households appear to be simply trying them and moving on.
- The middle group, occasional purchasers (34%), bought around 7-8 servings per adult annually and a fifth of these households purchased alcohol at increasing or high-risk levels. This rate of no/lo drinks purchasing, equivalent to one serving every seven weeks, is also low.
- The smallest group, dual purchasers (13%), tell a more interesting story. They averaged nearly 38 no/lo servings per adult per year and, despite being the smallest group, accounted for 58% of all no/lo drinks purchased. They were also the heaviest alcohol buyers with around 30% purchasing at increasing or high-risk levels.
Who are these households?
Occasional and dual purchasers tended to be older than no/lo triers, and all three groups were more likely to be of higher socio-economic position than households who bought no alcohol or no/lo drinks at all.
What does this mean for public health?
For most households buying no/lo drinks, the volume they purchase is simply too small to meaningfully reduce alcohol consumption — unless many alcoholic drinks are being replaced with far fewer no/lo drinks, which is a behaviour we don’t currently have evidence for. On this basis, concerns about surrogate marketing and no/lo drinks normalising drinking in new contexts may currently outweigh the harm reduction benefits for this majority group.
However, within the dual purchasers group of higher-risk households buying no/lo drinks regularly, these products could offer an important tool to reduce alcohol consumption. But this only works if they are drinking them instead of alcohol, not on top of it – and the evidence on whether that is actually happening remains limited and mixed.
The higher socio-economic position of no/lo purchasing households is concerning and suggests that no/lo drinks purchasing may exacerbate existing inequalities in alcohol harms. Previous research has suggested that the high price of no/lo drinks relative to alcoholic drinks may act as a barrier to uptake by households from lower socioeconomic backgrounds.
Conclusion
No/lo drinks are not currently the population-level solution to alcohol harm that the headlines might suggest and shouldn’t be considered an alternative to the WHO’s ‘best buy’ alcohol policies of increasing alcohol prices, reducing availability and restricting marketing. Most people buying no/lo drinks do so infrequently and are already drinking at low-risk levels. But for a smaller group of older, higher-risk households who buy them regularly, they could offer a useful harm reduction tool.
Rather than relying solely on increasing no/lo availability, policymakers should focus on supporting substitution within these higher-risk groups and removing barriers to the adoption of no/lo drinks by those of lower socioeconomic position. Researchers, meanwhile, need to establish whether people adopting no/lo drinks are actually drinking less as a result, or simply drinking them in addition to their usual alcohol consumption.
Written by Oscar Rousham, PhD Candidate, Sheffield Addictions Research Group, The University of Sheffield.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.