Exploring women’s views toward no-lo alcohol products during pregnancy: a photo elicitation guided qualitative study

Background Pregnancy encompasses a period of socially expected and medically advised abstinence from alcohol. The UK has one of the highest rates of alcohol exposed pregnancies globally. ‘Non-alcoholic and low alcohol’ (NoLo) drinks may provide a viable means to support abstinence or harm reduction. We explore women’s views towards NoLo products including consumption barriers and enablers. Methods We conducted 18 semi-structured photo-elicitation interviews with women who were pregnant within the UK. Findings were analysed using reflexive thematic analysis. Results Two themes were identified: ‘navigating the sociocultural environment’ and ‘navigating the NoLo market’. Women used NoLo products to help adhere to societal norms of abstinence in pregnancy, while navigating the social expectation to consume alcohol in social environments. The NoLo market was viewed as hindering the adoption of NoLo products, with issues around inconsistent guidance and labelling, pricing and availability. Conclusions NoLos can aid social inclusion and satisfy social cravings for alcohol-adjacent products. Unclear guidance around ‘risk’ and perceptions of the possible ‘harms’ of low-alcohol drinks impacts consumption. Given pregnancy’s high-risk nature for alcohol-related harm, clear, evidence-informed guidance on NoLos is crucial for potential harm reduction. Specifically the need for clear marketisation and labelling between No and Low alcohol products.