Drinking motives, socioeconomic factors and the harm-reduction potential of NoLo alcohol products for mid-life women

This study provides novel evidence on perceptions and use of alcohol-free and low-alcohol (NoLo) products among mid-life women, a group underrepresented in alcohol research. A cross-sectional survey of 497 women aged 40-65 was co-developed with stakeholders to ensure relevance and acceptability. The survey assessed understanding of alcohol by volume (ABV) definitions (low-alcohol ≤1.2%; alcohol-free ≤0.05%), patterns of NoLo use, attitudes, and perceived helpfulness for harm reduction. Most respondents misunderstood ABV terms, with 64% assuming "alcohol-free" meant 0% ABV. Nearly half had used NoLo products in the past year, with uptake more common among participants with higher education levels and, more tentatively, with higher income, raising equity concerns. Bayesian regression identified taste motives as strong positive predictors of NoLo use, while enhancement motives (drinking for pleasure) were negative predictors. Around 75% rated NoLo substitution as helpful for reducing alcohol intake. In adjusted Bayesian regression, enhancement motives and AUDIT scores showed predominantly negative associations with perceived helpfulness, and taste motives showed no clear effect indicating that determinants of use and beliefs about helpfulness may differ. Acceptability varied by context: celebratory scenarios were rated most appropriate, while during pregnancy or in the workplace were least acceptable. Factor analysis revealed three sub-scales of NoLo perceptions; recent users reporting higher social and health benefits and fewer associations with alcohol-related cues. Findings underscore the need for policy to prioritise clear ABV labelling, inclusive messaging, and equitable access to appealing NoLo options that emphasise taste, social usability, and health benefits to maximise harm-reduction impact.