Are Increases in Purchasing Alcohol‐Free and Low‐Alcohol Drinks Associated With Attempts to Cut Down on Alcohol Consumption in England? A Time Series Analysis

INTRODUCTION: Alcohol-free and low-alcohol products (≤ 1.2% ABV; no/lo products) are a growing market in high-income countries, including Great Britain. These products may support people in reducing alcohol consumption, but their impact on public health is unclear. To address this gap, we analysed whether changes over time in the prevalence of households purchasing no/lo products were associated with at-risk drinkers reporting: (i) high motivation to cut down; (ii) cut down attempts; (iii) serious cut down attempts; and (iv) using no/lo products during attempts. METHODS: We used time series analysis of continuous household purchasing panel data and monthly cross-sectional survey data from adults in England (2018-2023). The primary exposure was household prevalence of purchasing no/lo products. Outcomes focused on cut down attempts in the last 12 months amongst at-risk drinkers, defined as scoring ≥ 5 on the consumption questions or ≥ 8 on all questions of the Alcohol Use Disorders Identification Test. RESULTS: Changes in household no/lo purchasing were not significantly associated with population-level prevalence of high motivation to cut down (B: -0.001 percentage points [pp]; 95% CI -0.013 to 0.011), current or past 12-month attempts (B: -0.012 pp; 95% CI -0.025 to 0.000), most recent attempt being reported as serious (B: 0.004 pp; 95% CI -0.016 to 0.023) or use of no/lo during the most recent attempt (B: 0.012 pp; 95% CI -0.023 to 0.046). These narrow confidence intervals do not include clinically significant effect sizes. DISCUSSION AND CONCLUSIONS: From 2018 to 2023, increases in the population-level prevalence of no/lo purchasing in England were not significantly associated with changes in the prevalence of cut down attempts amongst at-risk drinkers.