'Moderation Is the Holy Grail': The Acceptability of 'Sober Curious' Tools for Alcohol Reduction Among Midlife Women.

Introduction: Midlife Australian women are a population group in which alcohol consumption is not decreasing across generations, as in other groups. We explored midlife women's perceptions and experiences of engaging with sober curious tools (self-guided programs, apps, literature, podcasts, online forums) to determine the acceptability of such tools among those seeking to reduce drinking.

Method: Qualitative interviews with 26 Australian women (aged 45-64) of varying social classes, work and relationship statuses living in Adelaide/Melbourne/Sydney who self-reported heavy/medium drinking during 2021. We applied Sekhon et al.'s 'acceptability of healthcare interventions' framework to understand components that increase the acceptability of sober curious tools and an abductive logic to explain the mechanisms that impact acceptability.

Results: Acceptability was stronger among women who felt a sense of security and belonging when tools cohered with their preparedness to reduce drinking and accounted for their perceptions about feasible reductions. Importantly, sober curious tools increased the acceptability of reducing alcohol by increasing women's agency to 'question' heavy-drinking norms, especially when combined with social supports. It is important to women that they envisage themselves as the intended 'user' of sober curious tools. Acceptability differed for women based on social class inequities that result in marginalisation and that intersect with stigma because of ageism.

Discussion and conclusions: Sober curious tools are most acceptable to middle class and affluent women and represent capacities to reduce alcohol consumption. Understanding the experiences of diverse groups of women and their agency to engage with sober curiosity is important to inform future interventions.