Is why we drink alcohol important when considering the potential public health benefit of alcohol-free and low-alcohol drinks? A cross-sectional study investigating associations between alcohol drinking motives and alcohol-free and low-alcohol drink consumption among adults in Great Britain.

Introduction: The UK has promoted increased availability of alcohol-free and low-alcohol drinks (no/lo, ≤1.2% alcohol by volume) as a public health strategy. To be effective, no/lo beverages must replace, and not supplement, standard alcoholic drinks. Emerging evidence suggests that the reasons people drink alcohol may be an important determinant of the potential public health impact of these drinks. This study aimed to determine whether alcohol drinking motives were associated with no/lo consumption after accounting for sociodemographic characteristics and alcohol consumption.

Methods: A cross-sectional sample of adults residing in Great Britain (aged 16-93) who had drunk alcohol in the past year were recruited via the Alcohol Toolkit Study (N=2555; 49.0% female). The dependent variable was frequency of no/lo consumption (less than vs at least monthly). Five questions captured respondents' alcohol drinking motives (enhancement, social, conformity, coping-anxiety, and coping-depression), derived from the Drinking Motives Questionnaire-Revised. Sociodemographic characteristics, including age, gender, social grade, education, Index of Multiple Deprivation (a UK-wide measure of relative deprivation for small geographic areas), and hazardous alcohol use (Alcohol Use Disorder Identification Test), were also assessed. Descriptive analysis presents the proportion of respondents drinking no/lo at least monthly among low endorsement (ie, drinking for a motive less than half the time) versus high endorsement (ie, drinking for a motive at least half the time) of each drinking motive. Quasibinomial regression modelling explored relationships between alcohol drinking motives and no/lo consumption, accounting for sociodemographic characteristics and hazardous drinking.

Results: Drinking alcohol to conform was associated with an increased likelihood of at least monthly no/lo consumption after accounting for sociodemographic characteristics and hazardous drinking (OR 1.10, 95% CI 1.00 to 1.21, p=0.041).

Conclusions: No/lo drinks may facilitate reduced alcohol consumption by offering an alternative for individuals wishing to participate in alcogenic environments. However, those who drink alcohol to conform are not typically higher-risk drinkers, which may limit the public health benefit of no/lo drinks. Further research is needed to explicitly explore substitution effects.