Do the reasons people drink alcohol aid our understanding of sociodemographic differences in alcohol-free and low-alcohol consumption? A path analysis on a cross-sectional study of adult alcohol drinkers in Great Britain

Introduction

In the UK, consumption of alcohol-free (< 0.05% ABV) and low-alcohol (≤ 1.2% ABV; NoLo) drinks is more prevalent among heavier drinkers and socially advantaged groups. If heavier drinkers are substituting alcoholic drinks with NoLo drinks, this could improve public health. However, socioeconomic differences in consumption could exacerbate alcohol-related health inequalities. Socioeconomic groups vary in their reasons for drinking alcohol, with less advantaged individuals more likely to drink alcohol to cope. This study examined whether alcohol drinking motives can help explain differences in NoLo consumption.

Methods

A total of 2549 adults residing in Great Britain provided data on at least monthly NoLo consumption, hazardous drinking (AUDIT-C), alcohol drinking motives, social grade, education, age and gender, via the Alcohol Toolkit Study. Path analysis explored mediating effects of drinking motives between sociodemographic characteristics, hazardous drinking and NoLo consumption.

Results

Drinking alcohol to conform, education and hazardous drinking were positively associated with NoLo consumption. Drinking alcohol to cope with depression was a serial mediator between social grade and NoLo. Drinking to cope with depression, more frequently reported among lower social grades, weakened the positive relationship between hazardous drinking and NoLo consumption (β = −0.001, 95% CI −0.002, −0.000). Enhancement and social motives also weakened this relationship, partially mediating pathways between age, gender, education and NoLo consumption.

Discussion and Conclusions

While hazardous drinking is positively associated with NoLo consumption, for those drinking to cope with depression, for enhancement or for social reasons, this effect diminishes, potentially limiting the public health potential for those who drink for these reasons, including disadvantaged groups.

Key Point Summary

There is increasing evidence that alcohol-free and low-alcohol (NoLo) drinks are more likely to be consumed by the more socially advantaged, which could lead to an increase in health inequalities

This study seeks to understand whether the reasons people drink alcohol, captured using items from the Drinking Motives Questionnaire—Revised, can help explain sociodemographic differences in NoLo consumption, with a particular interest in understanding the socioeconomic differences observed.

Drinking alcohol to cope with depression was found to mediate the relationship between social grade and NoLo consumption by weakening the positive relationship between hazardous drinking and NoLo consumption. Drinking alcohol for enhancement and for social reasons also reduced the relationship between hazardous drinking and NoLo consumption.

Alcohol drinking motives may help us better understand who is likely to substitute alcohol with NoLo and benefit from public health policies to increase the availability of NoLo drinks to reduce alcohol-related harm.