Understanding Purchasing Patterns of Alcoholic, Alcohol-Free, and Low-Alcohol Drinks: A Latent Profile Analysis

BackgroundAlcohol-free and low-alcohol (no/lo) drinks ([&le;]1.2% ABV) are increasingly popular in high-income countries. Their potential to reduce alcohol-related harm depends on who buys them, in what quantity, and their incorporation into overall drinking patterns. We aimed to (i) compare characteristics of purchases containing only no/lo drinks, only alcoholic drinks, or both, over time between 2018 and 2023; (ii) identify subgroups with distinct purchasing patterns in 2023; and (iii) describe purchasing and soiodemographic differences between these subgroups. DesignLatent profile analysis of cross-sectional household purchasing data. SettingGreat Britain, 2018 and 2023. ParticipantsNationally representative samples of 30,401 (2018) and 28,254 (2023) households. 4,975 households who purchased no/lo drinks in 2023 were included in the latent profile analysis. MeasurementsData included off-trade (i.e. shop) purchases categorised into: no/lo-only; alcohol-only; or no/lo alongside alcohol. Household characteristics were frequency of each purchase type; standard servings of no/lo drinks per adult; alcohol risk levels based on weekly units of alcohol purchased per adult in household (non-drinker: 0 units; low-risk:[&le;] 14 units; increasing risk: >14[&le;] 35 units; high-risk: >35 units [1 unit = 8g alcohol]); household age; social class; region; and ethnicity. FindingsFrom 2018 to 2023, the proportion of purchases that were alcohol-only fell from 97% (95% CI: 97%-97%) to 95% (CI: 95%-95%) while no/lo-only purchases rose from 1.4% (CI: 1.3%-1.4%) to 2.7% (CI: 2.7%-2.8%) and no/lo alongside alcohol purchases rose from 1.2% (CI: 1.2%-1.2%) to 1.9% (1.9%-2.0%). In 2023, no/lo-only purchases contained fewer servings (median = 6.9) than no/lo alongside alcohol purchases (median = 6.5 plus 24.5 alcohol units) and alcohol-only purchases (median = 24.6 units). No/lo-only purchases occurred earlier in the week, no/lo alongside alcohol purchases peaked on Fridays and Saturdays. Latent profile analysis identified three classes: (i) no/lo triers (53%) averaged 2.1 no/lo servings per adult annually with 95% purchasing no or low-risk levels of alcohol. (ii) Occasional purchasers (34%) averaged 7.5 servings with 20% purchasing alcohol at increasing or high-risk levels. (iii) Dual purchasers (13%) averaged 37.8 servings with 39% purchasing alcohol at increasing or high-risk levels. Dual purchasers and occasional purchasers were older than no/lo triers (60% [p<0.001], 54% [p=0.010], and 49% 55 years respectively). Dual and occasional purchasers were more often white than no/lo triers (97% [p = 0.014], 97% [p=0.0074], 94% respectively). ConclusionsIn Great Britain, most households purchasing no/lo drinks do so infrequently and purchase alcohol at low-risk levels; however, a smaller group of older, higher-risk households purchase no/lo drinks more frequently.