Alcohol-free drinks may reduce harm, if marketing loopholes stop

By Vijay Kumar MalesuReviewed by Lauren HardakerJan 19 2026

As alcohol-free drinks surge in popularity, a new analysis in BMJ warns that without strong regulation and a focus on real substitution, these products could widen inequalities and undermine proven alcohol control measures.

Study: How should public health respond to rise of alcohol-free and low alcohol drinks? Image credit: Franck Legros/Shutterstock.com

In a recent analysis and evidence-informed policy review published in the BMJ, a group of authors examined existing research and policy evidence on the health effects of low-alcohol and alcohol-free drinks and outlined evidence-based principles to maximize potential benefits while reducing risks.

Alcohol-free drinks rise amid uncertain public health impact

Alcohol-free or low-alcohol drinks have become one of the most popular choices in the United Kingdom (UK), with 20 % of adults consuming them at least occasionally. This reflects a broader global trend towards healthier and more moderate drinking.

These products are widely available in supermarkets and social settings, where they are promoted as a safer choice. While they may help reduce health risks related to alcohol when they replace higher-strength drinks, there are still concerns about their marketing, fairness, and possible unintended consequences.

Understanding whether these drinks actually help the public to reduce alcohol consumption or primarily serve as a profit-making strategy is very important. The authors emphasize that current evidence is limited and that further research is needed to clarify who benefits most, in which settings, and at what cost.

Growing popularity of alcohol-free and low-alcohol drinks

Alcohol-free and low-alcohol drinks, commonly referred to as “no and low alcohol” (nolo) drinks, are designed to taste like traditional beers, wines, or spirits with little or no ethanol.

In the UK, these products do not contain more than 1.2 % alcohol by volume (ABV), allowing them to be called “low alcohol”. They differ from reduced-strength alcoholic drinks, which still contain sufficient alcohol to cause intoxication and long-term health harm, and from non-alcoholic substitutes such as kombucha or botanical soft drinks.

Sales of these products are booming in high-income countries due to better production techniques, wellness trends, and consumer interest in flexible drinking patterns. Analysts see this growth continuing across the world, mainly in Europe, North America, Asia, and parts of Africa.

However, despite rising popularity, nolo drinks still account for a small share of total alcohol sales, highlighting the gap between consumer awareness and actual substitution at the population level. Since many of these items share branding with alcohol, they may be changing how people view drinking.

Public health benefits of substitution

The main potential health benefit of alcohol-free and low-alcohol drinks is that they replace drinks high in ethanol. When people choose these products over standard alcoholic beverages, the risk of alcohol-related harm may go down. This is especially relevant for heavy drinkers, people with limited resources, and those who drink in high-risk situations such as during pregnancy, adolescence, or before driving.

Studies suggest that some people are already switching to alcohol-free drinks. Still, the scale of this substitution appears modest, and the effects may be too small to deliver substantial population-level health gains. At social gatherings like pubs and restaurants, these drinks may help people participate without consuming alcohol or feeling left out. They may also support attempts to cut down on drinking, although evidence of their effectiveness in addiction treatment or recovery settings remains limited and should not be assumed.

Not everyone is switching to alcohol-free drinks equally. As these products often have similar pricing to alcoholic drinks, people in lower socioeconomic groups, who experience higher alcohol-related harm, use them less. Without targeted policies, alcohol-free drinks might therefore make health inequalities worse, not better.

Marketing practices and emerging risks

Though alcohol-free and low-alcohol drinks may offer some benefits, they also raise serious public health concerns. One major issue is surrogate marketing, where alcohol brands use alcohol-free variants to bypass advertising bans. By using shared branding, similar packaging, and sponsorship of sporting events, alcohol companies can maintain brand visibility in spaces where traditional alcohol marketing would otherwise be restricted, such as televised sporting events or family-oriented venues.

There are also concerns that these products or their marketing may trigger cravings among people in recovery or act as cues for drinking during pregnancy or attempts to abstain. The authors stress that evidence for these effects is limited and often dated, but they argue that the potential risks warrant caution. Due to surrogate marketing, children and adolescents may be exposed to these products at a young age, potentially normalising alcohol brands before the legal drinking age, even though robust evidence of “gateway effects” is not yet established.

In addition, alcohol-free spaces such as gyms, family events, and workplaces help set social norms. Allowing alcohol-branded products in these places may weaken boundaries that protect vulnerable groups. However, some consumers may welcome alcohol-free alternatives in such settings, particularly where soft-drink options are limited.

Industry influence and policy challenges

Another challenge lies in the role of the alcohol industry in framing alcohol-free and low-alcohol drinks as a solution to alcohol-related harm. By promoting these products, companies may position themselves as public health partners while simultaneously resisting more effective measures such as pricing controls, advertising restrictions, or reduced availability of high-strength alcohol.

International guidance from the World Health Organization (WHO) has emphasized that substitution should not be used to circumvent existing regulations or expand alcohol marketing to new audiences. Nevertheless, policy responses vary widely between countries.

Some governments have extended alcohol marketing restrictions to include alcohol-free products with shared branding, while others permit sponsorship and advertising under existing loopholes, leading to uneven protection of public health across regions and between more tightly regulated and more liberal alcohol markets.

Labeling practices further complicate the issue. Terms such as “light” or “reduced alcohol” may mislead consumers about actual alcohol content, undermining informed choice.

Principles for a precautionary public health response

A precautionary approach to alcohol-free and low-alcohol drinks prioritizes public health over commercial interests without assuming either major benefits or harms in advance. Key principles include promoting genuine substitution away from higher-strength alcohol, ensuring equal visibility of alcohol-free options in licensed premises, and protecting alcohol-free spaces from brand encroachment.

Policies should aim to create clear regulatory definitions that distinguish alcohol-free drinks from reduced-strength alcohol and soft drinks. Price incentives, availability standards, and social marketing campaigns may help encourage substitution, particularly among high-risk groups. At the same time, marketing restrictions should apply equally to alcohol-free products that share branding with alcoholic beverages. Transparent policymaking is needed to protect public health from industry influence, drawing on lessons from other consumer-product harm-reduction debates, such as e-cigarettes and reformulated foods.

No-alcohol drinks offer promise but no guaranteed solution

Alcohol-free and low-alcohol drinks present both an opportunity and a challenge for public health. When they genuinely replace higher-strength alcohol, they may reduce disease, injuries, and social harm. However, current evidence suggests that both benefits and risks remain uncertain and context-dependent. Without clear rules and regulations, these products could promote harmful marketing practices and distract from proven alcohol control measures.

A balanced, precautionary approach that promotes substitution, protects at-risk groups, and limits commercial influence is essential. Strengthening the evidence base and aligning policies with public health priorities will determine whether alcohol-free and low-alcohol drinks become a meaningful tool for harm reduction or a missed opportunity.

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