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“As with e-cigarettes and reformulated foods, we should not take market-led solutions to public health problems at face value,” wrote a group of prominent alcohol harm researchers about no-lo drinks in the BMJ this week.

There is currently no clear evidence for no-lo drinks taking the place of alcohol products to any significant degree, the piece says. Where there is some the effects “may be too small to deliver substantial health gains”. No-lo sales may be rising, but they may be supplanting soft drinks not alcoholic ones.

“No-lo drinks present risks to wider public health policy,” the piece warns. Giving alcohol interests undue credit for contributing to a reduction in alcohol harm with no-los might allow them to pose as “contributors to reducing alcohol related harm”. In turn this would give alcohol interests undue influence over policy-making, it warns.

Noting alcohol-free Corona Cero’s recent Olympic sponsorship deal, the piece says, “Ensuring alcohol marketing codes apply the same rules to no-lo drinks would prevent this encroachment of alcohol brands into previously alcohol-free forums.”

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AR comment: We should not credit no-los with the status of a solution to our alcohol problems before there is any solid evidence. Alcohol-free drinks been around for a while and a miracle has yet to occur. And yet the breathless coverage leaves a different impression.

Further research is, of course, always welcome, but common sense is a useful guide in the meantime. Alcohol companies would surely not promote a product which would seriously undermine their core business, that of selling an addictive product.

To give the benefit of the doubt on this not only gives alcohol interests a foot in the door to health policy discussions, it allows them to crowd out discussion of harm reduction policies that have solid evidence to back them up. There is good reason to resist the hype.

On the individual level it is surely wrong to emphasis the benefit of replacing one type of drink with another. Promoting no-los encourages us to participate in the trickiest scenarios to navigate minus alcohol.

Instead, why not encourage a wider focus on recreational activities which are not centred on beverages of any kind? ■

Alcohol products were as affordable or became more affordable in most countries over the last few years, when evidence shows that reducing affordability is a crucial step to curbing alcohol harm, found a WHO report released yesterday.

Beer was at least as affordable in 69% of the countries where data was available when prices in 2025 werecompared to two years earlier. For spirits this was the case in 78% of countries. This was often because alcohol taxes failed to match inflation.

“Most alcohol taxes remain low and are not optimally designed,” the report says. Alcohol interests are strongly opposed to raising alcohol taxes because it reduces their profits which derive in large part from higher levels of consumption.

At least 167 of the 181 countries surveyed applied national-level alcohol excise taxes to at least one type of alcohol product, with most of the rest banning the sale of alcohol. Wine is not specifically taxed in 25 countries, 14 of them in Europe (see map).

The WHO launched an initiative called “3 by 35”  in July to encourage countries to reduce the affordability of alcohol, along with tobacco and sugary drinks. It hopes to see real terms price of “any or all” of these products by 50% by 2035. 

The affordability crisis is deeply unpopular, but raising alcohol taxes is not. A Gallup poll across five diverse countries–Colombia, India, Jordan, Tanzania and the US–found 69% support for higher alcohol taxes in 2023. ■

Alcohol deaths surged in the US in the wake of the covid pandemic, peaking in 2021 to almost 40% above the pre-pandemic level (see table). The alcohol death toll in 2024 was still 20% above that seen in 2019, according to the latest provisional CDC data for deaths directly attributable to alcohol. There is still no full-year figure for 2025, but extrapolating the provisional figure of 39,558 for the year to December 6th suggests alcohol deaths are likely to be at least 11% higher than in 2019. Provisional figures typically increase because the CDC data collection network adds to them over time. The provisional figure for 2024 increased by a thousand since Alcohol Review first reported it in April, adding three percentage points in the comparison to 2019. ■

The Trump administration this week advised Americans to “consume less alcohol for better overall health”, dropping specific low-risk amounts from its guidance after 35 years. Alcohol harm experts had recommended the low-risk amount should be halved for men.

Alcohol harm experts say the official dietary guidelines should tell consumers what a low risk amount of alcohol consumption is based on robust statistical research, rather than leave it up to them to decide for themselves.

“The guidelines abandon specific consumption benchmarks—such as the long-standing limits of two drinks per day for men and one for women—leaving consumers without clear, actionable guidance.,” wrote Mike Marshall, CEO of US Alcohol Policy Alliance in an email.

Earlier drafts of the guidelines reportedly kept specific low-risk guideline amounts. Officials from the US Department of Health and Human Services had drafted a proposal to halve the recommended low risk amount of alcohol for men to one standard drink (18ml) a day like for women, said a Reuters news agency report.

The new guidelines also have other flaws, Marshall said, omitting mention of underage drinking, alcohol’s links to cancer.The US lobbing disclosure register shows the alcohol industry spent millions on lobbying efforts over the last two years. Alcohol industry hailed the new guidelines as a victory.

Alcohol deaths in the US were 20% above the pre-pandemic level in 2024 and look to have been at least 10% above in 2025, according to an Alcohol Review estimate based on provisional CDC data. These numbers tend to increase over time as data is gathered from data centres across the country. ■

Looking to the bottom of alcohol-free drink bottles can only take us so far in any bid to curtail our alcohol consumption. Even alcohol’s bogus answers to life’s problems are not to be found there.

It is true alcohol-free drinks can be tastier and healthier alternatives to sickly soft drinks. This is good. And they can also provide a useful visual prop for places hostile to people not drinking alcohol. But they are not alcohol alternatives.

To genuinely replace alcohol they would need to help us relax, feel rewarded, gain confidence, have fun, feel carefree and be sociable. Alcohol-free drinks will not do this for us. We need to look to alternative activities, not alternative beverages.

The quest for sober satisfaction turns what might be seen as an act of self-denial into one of hedonistic exploration. There are an endless array of new experiences, new skills and new social situations to be had. It is a journey not an event. 

Eleven years ago I was a standard-issue British Gen X weekend binger and then I gave alcohol for a couple of years to inform my book on alcohol. I then stayed off it for another three years, before becoming a low-risk alcohol drinker.

The first month was hard, really hard. It was not nearly enough time to find new activities or to build and find environments which suited me. But it got easier over time, until it was the new normal. One never stops learning how to make it better.

One thing that is perhaps worth sharing is that while it is nice to feel okay as a non-drinker in alcohol drinking scenarios, it is a questionable end goal. Even after more than a decade alcohol drinking scenarios can be okay for a while, but typically it is not where I would want to do for the whole night.

Not drinking alcohol around alcohol drinkers is typically very challenging and is very likely to remain so. We are, after all, literally in a different state of mind. Why fight it? Why not invest all that energy into alternative activities instead?

It is typically far easier for non-drinkers to spend time in alcohol-free environments and make one at home. So why not do that? Dodge the alcohol aisle at the supermarket and filter whatever alcohol ad and media exposure you can.

We deserve the freedom to look for the feelings we might want, be it relaxation, excitement, humour, camaraderie, whatever it might be. There is an likely activity to get closer to all of them and none of them need involve a bottle. ■

The UK’s New Year’s Honours list today recognised six people working to reduce the impact of alcohol harm, a former frontbench Labour MP, a family judge and four public health directors. 

Jonathan Ashworth, a former shadow health secretary, receives a CBE in part for advocating on behalf of the children of people with alcohol problems for the Children of Alcoholics charity. He made a poignant speech in parliament about his own experiences in 2017.

Judge Patrick Perusko receives a CBE for services to the administration of justice for his work pioneering Family Drug and Alcohol Courts in Bedford and Bedfordshire. He talked about the courts, and his background, in Oct 2021.

The honours list also recognises the work of several directors of public health. Greg Fell, president of the Association of Directors of Public Health (ADPH) and director of public health at Sheffield council, received an OBE.

MBEs went to three more public health directors: Dr Tim Allison, recently retired from NHS Highland; Dr Catherine Mbema at Lewisham council; and Professor Alice Wiseman in Gateshead, who is also vice-president of ADPH. 

Professor Wiseman’s presentation on combatting alcohol industry influence at the local level at AR2025 in March is available on the event page under the heading “Full live plenary sessions”.  ■