Are no- and low-alcohol products a possibility or a problem in decreasing alcohol harm? This new WHO snapshot brief – produced in cooperation with Movendi International – summarizes existing evidence.

In 2021, the World Health Organization (WHO) launched the Snapshot series on alcohol policies and practice about blind spots related to preventing and reducing alcohol harm. WHO’s Less Alcohol unit is responsible for the alcohol policy briefs. So far they have published 11 policy briefs. Some of the topics include alcohol consumption and socioeconomic inequalities, addressing and managing conflicts of interest in alcohol control policies, population-wide interventions for reducing alcohol consumption and the importance of the per capita alcohol use indicator, and a health promotion approach for reducing youth exposure to alcogenic environments.

Recently, the WHO released the tenth brief in the series: “A Public Health Perspective on Zero- and Low Alcohol Beverages“.

This brief was produced in cooperation with Movendi International and Movendi International members from Norway and Thailand contributed case studies.

Key points and purpose of the brief

There is an expanding market of no- and low-alcohol beverages (NoLos), but so far evidence is lacking about the production, consumption, and potential health impact of these products.

Labelling and marketing of NoLos are not properly regulated, inconsistent across countries, and leave gaps and loopholes for alcohol companies to conduct alibi marketing and to mislead consumers. The availability of NoLos can potentially drive consumer choice and consumption and normalise alcohol use – serving as gateway products.

Inadequate regulation and the lack of clear definitions in many countries mean that NoLos presently comprise a broad spectrum of products, ranging from 0% to 3.7% alcohol by volume (ABV). “Alcohol-free” products may in some markets contain up to 2.8% ABV and low-alcohol products could contain between 0.05% and 3.7% ABV.

There is limited evidence on the effects of NoLos on overall alcohol consumption. Research to date has described both positive and negative effects on population health. While some studies argue that NoLos may help individuals move away from higher alcohol content products, other studies argue that NoLos further normalise alcohol, especially in environments where alcohol has not been present before and may promote the “taste for alcohol”, particularly among populations for whom consumption is particularly risky.

Alibi marketing and the Norwegian best practice

Alibi marketing is a particular concern when it comes to NoLos. In most countries, marketing of NoLos is largely unaddressed by laws and policies, meaning that alcohol companies can do whatever they like to market their brands by claiming that the marketing is for the NoLo variety of the brand. 

In Norway the government decided already in 1997 to extend the ban on alcohol marketing to include marketing of all brands for which there are products with an alcohol content above the limit. This extension was an attempt to stop alibi marketing of NoLo products that share a brand with alcohol products.

Evidence shows that the extension of the alcohol marketing ban led to reduced overall alcohol consumption. Reports from Movendi member organisation IOGT Norway indicate that the issue with alibi marketing was largely solved by this Norwegian alcohol policy best practice. But the policy approach is under attack by the alcohol industry. The Norwegian beer producers association is currently pushing for a removal of the ban on the marketing of NoLo products that share names and/or brands with alcohol products.

The WHO brief on NoLo alcohol products at a glance

A rapid overview of the new brief contains summaries of the problem, key evidence, case studies from different parts of the world, and an exploration of the way forward.

The problem

There is an expanding market of no- and low-alcohol beverages (NoLos), but they remain a tiny share of the overall alcohol market. Often, NoLos are portrayed as a solution for alcohol use or a “harm reduction” strategy for heavy alcohol users. Instead, NoLos normalise a culture of alcohol consumption and blur potential conflict of interest in developing public health policies.

NoLos’ effects on global ethanol consumption and overall public health are still in question. Policies and regulations about their availability, acceptability and affordability are lacking, and evidence about the benefits of NoLos is limited.

Concerns have been raised about the impact of NoLos in reducing alcohol use and related harm and about the possible drawbacks and implications, such as misleading minors, pregnant women, abstainers or those seeking to stop consuming alcohol about their actual ethanol content. Further, there are concerns about the implications of NoLo branded products being displayed close to the brand’s main alcoholic beverages and their potential to subtly lead to new occasions of consuming alcohol.

The governance of NoLo products is fragmented and inconsistent, with no standards for labelling and marketing across countries.

The evidence

There is a lack of evidence about the production, consumption and potential health impact of NoLos. Labelling and marketing of NoLos are inadequately regulated, inconsistent across countries and the alcohol industry uses this situation to deploy alibi marketing and to mislead consumers. The availability of NoLos can drive alcohol consumption and normalise alcohol consumption – serving as gateway products.

Heavy alcohol users seem to consume NoLo on top of their regular alcohol consumption. On the other end, NoLo beers did not seem to act as a gateway to regular beer consumption but rather replaced the purchase of the higher ethanol beverages, especially when made relatively more available. The extent to which substitution between NoLos and higher strength beverages occurs remains unclear.

Fiscal and pricing policies based on ethanol content may drive consumption towards lower-strength alcohol products and may support changes on both the production and consumption side.

The know-how

Experiences from the Netherlands, Nigeria, Norway, and Thailand provide insights into the possible directions for policy interventions, particularly to address the marketing, labelling and taxation of NoLos.

The way forward

  1. To understand the public health implications of NoLos, there is a need to monitor their consumption and impact on aggregated alcohol consumption.
  2. The alcohol by volume content of NoLos must be defined, harmonised and clearly labelled.
  3. NoLo marketing needs to be regulated to protect children, pregnant women and those seeking to stop consuming alcohol, for example, by extending existing marketing bans to include NoLo products.
  4. Fiscal and pricing policies to reduce the affordability of products with higher strengths of ethanol may favour a shift towards lower alcohol strength beverages; however, their effectiveness and safety should be further investigated.

Suggested citation

A public health perspective on zero- and low-alcohol beverages. Brief 10. Geneva: World Health Organization; 2023 (Snapshot series on alcohol control policies and practice). Licence: CC BY-NC-SA 3.0 IGO.

The entire snapshot series

  • Brief 1: “Addressing alcohol consumption and socioeconomic inequalities: how a health promotion approach can help” (June 4, 2021)
  • Brief 2: “Unrecorded alcohol: what the evidence tells us” (July 2, 2021)
  • Brief 3: “Addressing and managing conflicts of interest in alcohol control policies” (September 3, 2021)
  • Brief 4: “Health warning labels on alcoholic beverages: opportunities for informed and healthier choices” (November 8, 2021)
  • Brief 5: “Population-wide interventions for reducing alcohol consumption: what does the per capita consumption indicator say?” (November 16, 2021)
  • Brief 6: “Digital marketing of alcoholic beverages: what has changed?” (December 9, 2021)
  • Brief 7: “Policy response to alcohol consumption and tobacco use during the COVID-19 pandemic in the WHO South-East Asia Region: preparedness for future pandemic events” (July 2022)
  • Brief 8: “A public health perspective on alcohol establishments: licensing, density and locations” (November 2022)
  • Brief 9: “Policy, system and practice response to alcohol consumption during the COVID-19 pandemic in seven countries of the WHO African Region” (October 2022)
  • Brief 10: “A public health perspective on zero- and low-alcohol beverages” (April 2023)
  • Brief 11: “A health promotion approach for reducing youth exposure to alcogenic environments” (September 2023)

Source Website: World Health Organization