Study Reveals How ZAPs Could Act As Big Alcohol’s Trojan Horse

Zero alcohol products and adolescents: A tool for harm reduction or a trojan horse?

Exploratory study

Abstract

Introduction

Zero alcohol products (ZAPs) could reduce alcohol-related harms by acting as a substitute for alcoholic beverages. However, concerns have been raised regarding the potential for these products to expose young people to additional alcohol-related stimuli, further normalising alcohol use and acting as a gateway to underage alcohol consumption. Scarce research has examined whether these concerns are warranted.

Method

This project comprised two parts involving Australian adolescents aged 15–17 years.

• Part 1 was a series of 5 online focus groups (n = 44) that provided initial insights into perceptions of and experiences with ZAPs.
• Part 2 was a national online survey (n = 679) that assessed the generalisability of the focus group findings and identified factors associated with ZAP-related attitudinal and behavioural outcomes.

Results

ZAPs were found to be salient and attractive to Australian adolescents. Over a third of surveyed adolescents (37%) had tried ZAPs.

The focus group participants and survey respondents generally perceived ZAPs in a positive light, seeing them as a useful alternative to alcohol for both adolescents and adults who want to circumvent social expectations to use alcohol.

Some of the study participants acknowledged the potential for ZAPs to serve as a gateway to alcohol use and recommended reducing their visibility and accessibility.

Conclusion

ZAPs are likely exposing minors to additional alcohol-related stimuli potentially increasing their risk of underage alcohol consumption.

Regulatory responses to ZAPS need to protect young people from the potential adverse consequences of ZAPs exposure while enabling the products to be used by adults as an alcohol substitute.

Background

Zero alcohol products (ZAPs), also referred to as no-alcohol products, are designed to mimic the appearance, taste, and smell of alcoholic products, but contain no or very low amounts of alcohol. In most jurisdictions, beverages have to contain less than 0.5% alcohol by volume to be categorised as a ZAP. These products are increasingly popular across numerous countries and regions, including Australia, Canada, the EU, Japan, South Africa, the UK, and the US.

By replicating the organoleptic properties of alcoholic products, ZAPs could reduce alcohol use and the associated harms by acting as a substitute. However, the scarce research examining whether ZAPs act to reduce alcohol consumption among current alcohol users has yielded mixed results, with some studies finding a substitution effect and another finding an additive effect (i.e., ZAPs being consumed in addition to, rather than in place of, usual alcohol products).

British survey data from 2013 to 2019 found that ZAPs were the least commonly used technique for trying to moderate alcohol consumption, with only 6% of alcohol users using ZAPs for this purpose.

Concerns have been raised about the potential for the growing ZAPs market to increase young people’s exposure to alcohol-related stimuli. In most jurisdictions, ZAPs are not subjected to the same regulations that are imposed on alcoholic beverages in terms of where they can be sold and how they can be advertised, the exceptions being France and Norway where the marketing of ZAPs faces the same limits as alcoholic products.

Due to this lack of regulation, in many countries ZAPs can be used as a form of brand extension and a means to engage in ‘surrogate marketing’ (i.e., circumventing regulations by promoting core features of alcohol brands but not the products themselves). By advertising ZAPs using the same core branding as their alcoholic products, such as the brand name, logo, and colour schemes, producers can increase the visibility of their alcoholic brands in previously inaccessible domains, including contexts that will increase young people’s exposure to alcohol branding.

The vast majority of ZAP products sold have an alcoholic parent brand.

Therefore, ZAPs are likely to result in minors witnessing more alcohol-related stimuli, which in turn has been consistently associated with earlier and more intense underage alcohol use.

A further concern relating to ZAPs is their potential to act as a gateway to alcohol use by acclimatising young people to the taste of alcoholic beverages and the practice of consuming alcohol-branded products. While there is very little data available on this issue, a recent study in Taiwan found 15% of surveyed high school students had purchased and 19% had consumed non-alcoholic beers in the previous year. Those students who had consumed non-alcoholic beers were more likely to intend to consume alcohol over the next year.

These findings suggest a possible link between the use of ZAPs and subsequent alcohol consumption among underage people.

Concerns that ZAPs might negatively affect young people have been raised by researchers, multilateral health organisations, and health agencies.

Meaning

The present results provide valuable insights into a new area of research, revealing the ways in which Australian adolescents engage with ZAPs. Most of the surveyed adolescents recalled seeing ZAPs and ZAP advertisements, indicating that these products are highly salient to this age group.

ZAPs were generally viewed favourably, particularly in terms of being a useful alcohol alternative that can help alcohol users to consume less alcohol and a means for underage people to celebrate without using alcohol. The positive perceptions of ZAPs corresponded with over a third of respondents having tried these products and one in ten intending to buy them within the next month, and fits with research linking attitudes to ZAP consumption in the adult population.

Overall, the findings strengthen previously articulated concerns relating to underage people acquiring and using ZAPs, with some participants agreeing that they could act as a gateway to alcohol use. In addition, researchers have identified negative outcomes resulting from youth exposure to alcohol-related stimuli, and the results of the present study suggest that ZAPs might increase exposure to alcohol branding.

Focus group participants reported trying these products out of curiosity and wanting to fit in with others who were consuming alcohol, which is aligned with adolescent tendencies to seek new and adult experiences during this phase of development. The use rates observed among survey respondents were substantially higher than the 19% of Taiwanese adolescents who reported consuming ZAPs in a recent study, potentially reflecting pro-alcohol cultural norms in Australia.

Among the study participants, consumption of ZAPs often took place at home in the company of parents, who were also the most common provision source of ZAPs. Drinking ZAPs socially at home with parents could normalise the consumption of alcohol-branded products, create positive experiences around the use of alcohol-branded products, and suggest relaxed parental attitudes to using ZAPs.

While it is unclear whether this would increase children’s desire to use alcohol, the alcohol literature has shown that allowing children to have ‘sips’ of alcoholic beverages increases the risk of negative alcohol-related outcomes for children.

Developing evidence-informed communication strategies to educate parents about the potential risks associated with allowing their children to use ZAPs could be an effective method of discouraging parental provision.

In Australia, it is legal for people aged under 18 to purchase ZAPs, although some retailers are opting to refuse service to minors voluntarily.

The present findings show that Australian adolescents can easily purchase ZAPs from a range of outlets. This is of concern given the World Health Organization’s cautions about allowing minors to purchase ZAPs. The focus group discussions and survey responses also indicate that some of these purchases are taking place in licenced venues for consumption on-premises with others who are consuming alcohol. This may serve to strengthen links between consuming alcohol-flavoured beverages and socialising in these types of venues, potentially inducting minors into consuming alcohol-like products at licenced premises before they can legally purchase alcohol.

ZAPs are likely to exacerbate this issue; research shows that when alcohol brands are displayed on non-alcoholic products, young people associate the ZAPs with the corresponding alcoholic beverages. Therefore, any extra exposure to alcohol branding via ZAPs is likely to be problematic, especially if advertising occurs in spaces where alcohol advertising is prohibited to protect younger people, for example during children’s television viewing hours.

Focus group participants noted the social pressure to consume alcohol as an adult within Australian culture and growing peer pressure to use alcohol in their own social settings, which is consistent with research findings.

Some participants in the present study, and females in particular, thought that ZAPs would help adults and adolescents avoid peer pressure to use alcohol. These findings are aligned with theoretical frameworks that highlight the key role that social motivations play in underage alcohol use. For example, adolescent alcohol use has been consistently linked to desires to fully participate in social occasions by conforming to alcohol-related social norms. This is an acknowledged aspect of the ‘identity work’ involved in the transition to adulthood.

Several potential regulatory responses to ZAPs were proposed by the focus group participants that centred on reducing the visibility of ZAPs in retail outlets likely to be frequented by minors and reducing the accessibility of ZAPs for young people. Strategies that target the visibility and accessibility of alcohol can reduce alcohol-related harms, suggesting similar approaches could be useful for regulating ZAPs.

However, unlike alcohol products, the potential for ZAPs to serve as a tool to reduce harm represents a regulatory conundrum between restricting young people’s access to avoid potential gateway and alcohol-normalisation effects, while not preventing access in the context of avoiding alcohol use.

Other regulatory responses proposed in the literature, such as banning the use of ZAPs for surrogate marketing to extend alcohol branding or circumvent current alcohol marketing controls or prohibiting the sale of these products in contexts where alcohol sales are not permitted, were not proposed by the focus group participants, but could constitute effective strategies.

Levels of support for the examined ZAP policies to prevent and reduce harm were low among the survey respondents, which was in contrast to the apparent receptiveness to these policies when they were conceived by focus group participants. An advantage of focus groups compared to surveys is that they allow for more in-depth deliberation of topics via group exploration of the discussed issues. Potentially the focus group discussions relating to the possible drawbacks of ZAPs fostered a greater appreciation of these issues among the focus group participants compared to survey respondents, who primarily saw ZAPs as being a beneficial alcohol alternative.

These findings suggest that without public awareness of the potential downsides of ZAPs, support for harm-reduction strategies might be limited.

Key take-away

ZAPs are growing in popularity and could assist alcohol users to reduce their alcohol use. While these types of products could assist adults and adolescents to navigate social expectations to use alcohol, they are not without their drawbacks.

ZAPs could increase young people’s exposure to alcohol-related stimuli, normalise alcohol use, and accustom minors to the taste of alcoholic beverages, potentially increasing the likelihood that they will engage in underage alcohol use.

This study demonstrated that ZAPs are highly salient for Australian adolescents, with most of the study respondents recalling the products and their advertisements and expressing favourable views, and a sizeable minority reporting prior consumption.

Given this interest, the present findings highlight the need to treat ZAPs with caution and devise strategies to foster their potential as a tool to reduce harm while simultaneously ensuring that they do not adversely affect underage people by acting as a trojan horse for the alcohol industry.

Striking this balance will help to minimise the potential risks of these increasingly popular products.

Source Website: Science Direct