Does the non-alcoholic craze just keep us drinking?
Everyone needs their vice. For me, it’s tacos. Tacos and a cheap can of beer. But each January, the tacos hit differently because the beer is gone. I’ve been Dry Januarying for longer than I can remember, and will be the first to praise the hashtag. Over time, mine has extended to February, March, and now through most of the year until the Midwest grows cold and the parties feel cozy.
The annual reset offers me a health tune up, and a cessation of habit—and that’s true for up to half of us who report that Dry January curtails drinking longer term. A glass of champagne or the occasional paloma gets swapped for seltzer and a splash of juice—or god forbid, tap water (*shivers*)—and I cease reflexively grabbing something alcoholic to celebrate a hard day’s work.
Whereas I used to quietly mainline homemade gingerade for the month while sidestepping the judgement of friends, the big brandification of sobriety means that my local liquor store eagerly emailed me on January 1 this year, inviting me back to try their Willy Wonka assortment of non alcoholic beers and spirits—what’s been estimated as a $13 billion global market in 2023 and growing. NA drinks were once a mark of shame, but now they’re the popular kids, with enticing flavors, sharp labels, and a tempting, ever-so-sanctimonious halo effect of self-care in an era when we should know better.
“Any level of alcohol is bad for you,” notes Daniel Roche, echoing warnings from the former Surgeon General. Roche is an assistant professor at the University of Maryland School of Medicine who studies alcohol and nicotine addiction. “Going back 10 to 20 years, there was still some argument that there might be some benefits of alcohol, but now, any level of consumption is associated with almost every cancer.”
At face value, the NA movement is a boon for health. But I’ve also had the creeping suspicion that it’s too convenient. This is the first Dry January where I’ve found myself chipping away at a 12-pack of (NA) Budweiser, its white and silver cans glinting in the light like vermeil clydesdales. I’ve been enjoying the bite of hops chasing a rich al pastor, my palate convinced that I’m drinking the real stuff, to the point I’ve been asking myself if I should run back to the store to grab another pack.
I haven’t had a drop of alcohol in weeks, but I still wonder: Am I really giving up drinking this month, if I’m still drinking beer? Am I breaking any habit if I’m reaching into a cardboard box labeled by Anheuser-Busch InBev?
The answer is maybe. And maybe not. Through conversations with half a dozen addiction clinicians and researchers, experts firmly agreed that the proliferation of non-alcoholic beverages pose a net gain for public health. But they generally concurred that I may be onto something. There is little known about how non-alcoholic beverage affect our long-term relationships with drinking, and they could come with risks of their own—namely, keeping us dependent on the rituals of alcohol at the opportunity of breaking up with it entirely.
“We’re still sorting that out,” says Kenneth Leonard, director of the Research Institute on Addictions at University at Buffalo, noting that anything that cues the sensations of alcohol might lead some to seek the real thing. “It could certainly elicit some interest in returning and having an alcoholic beverage, and maybe saying, ‘I can just have one, or maybe I can have a couple.’”
Our changing treatment of addiction
To reiterate, the experts I talked to ranged from ever so positive to quite bullish on the proliferation of non-alcoholic products. While many shared light, curious concerns, they agreed that anyone from a light drinker (consuming 1 to 2 drinks a day) to a heavy drinker (who consumes 4 to 5) might benefit from trying them.
The key reason for their support is that the medical community’s approach to addiction has shifted over time. Traditional programs like Alcholic’s Anonymous (which did not respond to comment) coach the complete cessation of drinking—which has often even included non alcoholic beers, in case they might trigger a relapse. But over the past few decades, clinicians have softened their approach in treating addiction from abstinence to what’s known as “harm reduction.”
“I think in the clinical world that there’s recognition that people are not going to change in ways they don’t want to change,” says Leonard. “You have somebody come in for treatment for an alcohol use problem, and they say, ‘I want to cut down on my drinking,’ you know, a clinician is not going to say, ‘well, I’m only going to treat you if you’re committed to abstinence.’”
Even though abstinence is the ideal long-term outcome to most clinicians, they acknowledge human nature, and will take what they can get. If an NA drink swaps out just one alcoholic drink, they are less concerned about the potential for unknown, long-term consequences than this singular net gain—and having a patient take a first potential step in a greater path to recovery.
“The science has progressed at this point,” says Joel Sprunger, a clinical psychologist in the addiction sciences division at the UC College of Medicine. “If I can get somebody to go from drinking a 12-pack a night to six-pack a night, it’s still a lot, but it’s half. Being able to make that change can build momentum…let’s cut it in half again. Now I’m going to go from six to three, and then from three to one, and then maybe ‘I don’t need it’ after a while.”
The science of habits
Breaking an addiction to ethanol is particularly difficult, but all new habits take time to form: an average of 66 days (though as many as 258), according to a landmark study published in 2009 that followed nearly 100 people as they charted new behaviors in drinking, eating, and activities like running.
Phillippa Lally, who is now the Co-director of Habit Application & Theory Research Group at the University of Surrey, was the lead author on this study. And she is quick to caution, per her own research, that the single month of January won’t be long enough for many people to break any habit. However, as for the effect of swapping a beer for an NA beer, she believes it could actually be beneficial to cut back consumption long term.
“You can’t easily break a habit . . . particularly not just by consciously stopping yourself from doing it. It takes effort every time. So, you could exert this effort for the whole of January and then stop and you haven’t broken the habit,” Lally writes via email. “Substitution is a potentially useful approach to break a habit: Form a new habit that is stronger than the old one. Choosing a substitute that meets the same goals as the original habit is also a good idea, so a NA drink is a potentially good approach to that too, because it meets the goal of having a drink, potentially of being social, of the enjoyment of the flavor (presuming you do enjoy the flavor).”
In psychological theory, Lally is correct. In the actual practice of consuming alcohol, she might not be. A study from 2022 tracked beer purchases across 64,280 British households over three years. It asked the question that we are now: Do low and no ABV beers reduce our drinking? In this study, alcohol alternatives were consumed in small overall amounts at a population level: regular beer outsold NA beer at a rate of 32:1. But what it found was striking, and you can see it for yourself on the timeline below. Once households started buying “nablab” (no and low alcohol beer), they did consume less alcohol overall. Nablab purchases offset 22.5% of regular beer drinking—and that shift in habit continued even a year later. But they also kept on buying normal beer, albeit not as much. (It’s also worth noting that another study looking at no and low-alcohol beverages in Great Britain and Spain found little benefit in their consumption: These lighter options were linked to lower mortality rates, but at such low levels it was a moot intervention.)
In other words, NA drinks appear to reduce consumption by someone who drinks, potentially long term, but they aren’t a proven gateway to full sobriety, either. People who started drinking NA beers were still drinking the same, diminished amount of alcohol from the first day they bought an NA beer to a year later. While the study’s author did not respond to request for comment, Roche is bullish on the findings, and says he could imagine those nablab drinkers really could kick the habit longer term, but that we don’t yet know. His take on NA drinks is optimistic but measured.
“I don’t know that I would come out and say I fully support it, but also I’m not strongly against it either,” says Roche. “I think, you know, having more options available to people as they make more informed decisions about the role that they want these beverages to play in their lives is a good thing.” Indeed, one study found that simply by expanding the number of different NA options available next to alcohol increased their rate of purchase. So the proliferation of NA drinks itself likely means more of us will be drinking them.
Breaking the links between drinking and our identity
Yet I can’t help but wonder if drinking these convincing mocktails or NA beers is only perpetuating our identity as drinkers. And that’s a point that could make you stick with a habit you might otherwise try to kick completely.
“There is . . . a question of identity here,” writes Lally. “If people identify as doing dry January, then they are likely to drink again in February. Whereas if they identify as someone who no longer drinks, or drinks rarely, it’s more likely to stick, but that is likely harder to encourage people to.” Could the same be true to someone who still cracks a “beer” with their tacos?
An alternative approach, Lally notes, is to remove cues that lead us to drink, whatever they may be. “If these are removed permanently then the change should stick,” she continues. “However, a lot of the cues are things we can’t remove from our lives.”
Indeed, alcohol is closely associated with every major social activity for adults—which is both cultural and the result of omnipresent marketing (see: the NFL). “Whether we’re talking about dating, whether we’re talking about picnics or end of year parties or retirement parties or all those things, there’s always celebrations,” says Leonard. “There’s wine, beer, champagne, all those opportunities. And so you have to sort of imagine, what would those events be with[out alcohol]. You know, maybe they would be fine.”
The researchers I spoke to agreed that throwing back a few NA drinks at a party was a healthy behavior—and it might even help you deal with social anxiety. If you strongly associate beer with being a social lubricant, well, studies show the placebo effects may come along with it. You may actually get chattier and jollier drinking NA beer. “But I think eventually, that’s going to peter out well without the drug on board,” says Roche. And your association between celebration and consumption may naturally fizzle out, too.
“In traditional conditioning models of learning, you have a conditioned stimulus, which is beer, and you have an unconditioned stimulus, which is alcohol. The way you extinguish that is, you present the beer cue without the alcohol. And then that should weaken that learning of this really positive, associative factor [of a buzz],” says Leonard. ”But we don’t have the data on that.”
What else can we do after dry January?
If you’ve read this far, then you might be wondering, what other actions either you or the industry at large can do to reduce the consumption of alcohol. In fact, we do have some data on just that.
For the industry, one study has calculated that, if the producers were to reduce the ABV in drinks across the board by 10%—an amount that would be largely unnoticeable in many contexts—we could reduce overall mortality rates by up to 1.26%. For mass public health, reducing alcohol in alcoholic beverages could make the biggest immediate impact simply because people would drink less ethanol for the same volume of beverage. Similar research on tobacco has even demonstrated that, by swapping cigarettes for lower nicotine cigarettes for six weeks (in randomized double blind trials), people reduced their dependence on and craving for nicotine. Simply offering less of a drug seems to be a good way to get people to consume less of it: even making cups smaller can lead people to drink less at parties.
As for individuals, drinking can be a tough habit to break without breaking up with your rituals and social circles associated with it. But if you want to make abstinence feel easier, one of the most effective things you can do is to make more plans for the morning. People who had activities like exercising or volunteering planned for the next day are about half as likely to drink the night before.
My biggest takeaway from a couple decades of enjoying alcohol is that, deep down, I’ve always known it wasn’t good for me—even when studies conveniently teased that a glass or two of wine a day might lengthen your life. Reaching into the fridge for an NA beer feels sneakily similar. You can never have your cake and eat it too. Something always costs something.
But I also recognize my concerns are probably vastly overblown, and in just a few years, culture is attempting to reframe and reconcile thousands of years of practices we’ve had around alcohol. Perhaps not every decision we make is perfect (and thank god or what fun would life be?)—but when it comes to our physical health, there’s almost always a better thing we can be drinking, and chances are, that glass of NA will do you more good than harm.
Liana Reid, who kicked her own heroin addiction decades ago to become a professional interventionist, puts it all pretty bluntly. “If we’re gonna save some lives, people can save some lives by switching to NA,” she says. “It won’t have the same effect. They won’t end up in another country or behind the wheel of a car killing somebody.”