"They start on the zero-alcohol and they wanna try the real thing": Parents' views on zero-alcohol beverages and their use by adolescents.

OBJECTIVE: Zero-alcohol beverages containing 0.0-0.5% alcohol by volume may offer public health benefits if individuals use them to substitute for alcohol-containing products, thereby reducing alcohol use. There are, however, concerns that zero-alcohol beverages may encourage adolescents' earlier interest in alcohol and increase exposure to alcohol company branding. As this poses a challenge for parents, we studied parents' views on zero-alcohol beverages and their provision to adolescents. METHODS: We interviewed n=38 parents of 12-17-year-olds and used reflexive thematic analysis to interpret interview data. RESULTS: Parents considered zero-alcohol beverages to be 'adult beverages' that potentially supported reduced adult drinking but were unnecessary for adolescents. Parents were concerned that adolescent zero-alcohol beverage use could normalise alcohol consumption and be a precursor to alcohol initiation. There was a potential conflict between moderate provision in 'appropriate' contexts, and potential benefits, which were each supported by some parents. Uncertainty on health qualities was also reported. CONCLUSIONS: Parents reported conflicting and cautious views on zero-alcohol beverage provision to adolescents. IMPLICATIONS FOR PUBLIC HEALTH: As evidence on the impacts of zero-alcohol beverage availability develops, parent-targeted messages highlighting the potential risk of normalisation of alcohol use for young people could be developed, in conjunction with broader policy responses.

Which parents provide zero-alcohol beverages to adolescents? A survey of Australian parents' practices and intentions.

OBJECTIVE: Zero-alcohol beverages (<0.5% alcohol by volume) appear and taste similar to alcoholic beverages but are regulated similarly to soft drinks in many countries, blurring the distinction between alcoholic and non-alcoholic beverages. How parents view provision of zero-alcohol beverages to adolescents is likely a key determinant of adolescent consumption. We investigated factors associated with parents' provision of zero-alcohol beverages to adolescents, including attitudes toward zero-alcohol beverages and demographic, knowledge, and behavioural factors known to be associated with provision of alcoholic beverages. METHODS: We conducted an online cross-sectional survey of N = 1197 Australian parents of adolescents aged 12-17 years in April-May 2022. We examined associations with zero-alcohol beverage provision using binomial logistic regression, and with future provision intentions using multinomial logistic regression analyses. RESULTS: Factors significantly associated (p < .001) with parents' provision and future intentions to provide zero-alcohol beverages to their adolescent included beliefs that zero-alcohol beverages had benefits for adolescents (Adjusted Odds Ratio [AOR] 2.69 (provision); 3.72 (intentions)), provision of alcoholic beverages (AOR 2.67 (provision); 3.72 (intentions)), and an incorrect understanding of alcohol guidelines for adolescents (AOR 2.38 (provision); 1.95 (intentions)). CONCLUSIONS: Parents' provision and intentions to provide zero-alcohol beverages were associated with beliefs about zero-alcohol beverages as well as some factors associated with provision of alcoholic beverages. Precautionary advice to parents that the provision of zero-alcohol beverages may serve to normalise alcohol consumption may be warranted.

Vaping harms awareness messaging: exploring young South Australians' responses to vaping prevention campaign materials.

Nicotine vaping products (NVPs) pose health risks associated with nicotine dependence and increased likelihood of tobacco consumption. Despite having a secondary role in smoking cessation, recreational NVP use is increasing among younger people. Vaping prevention campaigns aim to influence views on the health risks of vaping. This study examined perceptions of Australian and international vaping prevention campaigns among 27 young South Australians aged 16-26 years who do and do not use NVPs, to inform targeting and framing of vaping risk messaging. Participants viewed example materials from three vaping prevention campaigns: 'Epidemic', 'Do you know what you're vaping' and 'Unveil what you inhale'. Focus groups and interviews assessed whether materials were easily understood, appropriate, relevant, credible and effective in health communication. Participants indicated that all campaigns would influence their thoughts and actions related to vaping. The 'Do you know what you're vaping' campaign prompted thoughts about uncertainty about individual health risks, though participants did not indicate that this was enough to motivate vaping cessation. Participants considered the 'Unveil' campaign effective, with those who did not vape indicating they would click through to access resources, and those who did vape responding well to the 'challenge' aspect of the messaging. The 'Epidemic' campaign fear appeal did not clearly prompt change in vaping views or behaviours. Campaigns using a challenge approach may generate conversation about vaping harms, while fear appeals can be dismissed by younger audiences. Evidence-based short messages and the presentation of multiple versions of content were considered effective approaches.

'I'd be willing to take that risk for the enjoyment of the time that I have': a COM-B influenced analysis of older people's perspectives on their alcohol consumption.

Objectives: To explore how older people understand, perceive, and evaluate the various factors which drive their alcohol consumption behaviours.Methods: Semi-structured interviews were conducted with 33 Australian community-dwelling older adults (aged 65+ years) who drank alcohol at least once a month. Thematic analyses identified common themes which were then mapped onto the COM-B theoretical framework.Results: Drinking behaviours were driven by a lack of capability in the form of poor knowledge regarding safe drinking behaviours and guidelines; high opportunity for consumption due to ease of accessing alcohol and its prominence in social routines; and high motivation to drink due to perceived benefits outweighing perceived risks.Conclusion: Increasing older peoples' knowledge of the risks associated with consumption and safe drinking behaviours represents a key health promotion priority in order to reduce the burden of alcohol-related harms among this group.

Prevalence of parental supply of alcohol to minors: a systematic review.

Parental supply of alcohol to minors (i.e. those under the legal drinking age) is often perceived by parents as protective against harms from drinking, despite evidence linking it with adverse alcohol-related outcomes. This systematic review describes the prevalence of parental supply of alcohol, as reported in the international literature. The review was registered with PROSPERO (CRD42020218754). We searched seven online databases (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science and Public Health Database) and grey literature from January 2011 to December 2022 and assessed the risk of bias with the JBI Critical Appraisal Checklist. Among 58 articles included in narrative synthesis from 29 unique datasets, there was substantial variation in the definition and measurement of parental supply of alcohol. Overall prevalence rates ranged from 7.0 to 60.0% for minor-report samples, and from 24.0 to 48.0% for parent-report samples. Data indicate that parental supply prevalence is generally proportionately higher for older minors or later-stage students, for girls, and has increased over time among minors who report drinking. Literature on the prevalence of parental supply of alcohol is robust in quantity but inconsistent in quality and reported prevalence. Greater consistency in defining and measuring parental supply is needed to better inform health promotion initiatives aimed at increasing parents' awareness.

"We Were Totally Supportive, of Course": How People Talk About Supporting a Significant Other to Stop or Reduce Their Drinking.

Despite the strong influence our significant others have on health behaviors such as alcohol consumption, little is known about when they are willing to provide support for changing such behaviors. We conducted interviews with 13 Australian adults who had a partner, friend, or family member who stopped or significantly reduced their alcohol consumption within the past 2 years, to understand how these significant others accounted for providing support for this behavior change as reasonable. Through thematic discourse analysis, we identified three types of accounts: (a) deontological, referring to duty or obligation to support others; (b) consequentialist, where costs for providing support were minimized or balanced; and (c) relational, attending to the importance of maintaining relationships. By identifying the principles people draw on to justify supporting a significant other who changes their alcohol consumption, this study enhances our understanding about when significant others are likely to support health behavior changes.

Heroic journeys through sobriety: How temporary alcohol abstinence campaigns portray participant experiences.

BACKGROUND: In Australia, recent years have seen a rise in the popularity of temporary abstinence campaigns, in which people pledge to abstain from alcohol for a month while raising funds for charity. In addition to their fundraising aims, such initiatives have been viewed as tools for broader behavioural and cultural change around alcohol, encouraging participants to reflect on their drinking and make longer-term changes to their behaviour. The extent to which these initiatives promote enduring change may depend on how they portray the experience of temporarily abstaining from alcohol, and how they position participants. METHOD: We conducted a thematic discourse analysis of e-mails and website content from the 2016 editions of Dry July™ and Ocsober™, two Australian temporary abstinence campaigns. RESULTS: Both campaigns featured an overarching portrayal of participation as a hero's journey through sobriety, with participants embarking on a quest to fundraise for their cause, and returning from their experience transformed. However, the campaigns differed in the way they positioned participants. Dry July™ consistently positioned participants as heroes, promoting both fundraising and reflection on longer-term behaviour changes. In contrast, Ocsober™ offered varied and inconsistent positions which were less likely to engage participants or prompt enduring changes in behaviour, for example positioning participants as alcohol abusers or on a detox. CONCLUSION: Our findings emphasise the need to attend to how campaigns materials position participants in order to strengthen the effectiveness of such campaigns as health promotion tools.

How have people who have stopped or reduced their alcohol consumption incorporated this into their social rituals?

OBJECTIVE: Limiting alcohol consumption is beneficial for health, but can be challenging given the role alcohol plays in the rituals of many social occasions. We examined how people who stopped or reduced their alcohol consumption incorporated this change within their social rituals. DESIGN: We conducted 16 semi-structured one-on-one interviews with adults aged 25-65 years, who lived in Australia and had stopped or significantly reduced their alcohol consumption in the previous year. RESULTS: Through thematic analysis, we identified four approaches to adapting drinking rituals: replacing alcohol with other drinks, replacing drinking with other social activities, changing the meaning of drinking rituals and replacing drinking occasions with activities that achieve different goals. These approaches varied in the extent to which they reflected a low or high change in the meanings and/or behaviours attached to the ritual. Approaches involving little change, such as using alternative drinks, were more readily accepted by participants' social companions than approaches involving more substantial changes such as replacing drinking with activities achieving different goals. CONCLUSIONS: Considering both the role and meaning alcohol carries in social interactions, and how else these might be achieved, may assist people to stop or reduce their drinking, without sacrificing their social lives.

'Why can't I just not drink?' A qualitative study of adults' social experiences of stopping or reducing alcohol consumption.

INTRODUCTION AND AIMS: Alcohol is ingrained in Australian culture, playing an important role in many social occasions. This can make reducing or stopping alcohol consumption challenging, as one risks rejecting, not just a drink but also the valued social norms that drink represents. This study aimed to investigate the social experiences of adults who stop or reduce their alcohol consumption. DESIGN AND METHODS: Sixteen semi-structured interviews were conducted with people aged over 25 years who had stopped or significantly reduced their alcohol consumption for at least 3 months in the past year and were thematically analysed. RESULTS: Participants found themselves stigmatised for violating expectations around alcohol consumption when they tried to stop or reduce their own drinking. Although most were able to either conceal their change in alcohol consumption or present it so that it did not challenge norms around drinking, this approach was seen as a temporary measure and not one to employ with people with whom they socialised regularly. Instead, many participants sought to change their interactions with their social group to focus on activities with which alcohol consumption was not strongly associated. DISCUSSION AND CONCLUSIONS: Reducing or stopping alcohol consumption can have positive consequences for health, yet it can also raise social challenges that individuals need to negotiate in order to maintain their social well-being. This tension suggests a need for health promotion campaigns to address the social as well as health consequences of reducing alcohol consumption. [Bartram A, Eliott J, Crabb S. 'Why can't I just not drink?' A qualitative study of adults' social experiences of stopping or reducing alcohol consumption. Drug Alcohol Rev 2017;26:449-455].