Cutting consumption without diluting the experience: Preferences for different tactics for reducing alcohol consumption among increasing-and-higher-risk drinkers based on drinking context

Contexts in which people drink vary. Certain drinking contexts may be more amenable to change than others and the effectiveness of alcohol reduction tactics may differ across contexts. This study aimed to explore how helpful context-specific tactics for alcohol reduction were perceived as being amongst increasing-and-higher-risk drinkers. Using the Behaviour Change Technique Taxonomy, context-specific tactics to reduce alcohol consumption were developed by the research team and revised following consultation with experts in behaviour change. In four focus groups (two online, two in-person), N = 20 adult increasing-and-higher-risk drinkers in the UK discussed how helpful tactics developed for four drinking contexts would be: drinking at home alone (19 tactics), drinking at home with partner or family (21 tactics), in the pub with friends (23 tactics), and a meal out of the home (20 tactics). Transcripts were analysed using constant comparison methods. Participants endorsed four broad approaches to reducing alcohol consumption which encompassed all the individual tactics developed by the research team: Diluting and substituting drinks for those containing less alcohol (e.g. switching to soft drinks or no- or low-alcohol drinks); Reducing external pressure to drink (e.g. setting expectations in advance); Creating barriers to drinking (e.g. not buying alcohol to keep at home or storing it in less visible places), and Setting new habits (e.g. breaking old patterns and taking up new hobbies). Three cross-cutting themes influenced how applicable these approaches were to different drinking contexts. These were: Situational pressure, Drinking motives, and Financial motivation. Diluting and substituting drinks which enabled covert reduction and Reducing external pressure to drink were favoured in social drinking contexts. Diluting and substituting drinks which enabled participants to feel that they were having ‘a treat’ or which facilitated relaxation and Creating barriers to drinking were preferred at home. Interventions to reduce alcohol consumption should offer tactics tailored to individuals’ drinking contexts and which account for context-specific individual and situational pressure to drink.Author summary: Reducing alcohol consumption is a public health priority in the UK. The contexts in which people drink are highly variable. This has implications for intervention development as i) Certain drinking contexts may be more amenable to change than others, both in terms of whether people drink at all and how much they drink and ii) Tactics for alcohol reduction could be more or less applicable in different drinking contexts. In this study, increasing-and-higher-risk drinkers discussed alcohol reduction tactics developed by the research team for inclusion in an effective and popular alcohol reduction app, Drink Less. Twenty increasing-and-higher-risk drinkers participated in four focus groups (two online, two in-person). Participants endorsed four broad approaches to alcohol reduction which encompassed the alcohol reduction tactics developed by the research team; Diluting and substituting drinks, Reducing external pressure to drink, Creating barriers to drinking and Setting new habits in the context of an alcohol reduction app. Three cross-cutting themes, Drinking motives, Situational pressure and Financial motivation influenced how applicable these broad approaches, and individual tactics they encompass, were across drinking contexts. This work highlights the importance of accounting for drinking practices and offering tailored support within alcohol reduction interventions.