Barriers and facilitators to making an alcohol reduction attempt and strategies used among people who drink at risky levels in the United Kingdom: A qualitative study

Abstract

Aims: To understand the motives, goals, and strategies of attempts to reduce alcohol among people who drink at risky levels in the United Kingdom (UK).

Methods: We ran six online focus groups with people in the UK who drink at risky levels (Alcohol Use Disorders Identification Test [AUDIT] score ≥ 8; n = 26). We asked about participants’ reasons for making a reduction attempt or not, any goals they had, and any strategies used or considered. Transcripts were analysed using a codebook thematic analysis approach.

Findings: Barriers to making an alcohol reduction attempt included participants’ knowledge (e.g., not perceiving their drinking as harmful), motives to drink alcohol (e.g., coping, enhancement), and the physical (e.g., accessibility of alcohol) and social (e.g., cultural expectations) environment. Facilitators included their knowledge (e.g., realising consumption levels), motives to drink less alcohol (e.g., health-related), and social support. Goals included complete abstinence, reduction in units, improved mental health, and improved relationships. Strategies included changing drinking contexts or the behaviour within them (e.g., not drinking at home), abstinence-based strategies, and tracking units.

Conclusions: People drinking at risky levels in the UK reported a range of motives for drinking alcohol and drinking less alcohol, goals and strategies. These goals were largely inconsistent with the UK low risk drinking guidelines. Future research should assess whether alcohol reduction interventions that incorporate goals relevant to the individual, with tailored strategies based on the individual’s motives and goals for making a reduction attempt, are more effective than non-tailored strategies.