Background: Production and use of no- and low-alcohol (NoLo) beverages has increased globally in recent years. Using data from a large international sample of people who drink alcohol, this study aimed to investigate patterns of NoLo drink consumption. 

Methods: The study utilized data from the 2022 Global Drug Survey (GDS). We used cross-tabulation and multiple correspondence analysis to understand usage patterns and identify key groupings. Results: Of the 15,686 participants reporting NoLo use, most (59%) reported drinking NoLo products less than monthly. Frequent NoLo consumption was more prevalent in relaxed environments (92%) compared to team environments (27%) and party settings (49%), with a significant relationship between heavy alcohol drinking prevalence and increased likelihood of engaging in NoLo alcohol consumption. 

Conclusions: We uncovered nuanced preferences for NoLo drinks driven by cultural, consumption, and economic factors. Heavy alcohol drinking and an increased likelihood of NoLo consumption is suggestive of a growing acceptance of NoLo beverages as substitutes for alcoholic beverages perhaps, for example, as a response to avoiding experiences of embarrassment due to drunkenness in particular social settings. This suggests a need for further research into public health policies promoting NoLo options to mitigate alcohol-related problems.