John Holmes and colleagues argue for a precautionary approach that is guided by public health interests and considers both risks and benefits.

Sales of alcohol-free and low alcohol (nolo) drinks have increased substantially over recent years, driven by improved manufacturing techniques and consumer demand for better and healthier alternatives to alcoholic drinks (box 1).1 Nolo drinks have obvious potential to improve public health, depending on who drinks them, to what extent, and in which contexts. The more people replace alcoholic drinks with nolo alternatives, the more they reduce their risk of alcohol related disease and injury. This is particularly true for heavier drinkers, those in lower socioeconomic groups, and people drinking in high risk circumstances, such as when pregnant, driving, or in adolescence....