BACKGROUND AND AIMS: The United Kingdom Government is committed to reducing alcohol consumption through increasing the availability of alcohol-free and low-alcohol (No/Lo) drinks; however, little is known about whether these products are equally available across different types of neighbourhoods, which may have implications for inequalities in potential health benefits or harms from exposure to No/Lo drinks. This study measured differences in the availability and sales of No/Lo products in small retailers across disparate types of neighbourhoods in Great Britain and over time.

DESIGN: A longitudinal geographic design using retail transaction data collected over 20 weeks seasonally distributed between 2018 and 2022.

SETTING: The study was conducted in Great Britain (England, Scotland and Wales).

PARTICIPANTS/CASES: 11 278 479 alcohol transactions across 1432 small retailers in neighbourhoods with varying levels of socioeconomic deprivation and urbanicity.

MEASUREMENTS: No/Lo products were defined as alcoholic-mimic beverages containing ≤1.2% alcohol by volume (ABV). Each week, we calculated retail-level outcomes measuring No/Lo product availability defined as product range and sales volume (standardised as the number of serving units). Zero-inflated Poisson regression models were used to assess differences in these outcomes by neighbourhood income deprivation and urbanicity over time.

FINDINGS: No/Lo sales volume tripled over the study period yet accounted for only 0.25% of total alcohol sales by 2022. In 2018, 34% of retailers reported sales of No/Lo products, rising to 68% by 2022. Retailers in low-deprivation areas were more likely to sell No/Lo products and sold a wider product range compared with those in high-deprivation areas ([incidence rate ratio (IRR) = 2.30, 95% confidence interval (CI) = 1.60-3.30 in 2022). No/Lo alcohol sales volume was statistically significantly higher among retailers in the least deprived neighbourhoods (IRR = 1.33, 95% CI = 1.14-1.57 in 2022) and rural areas compared with high-deprivation and urban areas, but only in the most recent years.

CONCLUSION: Alcohol-free and low alcohol (No/Lo) product availability and sales increased among small retailers in Great Britain between 2018 and 2022, but these gains have been uneven, with greater access and uptake in more affluent and rural areas. This suggests emerging geographic disparities in access to and sales of No/Lo alternatives and their potential benefits or harms.