The popularity of nonalcoholic beverages (NABs) that mimic alcoholic drinks has been rising in the United States, with sales increasing 15% to 30% annually since 2018. This article explores the implications of NAB use among youth, the regulatory landscape in the US, and the potential need for more stringent controls to protect minors.

Rise in Popularity of Nonalcoholic Beverages

Nonalcoholic beverages, including beer, wine, liquor, and “mocktails,” are becoming increasingly popular:

• Sales Growth: US sales of NABs have grown by 15% to 30% annually since 2018.
• FDA Definition: The US Food and Drug Administration defines nonalcoholic beer and wine as having less than 0.5% alcohol by volume (ABV).

Youth Exposure and Use of NABs

Concerns are emerging about how NABs may socialise young people to alcohol-drinking experiences:

• Lack of Research: There is limited research on NAB use broadly and no studies focusing specifically on US youth.
• Japanese Studies: Research from Japan, where no laws restrict minors’ use of NABs, shows:
  • Prevalence: 20% to 30% of elementary, junior high, and high school students reported using NABs.
  • Interest in Alcohol: NAB use was associated with a greater interest in alcohol among elementary schoolers.
  • Precursor to Alcohol Use: NAB use preceded alcohol use in over 20% of junior high school students and was strongly associated with lifetime and past 30-day alcohol use during junior high and high school years.

Taiwanese Study

A study conducted among high school students in Taiwan revealed similar trends:

• NAB Consumption: 19% drank NABs in the past year, while 28% drank alcohol.
• Influencer Marketing: Nearly a third were exposed to NAB marketing by influencers, and 41% were exposed to alcohol marketing.
• Marketing Impact: Exposure to NAB influencer marketing was linked to purchasing and drinking NABs and increased intentions to purchase or drink alcohol among those who had not previously done so.

Regulatory Landscape in the United States

In the US, there are currently no federal regulations governing the sale of NABs to minors. A survey of state-level policies revealed significant gaps:

• State Regulations: Out of 51 responses from state alcohol regulatory authorities, 39 (76.5%) confirmed there was no state-level policy regulating NAB sales to minors.
• Departments of Health: All 37 responding state departments of health denied regulating NABs, often referring to state alcohol regulators.
• Other Departments: Three state departments of agriculture and one department of inspections, appeals, and licensing also denied regulating NAB sales.

Implications for Public Health and Policy

The lack of formal regulations leaves minors legally able to purchase NABs in most states. This regulatory gap raises concerns about potential increases in NAB use among youths and the possible normalisation of alcohol consumption behaviours.

The burgeoning popularity of NABs and the regulatory gaps in the US highlight the urgent need for tailored interventions and policies to protect minors from early exposure to alcohol-like products. With increasing sales and influence by social media marketing, the possibility of NABs gaining traction among young people could have significant public health implications.

Source: JAMA Pediatrics