Projects & Research Partnerships

Introduction

Alcohol remains a leading cause of premature death, illness and disability in the UK. While there has been significant research into alcohol-free and low-alcohol drinks, far less is known about the 'mid-strength' market – beers, ciders, wines and spirits that contain less alcohol than traditional versions but are still strong enough to cause intoxication and long-term harm.

This research is particularly important given the 2023 UK alcohol tax reforms, which introduced a strength-based tax system. This system creates new commercial incentives for the alcohol industry to produce and promote mid-strength drinks, which may be sold at competitive prices to increase profit margins or market share. This project seeks to understand how these commercial actions impact purchasing and consumption patterns.

Research objectives

This project aims to address the uncertainties surrounding mid-strength drinks by developing a clear research agenda. Specifically, it will:

• Establish a working definition of 'mid-strength' drinks through collaboration with public and professional stakeholders.
• Analyse market trends in Great Britain to determine what products are available, their prices, and where they are being purchased.
• Develop and pilot new research tools, including a survey to understand who is consuming these drinks and why.

Research activities

The project is based around three core activities designed to build a foundation for future national-scale research:

• Building stakeholder networks: Establishing a professional stakeholder group and a public involvement (PPI) group to help define 'mid-strength' and shape the research project and its outputs. This ensures the study aligns with the needs of public health policy, alcohol charities, clinical practitioners and members of the public.
  
  
• Analysing market trends: Examining trends in the volume, pack size and price of mid-strength drink sales compared to regular-strength versions across both supermarkets (off-trade), and pubs, bars and restaurants (on-trade) in Great Britain, using three major market research datasets:
  • Worldpanel by Numerator – a longitudinal, nationally-representative, household-level dataset which tracks scanned barcodes of all purchased items brought into the house each day. 
  • Circana – tracks weekly alcohol sales within shops and supermarkets
  • CGA – tracks quarterly alcohol sales within pubs, bars and restaurants
    
    
• Developing new research tools: Co-designing and piloting a cross-sectional survey to understand who is consuming these drinks, in what contexts, and why. The pilot will involve 'speak-aloud' interviews where participants describe their thought processes while responding to the survey, ensuring the final tool is clear, culturally sensitive and meaningful.

Public involvement (PPI)

Public involvement is a key component of this project, ensuring the research is accessible, inclusive and grounded in real-world experience. A diverse PPI group of eight public contributors will be established at the start of the project, recruited through existing networks.

The PPI group will be active partners throughout the project, participating in four meetings and providing feedback on key documents. Their involvement includes:

• Defining the research: Helping to shape the working definition of mid-strength drinks to ensure the study uses accessible terminology and addresses public concerns.
  
  
• Co-production of tools: Collaborating on the content and wording of the consumer survey to ensure questions are clear and inclusive for participants from diverse backgrounds.
  
  
• Inclusive dissemination: Co-producing a dissemination plan and helping to design public-facing materials, such as blogs and infographics, to ensure findings are relevant to the wider public, including underserved groups.
  
  
• Collaboration and support: Members will receive fair compensation for their time and will be offered training and development opportunities, such as building communication skills or learning about ethical research practices, to support their roles as peer researchers.

Impact and next steps

By conducting an academic market analysis of mid-strength drinks in Great Britain, this research aims to provide valuable evidence to inform national policy discussions. The project will explore whether mid-strength options have the potential to serve as a genuine tool for harm reduction or if they present public health risks that could influence health inequalities.

To ensure the findings are accessible, they will be shared through various public channels, including a short report, blog posts and an infographic co-produced with public contributors to ensure the insights are meaningful to a wide audience.

As an NIHR Career Development Award, this project supports Dr Perman-Howe's progression toward research independence. The data skills, stakeholder networks and pilot survey tools developed through this work will lay the groundwork for a future, national-level research funding application to further evaluate the public health impacts of the mid-strength market.