Trends in motives for attempts to reduce alcohol consumption among risky adult drinkers in England: A representative population survey, 2017-2024.

Background: Understanding the motives for reducing alcohol consumption, how they differ among various population groups, and how they have evolved over time is crucial for designing effective public health interventions. This study estimated time trends in motives for attempts to reduce alcohol consumption among risky adult drinkers in England between 2017 and 2024 and explored differences by sociodemographics and alcohol consumption levels. Methods: Data came from a nationally representative survey (Alcohol Toolkit Study), assessing 11,974 risky adult drinkers (mean [Standard Deviation] age= 45.8 [15.7] years, 60.1 % men) who made a past-year reduction attempt between January/2017 and August/2024. Participants reported factors motivating their most recent attempt (not mutually exclusive). We estimated time trends in the proportion of attempts to reduce alcohol consumption motivated by health concerns, cost, social factors (i.e., peer influence/support) and health professional advice, and calculated prevalence ratios (PRs) to compare changes in prevalence across the whole time series. Results: Over the time series, there was a small increase in the proportion of attempts motivated by health concerns (70.5-76.8 %; PR=1.09, 95 %CI1.01-1.18). Attempts motivated by cost and social factors nearly doubled (10.7-20.2 %; PR=1.89, 95 %CI1.37-2.60; 13.3-25.5 %; PR=1.92, 95 %CI1.46-2.52, respectively). Attempts driven by health professional advice increased (4.4-7.0 %; PR=1.57, 95 %CI0.96-2.57). Women, individuals from less advantaged social grades and with AUDIT-C 5-7 exhibited more pronounced changes in the proportion of attempts motivated by health concerns. Cost was a more consistent driver of attempts for those aged≥ 65. Conclusions: Health concerns remain the most common motive for attempts to reduce alcohol consumption, but the proportion of attempts motivated by cost and social factors nearly doubled over the study period. These findings suggest the need for public health interventions that consider both economic and social influences alongside health concerns to better support alcohol reduction.