Reasons for not drinking: Demographic variation and health risk awareness among abstainers and former drinkers in a national survey.

PURPOSE: Despite a decline in drinking in the United States, current reasons for alcohol abstention remain underexplored. We aimed to estimate the prevalence of reasons for not drinking among lifetime abstainers and former drinkers, compare reasons across demographics, and examine associations between awareness of alcohol's health risks and not drinking for health reasons.

METHODS

We used data from a 2024 nationally representative online survey of U.S. adults. Respondents reporting no past-year or lifetime alcohol use (n = 1772) rated the importance of five reasons for not drinking and indicated their awareness of alcohol health risks. We used bivariate comparisons and multivariate logistic regressions to examine subgroup differences in reasons for not drinking and associations with awareness of alcohol's health effects.

RESULTS

The most common reasons for not drinking were concerns about health and impaired control. In bivariate analysis, fewer gender and sexual minority individuals cited health and impaired control as reasons for not drinking, while more Black and Hispanic respondents endorsed health concerns and family/friend concerns as reasons. Awareness of alcohol's health risks was higher among those who cited health as a reason for not drinking. In multivariate analyses, gender, race, ethnicity, sexual identity, and awareness of alcohol's effect on cancer risk remained significant correlates of reasons for not drinking.

CONCLUSIONS

The most common reasons for not drinking related to concerns about health and impaired control, and reasons varied between population subgroups. These reasons for not drinking offer candidate content for future research testing alcohol reduction messaging.