In its action plan (2022-2030) to reduce the harmful use of alcohol, the WHO calls on economic operators to "substitute, whenever possible, higher-alcohol products with no-alcohol and lower-alcohol products in their overall product portfolios, with the goal of decreasing the overall levels of alcohol consumption in populations and consumer groups". In this paper, we investigate substitution at the level of the consumer based on Spanish household purchase data. ARIMA modelling of market research data of 1.29 million alcohol purchases from 18,954 Spanish households is used to study the potential impact of lower-strength alcohol products on reducing household purchases of grams of alcohol between the second quarter of 2017 and the first quarter of 2022. For households that recently bought either no-alcohol beer or wine (ABV ≤ 0.5%), the subsequent associated purchases of higher-strength beers and wines, respectively, and total grams of alcohol were reduced, the more so the higher the volume of initial purchases of beers and wines. The introduction of 20% ABV variants of same-branded 40% ABV whisky and gin during early 2021 was associated with reduced purchases of grams of alcohol within all spirits and of total grams of alcohol as a result of switching from other spirits products to the 20% variants, although not associated with reduced purchases of grams of alcohol within all variants of the studied same-branded whisky and gin; instead, an increase was observed in this category. With respect to Spanish household purchase data, the evidence behind the WHO's call for substitution is substantiated. Further research across different jurisdictions is needed to provide ongoing monitoring of the impact of potential substitution on consumer behavior and public health, including unintended consequences, with findings from research informing future alcohol policies at all levels.
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