Audrey K Buelo is a Research Fellow at the Institute for Social Marketing and Health at the University of Stirling and a qualitative researcher specialising in alcohol policy evaluation and the social and commercial determinants of health. Her current work explores how alcohol pricing policies and the cost-of-living crisis have affected vulnerable demographics across the UK. She has previously worked at Public Health Scotland and as an evaluation consultant supporting third and public sector organisations. She holds an MPH and PhD from the University of Edinburgh. Audrey is passionate about conducting high-quality research that has positive real-world impact.

Abstract

‘My need for alcohol was greater than food and the basics’: Understanding affordability during the cost-of-living crisis with people who are alcohol dependent and living in deprivation in the UK

Aims: This study explores how rising living costs in the UK affect individuals who are alcohol dependent and living in deprivation. It examines how this population perceives and manages affordability during a period of escalating prices, addressing a gap in evidence beyond specific pricing policies. The research also aims to understand how strategies to afford alcohol change over time and how affordability contributes to recovery trajectories.

Methods: Participants were recruited from non-NHS alcohol and related support services across Scotland and England. Eligibility included an Alcohol Use Disorders Identification Test score of 16 or higher and reliance on benefits as the main income source. Semi-structured, face-to-face interviews explored experiences of rising costs, coping strategies, and impacts on their lives. Data were analysed using thematic analysis alongside narrative portraits to capture lived experiences of affordability.

Results: Twenty-two participants (11 Scotland, 11 England) were interviewed (median Alcohol Use Disorders Identification Test score=39, indicating severe dependence). Rising costs increased stress and, for many, alcohol consumption. No participants reported reducing drinking due to higher prices, as alcohol consumption was prioritised. Coping strategies included trading down to cheaper products, switching brands, and borrowing. A conceptual visual model was developed showing how reduced affordability contributes to recovery trajectories.

Conclusions: Participants with alcohol dependence in deprivation experience disproportionate harms from rising alcohol and living costs. Reduced affordability does not support reduced consumption in the short term but may contribute towards later recovery-seeking (or alternative negative outcomes). Policymakers should ensure targeted support measures are in place to mitigate harm, improve access to care, and address the complex needs of those with alcohol dependence living in deprivation.