Sales of alcohol alternatives are surging; consumers and industry officials seek more transparency. In the fast-growing nonalcoholic beer business, "zero" doesn't always mean "none." The proliferation of sober-friendly brews, many of which still contain trace amounts of alcohol, has industry officials and consumers pushing for clarity over labels like "nonalcoholic," "alcohol-free" and "zero-proof." The debate has prompted lawsuits from consumers alleging misleading advertising, while an industry group is urging brands to abandon alcohol-free claims if they can't back them up. "When you're assuming there are zero traces of alcohol in it and then you find out that there are some, even though they're very minute, it catches some consumers by surprise," said Marcos Salazar, chief executive of the Adult Non-Alcoholic Beverage Association, a trade group. Consumers are split on where to draw the line.

A similar debate is playing out among organ donors and recipients. Tim Savoy said he began drinking nonalcoholic beverages around a year after his 2022 liver transplant for alcohol-related cirrhosis. He sticks to mostly beer alternatives and has one or two nearly every day.

Doctors have cautioned Savoy, 36 years old, about trace alcohol, and that volume matters. Savoy, a Washington, D. C., resident who works in philanthropy, knows others in the transplant community consider any alcohol consumption wrong.

He sees it as a much better alternative than regular beer, and said that routine blood work shows his liver functioning normally. "The minute that is not the case, I will completely re-evaluate," Savoy said. The process to make zero-proof and nonalcoholic drinks varies. Some brands opt to skip fermentation, which naturally produces alcohol, and instead mix ingredients such as herbs and spices in hot water before distilling the mixture.

Others control the fermentation, dilute the original formulation to reduce alcohol content, or remove alcohol through methods including vacuum distillation or filtration. But trace amounts of alcohol may remain. Removing it can require running the beverage through costly additional steps, such as advanced vacuum distillation or filtration, which some in the industry say strips out flavor. "It takes a lot of extra processing to get down to 0.0," said Athletic Brewing co-founder and CEO Bill Shufelt. "There's a major cost moat." Athletic, the largest dedicated nonalcoholic brewer in the U.S. by sales, displays its sub-0.5% alcohol by volume on its cans due to regulation, but Shufelt said the distinction is a nonissue for many customers.

He said that most of the top nonalcoholic beer brands in the U.S. have under 0.5% ABV, rather than zero alcohol. "Consumers are not looking for it, and if they are, they don't care enough about it to switch off of their brands," Shufelt said. Industry executives said that buyers of nonalcoholic brews often buy traditional alcoholic drinks, too, showing that many aren't strict abstainers. They argue that some foods, such as bread and ripe bananas, have the same or more trace alcohol than nonalcoholic drinks.

Dollar sales of nonalcoholic beer, spirits and wine in the U.S. grew more than 14% in the 52 weeks ended July 18, compared with the previous 52-week period, according to Nielsen IQ. The beverages have surged while traditional alcohol sales have stalled, with sales of nonalcoholic beer climbing to nearly $235 million for the three months ended June 27. Regulators draw a strict line: "alcohol-free" beverages must contain no trace.

Those with less than 0.5% alcohol by volume are "nonalcoholic." Some brands use terms such as 0% alcohol or zero-proof interchangeably with nonalcoholic, leaving it to the fine print to detail actual alcohol content.