The study examined sex-specific changes in beverage preference by age group in three Swiss linguistic regions, the relationship between preference and self-reporting of alcohol-related problems, and sociocultural and linguistic influences. A sample of 953, interviewed in 1987, was reinterviewed in 1995. Preference differed by region and remained relatively stable. Only young adults changed, adopting typical regional patterns. Self-reporting, and remission and incidence of problem-reporting, were related to total intake and to changes in total intake, but only at younger ages to changes in preference. Beverage preference has little value as a predictor of self-reporting of problems.