Background Patients' beliefs and attitudes toward receiving alcohol enquiry from general practitioners (GPs) are unclear. These need to be understood to implement pragmatic, early detection and brief intervention strategies. Methods We purposively sampled 23 participants from respondents of an earlier survey conducted in a general practice clinic in Sydney, Australia. Semi-structured interviews were conducted between June and August 2014, recorded, transcribed and analysed using grounded theory method to develop an explanatory model. Results There were three factors that influenced patients' acceptability of alcohol enquiry by GPs: ¿ perceived relevance of the alcohol enquiry dialogue to the consultation ¿ approach and language used in the patient-doctor interaction ¿ unease regarding the moral and stigmatising dimension of alcohol consumption. Discussion Patients are positive towards the role of GPs in health promotion, but nonetheless have reservations towards engaging in alcohol discussions. Setting the context for alcohol dialogue, linking it to patients' agendas, collaborative consultation styles and respecting patients' sensitivity may improve acceptability.