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25 Mar 2024

Evidence-based smartphone app can help people reduce their alcohol intake

Person holding a smartphone with the DrinkLess app

A new smartphone app that has been designed using evidence from behavioural science has been shown to help people reduce their alcohol intake

The free smartphone app, Drink Less, can help people who would benefit most from reducing their alcohol consumption to do so successfully, according to a large randomised controlled trial led by UCL researchers, and supported by the NIHR ARC North East and North Cumbria.

Drink Less is the first alcohol reduction app that has been systematically developed based on evidence and theory, using a person-based approach, and its design is underpinned by behavioural science.

The study, published in eClinicalMedicine and funded by the National Institute for Health and Care Research (NIHR), found that people randomly recommended to use the Drink Less app reduced their drinking by 39 units a week at six months – two more units a week on average than a control group who were referred to standard NHS advice.

NIHR ARC North East and North Cumbria Director, Professor Eileen Kaner, is a co-author of the study.

She said : “The North East suffers disproportionately from alcohol harm with the highest rates of alcohol-related hospital admissions and alcohol specific deaths in England. We know that alcohol use is a leading risk factor for ill-health and premature death, with a continuum of risk that increases with each drink. If we can support people to reduce their alcohol consumption by any level, we can reduce the alcohol-attributable health burden.”

The 5,602 participants of the study were all increasing or higher risk drinkers interested in reducing their alcohol consumption and were randomly assigned to either be sent a link to an NHS alcohol advice webpage or a link to download the Drink Less app.

Lead author Dr Melissa Oldham (UCL Institute of Epidemiology & Health Care) said: “These results show that the Drink Less app can be useful for people looking to reduce their alcohol consumption.

“Alcohol consumption can lead to many health conditions such as cancer and cardiovascular disease. About 20% of the adult population in the UK drink alcohol at levels that increase their risk of ill health and the Drink Less app could help these people to cut down.

“Reducing intake by an extra two units a week on average may seem small but is significant both in terms of preventing potential health harms as well as reducing costs to the NHS.”

The study was the first randomised controlled trial of an alcohol reduction app for the general population in the UK.

The Drink Less app allows people to set goals, record how much they drink and log their mood and sleep quality after drinking. It shows progress towards goals and can offer feedback and support with action plans for situations where users would usually drink.

Another feature is that the app shows where in the UK population users are in terms of how much they drink each week – i.e., what percentage of the population drink more or less than they do. This can be a shock as most people underestimate how much they drink compared with the general population, the researchers said. Anyone can download the app from the UK Apple App Store and see how they compare.

Participants were recruited via adverts on NHS webpages and on radio and social media, as well as via posters in GP surgeries. They were eligible if they were over 18, wanted to reduce their drinking, and categorised as an increasing or higher risk drinker based on a questionnaire assessing how much they drank.

The app was even more helpful for female participants, who reduced their drinking by an additional 2.5 units a week compared to women who were referred to the NHS advice webpage.

In a further analysis, the team estimated that if the Drink Less app were rolled out widely it would save the NHS hundreds of millions of pounds over 20 years.

Dr Sadie Boniface, Head of Research at the Institute of Alcohol Studies said: “NICE already recommends digital interventions as an add-on to existing services, so having an app which we know is effective is very welcome news. If the Drink Less app can be scaled up and rolled out more widely, it holds promise for population health.”

“Apps are one valuable tool in the box, but there is no silver bullet for alcohol harm. What we really need is a national strategy that includes apps alongside other interventions and policies which we know work, such as making alcohol less cheap, not as readily available, less heavily marketed, and improving access to alcohol treatment and support.”

Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, said: “At a time when deaths from alcohol are at peak levels, measures, like the Drink Less app, that are proven to reduce alcohol intake are a welcome development.

“There are many tools out there that support people to reduce their alcohol consumption, but few have the evidence base to show that they really work. It is good to see that the app developed by UCL now has the data behind it to back it up and could be used alongside, not in place of, population measures that address the price, availability and marketing of alcohol to reduce the harm caused by alcohol.”

Professor Brian Ferguson, Director of the NIHR Public Health Research Programme, which funded the study, said: “These findings show that the Drink Less app has the potential to help people monitor and reduce the amount of alcohol they consume. In addition, it highlights the importance of harnessing technology to help improve public health, although the app will need to be adapted to extend its population coverage.”

Read the full research paper: Effectiveness of a smartphone app (Drink Less) versus usual digital care for reducing alcohol consumption among increasing-and-higher-risk adult drinkers in the UK: a two-arm, parallel-group, double-blind, randomised controlled trial

Published in eClinicalMedicine (part of The Lancet) March 2024