Alcohol is an addictive drug which is part of the social fabric of many societies around the world despite scientific evidence showing that consuming alcohol is associated with a range of negative consequences for the physical and mental health of both those who drink and others in their proximity. Reducing one’s drinking is difficult not only because of alcohol’s ubiquity in society, but also because drinking is portrayed as something that enhances life and something that (almost) everybody should be able to control with little consequence. Coupled with a strong stigma attached to reaching out for help, many people who want to reduce their drinking cannot do so and do not get the help they need.
Support via digital means, for instance mobile phone apps, have the capacity to reach out into the community and be delivered anonymously to people who want to reduce their drinking. There does not have to be any personal contact to initiate the support, reducing the stigma of asking for help. Digital support can be initiated at any time, meaning that people do not need to wait for help but can access the support when motivation to do so is high.
Does it work?
We conducted a scientific study of a digital support tool in Sweden, to which people who were searching online for help to reduce their drinking were invited. A total of 2,129 participants were randomly allocated to either receive a novel digital support tool which was developed by our research team, or access to alcohol information which is typically found when looking online for help. We wanted to see if drinking was different between these two groups of people four months after enrolment.
What we found was that those who had access to the digital support tool were drinking 77% of the amount of alcohol that the group who were given access to existing online resource were drinking on a weekly basis. We also found that those with access to the digital support tool had approximately 1 in 4 fewer occasions of episodes when they drank heavily compared to the other group. These findings are in line with other studies of digital support tools for alcohol consumption reduction, although the effects on episodes of heavy drinking were higher here than usually observed.
All in all, our study concluded that a digital support tool, which was found and initiated by people on their own, was effective in reducing drinking.
What kind of support was given?
The core function of the digital tool was a text message which was sent to the individual each Sunday afternoon for four months. In the message was a recommendation to assess one’s past week’s consumption by clicking on a link. Those who clicked on the link were asked two questions about their current consumption, and then given feedback and advice for change.
The feedback and advice were focused on helping individuals motivate them to reduce their drinking, change their environment, give themselves opportunities to reduce their drinking, set goals and monitor their drinking over time, and teach skills for how to reduce one’s drinking. Participants could engage as much or as little as they wanted with the support tool.
What is next?
Although our findings are encouraging, there is still much that we can do to improve the support given. The age range of participants was 18 to 82, with the average participant being 45 years old. This means that there is likely to be heterogeneity with respect to the motives for drinking, and ways in which people drink, leaving potential for us to better tailor the support to different needs. We also want to explore avenues for referral to primary health care for those who want additional face-to-face support.
We do not believe that a digital support on its own will reshape society – this will require additional political and cultural shifts. But we do believe that it can be helpful for individuals that want to reduce their drinking. Since alcohol is part of the social fabric, we need to find ways of overwhelmingly embedding support into the same fabric – digital interventions should be part of this response.
Written by Dr Marcus Bendtsen, Associate Professor in Experimental Social Medicine and Public Health, Linköping University, Sweden.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.