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Ian Hamilton: Dry January is no match for the growing harms of alcohol consumption

Despite being in its seventh year, we still know little about the effectiveness of campaigns like Dry January, says Ian Hamilton

Alcohol is so ingrained into our lives that we often don’t realise how much we are drinking or take time to think about the impact it is having on us or those around us. The Dry January campaign, now in its seventh year, is proving to be more popular than ever, with an estimated four million people last January taking the pledge to go without alcohol for the month. The organisers, Alcohol Change UK, are to be congratulated for engaging so many people and getting them to test their relationship with alcohol. For many of those participating this could be revealing, as they discover they are more reliant on alcohol for socialising, relaxing, or coping than they had realised.

Yet it is strange how little we know about the effectiveness of campaigns like Dry January. Three years ago, I wrote in The BMJ that “this type of campaign has had no rigorous evaluation,” and unfortunately not much has changed in the intervening period. Even after seven years, and potentially millions of participants, we still don’t have strong evidence on how effective this campaign is at reducing long term and harmful alcohol consumption.

One recent attempt to investigate the impact of the campaign used a mix of interviews and surveys. At first glance, the study’s findings appear to support the Dry January initiative as the authors found that for some participants the reduction in drinking persisted beyond January. But there are problems with this study and a more recent attempt to evaluate Dry January: namely, the significant number of people who drop out, with the latter evaluation only able to follow up 816 people out of the original 2821 people surveyed. We don’t know why these people were lost to follow up; it could be that they were successful in becoming abstinent or, what is more likely in my view, they found this all or nothing approach too difficult and gave up.

Evaluating large scale campaigns like this is perhaps inevitably problematic. When people take up challenges to go without something like alcohol they could also be more likely to take up exercise, alter their eating habits, or make other healthy changes to their lifestyle. Consequently, any attempts to measure the benefits of giving up alcohol temporarily need to untangle this change from a whole range of other potential new behaviours.

What we need is an evaluation of Dry January that not only measures alcohol use, but collects information about other changes, such as taking up exercise. Providing financial incentives to participants when they complete follow-up questioning might help reduce the number of participants who drop out and therefore improve our understanding of the difficulties people encounter when trying to reduce their alcohol consumption over a longer period.

You might assume that any attempt to regulate alcohol consumption on the scale that Dry January has the potential to achieve would be bad news for the alcohol industry. But I don’t think that it is, as these kind of campaigns deflect attention from the alcohol industry’s core and loyal customer base.

Estimates suggest that more than 30% of all the alcohol sold is consumed by a mere 4.4.% of the population. Dry January is not aimed at this group and nor should it be, since we know that for some heavy drinkers abruptly stopping drinking risks serious side effects, such as seizures. What this group needs is specialist support and treatment, yet while the Dry January campaign is well resourced, addiction treatment services are increasingly feeling the strain of cuts. Treatment is expensive, and with the number of people dependent on alcohol rising in recent years, this is not the time to be cutting spending on services.

It’s likely that any attempt to try and tackle the core group behind this high level of alcohol consumption would be resisted by the alcohol industry. It can be difficult to see the way the industry operates to protect its core customer base, but there are numerous examples of how the alcohol industry attempts to shape policy and guard its interests.  

In the end, what seems like a harmless annual challenge is another reminder of the growing harms associated with alcohol consumption, which sadly public health is no match for.  

Ian Hamilton is an academic at the University of York with an interest in addiction and mental health. He previously worked as a mental health nurse with people who had combined mental health and substance use problems. Twitter @ian_hamilton_

Competing interests: I am affiliated with Alcohol Research UK.