Monday January 4 2016
Giving up alcohol for a month can bring a range of benefits
"Study … found that Dry January leads to healthier drinking habits," the Mail Online reports. Dry January involves giving up alcohol for the month. There is limited evidence about whether taking part in the challenge could lead to long-term changes in patterns of drinking.
A recent study looked at 857 UK adults taking part in the challenge. Around two-thirds of the sample successfully gave up drinking for one month.
Compared with those who failed to abstain, those who were successful were, unsurprisingly, more likely to drink less, have lower dependence scores, and be more able to refuse alcohol to start with.
Both successful abstainers and those who did not succeed in the challenge also had increased powers of abstinence and reduced consumption patterns up to six months later, albeit to a slightly lesser extent in those who did not succeed. So, in this sample at least, it seems taking part in the challenge brought benefits.
The important limitation of the long-term sample data was that it represented only about a quarter of those taking part in Dry January originally signed up by the researchers.
The rest didn't provide complete data for assessment. People without complete assessments had higher alcohol consumption patterns to start with, so the results could be representative of those with better chances of success.
Whether you're taking part in Dry January or not, keeping your alcohol consumption within recommended limits is wise all year round.
Where did the story come from?
This study was carried out by two researchers from the University of Sussex and one researcher from Alcohol Concern. No sources of financial support are reported.
It was published in the peer-reviewed journal Health Psychology.
The Mail Online's reporting of this research is accurate, but does not acknowledge the study's limitations.
What kind of research was this?
This was a prospective cohort study of adults in the UK taking part in the Dry January alcohol abstinence challenge, and followed them up at one and six months to look at their outcomes.
As the researchers say, temporary abstinence from alcohol is believed to have possible psychological health benefits and boost wellbeing.
Similar to the Stoptober campaign, where people are encouraged to quit smoking for one month, various countries are said to have set up campaigns to encourage people to abstain from alcohol for one month.
In this study, the researchers aimed to look at what personal factors are associated with likelihood of success, as well as how successful or failed abstinence influences subsequent alcohol consumption.
They expected that those who successfully completed the month would have an increased likelihood of reducing their alcohol intake in the future.
What did the research involve?
The research included a cohort of adults in the UK taking part in Dry January. They completed questionnaires before starting the challenge, after the dry month, and six months later.
The study included 857 people (71% female) registered on the Dry January website who were aged 18 or over, lived in the UK, and had complete questionnaire data available at all three assessment points.
The initial questionnaire included demographic details, and assessed factors such as:
- age at first drinking alcohol
- usual drinking days
- number of drinks on a typical drinking day
- longest period of abstinence since they started drinking (day, months or years)
- consumption volume, frequency, dependency or alcohol-related problems – assessed using the 10-item Alcohol Use Disorders Identification Test (AUDIT)
- drink refusal self-efficacy (DRSE) using the question, "Please use the scale below to indicate how easy it would be for you to refuse alcohol in each situation", with responses on a seven-point scale from very difficult to very easy – the situations are scenarios where people may be tempted to drink, such as when friends are drinking, when watching TV, when having emotional worries, and so on
- intentions for Dry January – such as to stop drinking altogether or just try to cut down
- whether they were doing the challenge with someone else
The assessment at one month focused on the changes in DRSE compared with baseline.
The six-month assessment questioned the number of days from the start of Dry January until they had their first alcoholic drink again. They also similarly completed DRSE and other questions from the initial assessment.
The researchers examined which factors were associated with likelihood of abstinence.
What were the basic results?
Roughly two-thirds of the study sample successfully completed Dry January – this was not specifically defined, but assumed to mean completely abstaining from alcohol for the month.
Compared with those who were not successful, at the start of the study successful completers had:
- fewer drinking days a week and fewer drinks on a drinking day
- fewer drunk episodes during the past month
- a lower AUDIT score
- higher DRSE social and emotional sub-scores – this showed they found it easier to abstain from alcohol in social and emotional situations
At the end of the month, people who successfully completed Dry January had significantly improved DRSE scores across all domains (social, emotional and opportunistic) compared with the start of the month.
Successful completion was also associated with reductions in the number of drinking days a week and the number of drinks, and how often they were drunk at six months.
People who failed to complete Dry January still showed significant improvements in DRSE social and emotional scores at one month, and the number of drinking days and number of drinks at six months. However, these improvements were not as large as those seen in people who were successful.
A small proportion of the total sample (11%) demonstrated "rebound effects", with an increased frequency of drunkenness at six months. This was more common among unsuccessful completers.
How did the researchers interpret the results?
The researchers concluded that, "Participation in abstinence challenges such as Dry January may be associated with changes toward healthier drinking and greater DRSE, and is unlikely to result in undesirable 'rebound effects': very few people reported increased alcohol consumption following a period of voluntary abstinence."
This cohort study followed adults in the UK who took part in a Dry January alcohol abstinence challenge, looking at the factors associated with success and the effects on future alcohol consumption.
As may be expected, factors associated with the likelihood of being able to successfully abstain for one month included drinking less alcohol, having lower alcohol dependence scores, and being more able to refuse alcohol to start with.
However, although these factors were significantly different between the "successes" and the "failures", it is worth noting the differences perhaps weren't so great in actual terms.
For example, people who successfully completed Dry January drank on average 4.78 days a week and consumed 3.78 drinks on these days at the start of the study, compared with 4.96 days and 4.21 drinks among those who failed to complete.
It is also notable that though successful completers demonstrated improved refusal skills and reduced consumption at six months, so did the non-completers, albeit to a lesser extent.
This means the differences – both before and after the challenge – between those who successfully abstained for one month and those who didn't are not as vast as might be expected. Overall, it seemed that just participating in the Dry January challenge had a positive effect, at least in this sample.
This brings us to the key limitation of this study – the people who were not included. Although there is a relatively large sample size, the study only had results for around a quarter (23%) of those registered for Dry January who would have been eligible to participate. Those missing did not have full questionnaire data available.
The researchers report that those with complete six-month data were more likely to have completed a dry month in the past, drank fewer drinks on a drinking day, reported less frequent drunkenness, had lower AUDIT scores, and had greater social DRSE.
The researchers did use statistical techniques to take account of the differences between people participating in follow-up or not. However, the results may still not be fully representative of what would be seen if all people who attempted Dry January had been followed up.
Also, the study does not include the many adults who don't choose to take part in the challenge, who may have different drinking habits or willingness to abstain.
As the researchers rightly acknowledge, without a control group it is not possible to know whether alcohol consumption might decrease among the population anyway at this time, as part of the general turn to "healthier behaviour" that many of us take at the start of a new year.
Other potential limitations include the reliance on self-reported data, which may include inaccuracies. For example, people may not be able to accurately recall the longest period they have ever gone without a drink during their lives.
Overall, this study provides observations on the reported effects of Dry January in a UK sample. However, the limitations described make it difficult to draw firm conclusions on the campaign's long-term effectiveness as a behaviour-change initiative to improve alcohol consumption patterns in the adult population in the UK.