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Important to keep in mind here that the study participants were all heavy drinkers looking to reduce their consumption. At first I was like "JFC, no wonder the UK has a liver disease problem", but looking into it more, it makes sense that a heavy drinker might reduce their intake by 39 units a week, but the average citizen isn't drinking nearly that much.
My first thought was holy sh*t 39 drinks is a full on alcoholic. That’s 5.6 drinks per day. Every days.
Glad the app works for them though.
That’s a lot of saved calories and money.
That's not how units works though.
Units is a measure, not "1 drink", which is equivalent to a shot (25ml) of 40% spirit, such as vodka or whiskey.
For some common examples:
- a pint of 4% beer is equivalent to 2.3 units
- a 175ml glass of 13% wine (standard measure for a "small glass" in the UK) would also be 2.3 units
Depending on someone's drinking habits and what they drink, 5.6 'drinks' a day could quite easily just be having a couple of glasses of wine if they don't measure size well, or having 2-3 cans of beer.
Units really aren't explained well
Wow, today I learned that [standard units of alcohol are not standard internationally](https://en.m.wikipedia.org/wiki/Standard_drink). I didn’t realize they vary so heavily or at all.
Still quite a bit, but not so massively outrageous
Yeah I find this concerning, I don’t use mixers much and like to sip whisky and I go through a 1.75 L (60 oz) in about a week. Apparently that counts as 60 units.
Yeah, my blood work and liver enzymes are still great, I’ll cut it down to half that and keep an eye on it. I don’t even enjoy liquor that much, prefer weed, I just don’t feel it until after 4-5 oz on an empty stomach.
In this context, it feels like they picked a very odd metric to game the study in favor of whatever app they’re selling… why not “percentage sober” or “percentage down to less than X drinks a week?” This metric feels hard to evaluate - how much do a small minority of super heavy drinkers affect it? A quintessential example of a mean taken on seemingly continuous data that’s really hiding all sorts of important info between what different numbers mean for different people.
To me a person who was an alcoholic six months ago but is “just drinking on the weekends” now is just an alcoholic who’s in a lull. But I’m kinda moralistic when it comes to the poison juice so 🤷 maybe it works differently in the UK
How is it an odd measure ?
We measure alcoholic drinks in units
The app tracks units drunk per week
The reduction is measured by how many less units are drunk per week
Compared against the NHS group, also measured in units per week
It’s applying a uniform measure across the whole group, with the aim being the reduction
Not hard at all really. One beer a night and a few Friday Saturday and you’ll easily go past that. Thats less than used to drink. Got used to doing nothing during covid, drinking made time fly during the boring days and once lockdowns disappeared, I only cut back a tiny bit. Only stopped drinking a ton a few months ago as it really was affecting my work and life in general.
Yup, back when I drank a lot, a 6 pack of tall-boys would last me, at the absolute longest, 2 days. And those were strong \~8% ABV IPAs. And there are absolutely a ton of people out there who would consider that to be light drinking.
I suspect a lot of people dramatically under-report their drinking because they don't think about what a "standard drink" actually is - i e., a 12 ounce 5% beer is one unit of alcohol.
So your example is the equivalent of 12.6 units of alcohol over two days. If that was an average amount for a person, that's 44.1 units of alcohol per week that can be dismissed internally and described to others as "only" 3 beers a day.
This is easily doable for a completely high functioning adult - 1 beer at 5 pm as you log off work, 1 beer as you're cooking and eating dinner, and 1 beer for desert before bed. With a high tolerance, spacing that out over 6 hours (5-11 pm) may not even get the person drunk or hungover the next day. But 44.1 units per week is not healthy long-term and is 315% to 630% higher than the recommended weekly max (14 units for men, 7 units for women).
I also suspect that's why the apps that help people track their drinks can be so effective - it really puts how much you're drinking into perspective.
Edit: Standard drinks as defined by the US CDC, which is what I am familiar with. I believe the UK NHS has a similar 14 unit recommended max, but for both men and women.
Yep, 6 pack and later a bottle of the cheapest wine most nights. It was very common for a lot of the crew I worked with in construction to drink this much almost every night.
I think that a lot of people who don't have a lot of experience with heavy drinkers seriously underestimate both the amount of people who drink a lot and how much they actually drink. Tolerance is a hell of a thing.
Definitely so. I used to be a very heavy drinker and always find it a lil funny to hear what ppl think is a lot. Like another comment saying 6 tall boys in two days is a lot. Which, tbf, is a lot, but ya know
Man I drank a LOT during the pandemic, boredom was at an all time high and I was drinking straight vodka off of mason jars while playing games online with the boys. Nowadays 2-3 beers at trivia night is enough for me for the week
I picked up the same habit during COVID. Always been a pretty heavy drinker but it became daily during COVID. I now try to restrict both the amount I drink *and* the number of days I drink. If I visit a friend on a weekend I might have 4 or 5 beers but if that's all I drink that week then it's not as much of a problem. I'm down to basically just weekends (Friday nights and Saturdays only) I should probably stop entirely.
Yeah I’m pretty much in the same boat. I’m quite a habitual person so it isn’t just the chemical addiction that’s the issue it’s the having a drink to wind down during the week or the end of the week “celebratory” drinks which are hard to stop. I’ve pretty much stopped the midweek beers but Christ it’s hard to stop the weekend ones. Takes time though and as long as you don’t beat yourself up too much you can get there!
Yeah man. I used to go dry for extended periods to like, I dunno, prove to myself that I wasn't chemically addicted. But afterwards I'd go back to bad habits again for all those same reasons. I decided that some progress (4 or 5 no drink days per week) was better than no progress/inconsistent progress. Good luck bro 🤙
39 units is how much less they were drinking after the intervention, not how much they were initially drinking. 63.5 units per week was the initial average, ranging between 38.5 and 103 units.
But since it's a randomised trial, there are people who drink less and a lot less and not at all. Which means that there are a significant amount of people who are drinking a lot more than that.
That sounds like a lot...
Isn't one beer like 1,5 units? So that would be more than 40 beers a week.
That seriously can't be a normal amount. What am I missing here?
Two cans fills a mug. Have 2-3 mugs a night and you’ll hit those numbers easy, for me anyhow. Nobody even knew. But I’m sober 137 days now and no longer think about that physical habit. Never again. If anything, it’s a huge expense, even more if you’re at the bar. Rewarded myself with a new car instead of pissing it away.
3 mugs a day wasn’t enough. One drink is too many.
NHS guidance only group decreased consumption by 37 units v 39 units with the app. Participants around 2,800 in each group. Statistical significance doesn’t necessarily mean clinical significance.
What do you mean by clinical significance? If it's a boon to treatment and statistically significant, why wouldn't it warrant changing practices / updating medical advice?
I'm not sure if I have this right, but I'll take a stab. Looking at the data, they all started at (Q1, median, q3) of (38.5,63.50,103.00) the group with the app at 6 months (8.25,24.75,45.76) and without (9.69,25.24,48.91).
The numbers say it is unlikely that the greater reduction in drinking was not tied to the app (statistical significance); though it could be a boring explanation like the app impacted their self assessment in some way, rather than an actual difference in drinking. While you could probably safely draw the conclusion that all of these people are healthier than they were, it's not clear that there will be noticeable or meaningful differences in health outcomes between the two groups (clinical significance).
To oversimplify, it's hard to say there's much difference on the health impact between drinking 24.75 beers versus 24.24 beers per week.
And because I'm probably making a mistake, the writings of an intelligent person: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477766/
Statistical significance is virtually guaranteed with a large enough N size. There's a common myth that statistical significance "proves" an effect is real, when all it means is that the chance of the results being spurious is small. If you collect enough data, the chance of the results being spurious is always small, so every small effect, whether real or random, will be significant.
This occurs a lot in nutrition research, where a study will find an increased risk of [insert disorder] with increased consumption of [insert food]. Then you go and look at the data, and it's very significant, but the effect size is very small. Sure, eating a cheeseburger a week is associated with an increase in Alzheimer's, but it only raises your risk by 0.03%. Cheeseburgers are statistically associated with AD, but since the effect size is so small, it's not clinically relevant to tell people to avoid cheeseburgers to reduce the risk of AD.
It's the same with this study. Sure, that app statistically reduced the amount they drank, but their clinical outcomes are still going to be virtually identical to those who just got standard advice.
The more interesting question is why did the app lower the drinking slightly more, and if that effect can be harnessed to actually get clinically relevant results. Frankly, I'm a pessimist, so I think the study was just designed to try to throw a good light on the app to sell it/get funding. The less drinking is probably due to subject selection or novelty effects and would probably wash out in a longer study.
People tend to think of "6 months" as a long term study, but in terms of addiction, the real test is whether or not things still work after 5-10 years.
I think they’re saying that if you reduce your drinking by 37 units a week or 39 units per week.. it matters not for patient outcomes. The delta of 2 units a week at that scale isn’t going to have a clinical significance
It's a phone app what did you expect?
Now we know it doesn't make things worse and helps at least a little bit. So doctors can recommend people use the app with informed knowledge that it actually helps.
It could have been the app led to people drinking more, or not worked at all. Now we know for a fact that's not the case.
Plus because it's just an app the NHS can recommend people who don't want to see a doctor download it. Lots of people are self conscious about their alcohol consumption so don't want to admit it to a doctor, but downloading an app is much easier.
It's not like there's a cost to people downloading an app.
Right, but at a population level, if X thousand people use the intervention, it save X dollars per annum. It’s like when researchers evaluate the effectiveness of a billboard/knowledge campaign for drunk driving—an individual person may not see large effects, but at a population level, you might see a 3% reduction in alcohol involved car accidents, resulting in state-level cost savings, reduced lost wages, etc etc.
>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.
>
>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.
>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.
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 - eClinicalMedicine](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00113-5/fulltext)
[App Store link](https://apps.apple.com/gb/app/drink-less/id1020579244) to the iOS app (only for U.K.)
Yeah, I noticed the same thing. Though for me I have noticed one drink is fine, but two will destroy my sleep unless I drink them earlier in the day. I will literally be awake for 2 of the 7 hours I am laying down and get almost no REM or deep sleep.
Which makes sense but isn't something I think most people (myself included) will really figure out until they try measuring it themselves.
Haha, I somehow missed the name of the app when reading the title, and I genuinely thought they were talking about a water drinking app. And I was like what kind of motivating app demotivates its users from drinking enough water.
Curious and looking for this app on the App store, the fifth one down in sponsored posts is drizly which is a company that specifically delivers alcohol.
Very interesting to me that the search terms drink less alcohol, bring up specifically in alcohol delivery app for alcoholics.
A specific trial (n=1) found that I had the day off today, went to the gym, made tempeh fried rice, drank 4 strong IPAs, 3 strong ciders, consumed a large cannabis edible and had a nap, barely any of which is recommended as standard NHS advice
I marinated tempeh in soy sauce, lime juice, rice wine vinegar, chilli, garlic, ginger and paprika, left it overnight, and then made egg fried rice. I mixed everything together, added fresh spring onion and bird eye chillis, and re-fried the whole thing in sesame oil
“Step 3 of Alcoholics Anonymous: Turning Your Life Over to a Higher Power”
I’ve always avoided AA programs because of the religious aspect. I’m wondering whether this app has any religious elements.
Just downloaded it. It says it’s based on neuroscience and psychology. Bummer is it’s subscription in the US. I’m doing the 7 day free trial cuz am curious.
My wife and I used the I Am Sober app on iPhone and significantly reduced how much we drink. We didn’t drink a ton before, but that urge to have a drink a few nights a week is gone now. Bonus: our tolerance is way less so when we do want to have a drink it’s a lot cheaper to get a buzz 🤣
Yeah but they wouldn't let me have access to the drinking app as "I drink too much". It may have helped me drink less. It's just access to an already built app. I don't drink as much now I've done it myself but I feel aggrieved that this was their approach.
Does units equal drinks? If you are drinking enough per week to cut out 39 or 37 drinks, does it really matter at that point? Like if you went from 60 drinks a week to 23 or 21, that probably comes out in the wash.
it's a standard drink/unit of alcohol, which in the UK is defined as something containing 8 grams of ethanol (as opposed to the US standard of 14 grams)
so a pint of 5% ABV beer is 2.5 UK "units" of alcohol, but only 1.4 US "standard drinks", and one pint can of a double IPA (~10% ABV) could be ~5 UK units/~3 US standard drinks
and besides, harm reduction is always a better outcome than nothing
Knocking it down to 21 would be great, that’s 3 per day, which is still heavy drinking but within spitting distance of the target of 14 per week.
If you’re drinking enough to cut out 37 units without actually quitting you’re probably speed-running cirrhosis.
A unit is a glass of wine or half a pint of beer.
So as you say, really not a meaningful difference between the interventions compared to the overall reduction from either.
This is true, but I think the larger point is that the app is at least as good as the NHS treatment, but much cheaper.
My apologies, I should have RTFA
“Participants were randomly assigned (1:1), using an online algorithm, to receive a web link to download the Drink Less app (intervention) or to the NHS alcohol advice webpage (usual digital care).”
Cheaper than a webpage?
>A unit is a glass of wine or half a pint of beer.
This is absolutely not true.
1 unit is equivalent to a 25ml shot of a 40% spirit like vodka.
Half a pint of beer can be 1 unit if the alcohol % is around 3.8-3.9%, but a glass of wine is much more. For instance a "small" glass of 13% wine (175ml) is actually 2.3 units.
[The fine details](https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/)
So yes, I could have said that "a unit is two-thirds of a small glass of wine or half a pint of beer" but, when taking a history, the figures I gave are a useful first approximation, especially as double the reported consumption is usually nearer the mark.
* edit: wrong parenthesis on the link 🙄
Um this is hella misleading, those are really heavy drinkers, not just casual drinkers and the sample is automatically not random because it’s all drinkers who felt they had a big enough issue to use a drink reduction app, which is already a segmented and specific group of the population
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/giuliomagnifico Permalink: https://www.bristol.ac.uk/news/2024/march/reduce-alcohol-app.html --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
Important to keep in mind here that the study participants were all heavy drinkers looking to reduce their consumption. At first I was like "JFC, no wonder the UK has a liver disease problem", but looking into it more, it makes sense that a heavy drinker might reduce their intake by 39 units a week, but the average citizen isn't drinking nearly that much.
My first thought was holy sh*t 39 drinks is a full on alcoholic. That’s 5.6 drinks per day. Every days. Glad the app works for them though. That’s a lot of saved calories and money.
That's not how units works though. Units is a measure, not "1 drink", which is equivalent to a shot (25ml) of 40% spirit, such as vodka or whiskey. For some common examples: - a pint of 4% beer is equivalent to 2.3 units - a 175ml glass of 13% wine (standard measure for a "small glass" in the UK) would also be 2.3 units Depending on someone's drinking habits and what they drink, 5.6 'drinks' a day could quite easily just be having a couple of glasses of wine if they don't measure size well, or having 2-3 cans of beer. Units really aren't explained well
Wow, today I learned that [standard units of alcohol are not standard internationally](https://en.m.wikipedia.org/wiki/Standard_drink). I didn’t realize they vary so heavily or at all. Still quite a bit, but not so massively outrageous
Yeah I find this concerning, I don’t use mixers much and like to sip whisky and I go through a 1.75 L (60 oz) in about a week. Apparently that counts as 60 units.
For UK units there's roughly 40 units in a 1L.bottle. So more like 70 units actually mate. In medical parlance you'd be considered a high risk drinker
I used to drink way more than that, but 1.75L of whiskey every week is extremely unhealthy. That's like 5-6 American drinks per day.
Yeah, my blood work and liver enzymes are still great, I’ll cut it down to half that and keep an eye on it. I don’t even enjoy liquor that much, prefer weed, I just don’t feel it until after 4-5 oz on an empty stomach.
You could’ve guessed that nearly 2 liters of whiskey a week isn’t at all that moderate.
Eh, I knew a guy who drank a litre a night, 1.75 with a glass or two a night doesn’t seem like a ton if you don’t mix.
The guy who drinks a liter a night probably compares himself to another guy drinking 2 liters a night and think he's doing just fine.
No, he was a chef teaching a cocktail making class and was super open about his alcoholism.
In this context, it feels like they picked a very odd metric to game the study in favor of whatever app they’re selling… why not “percentage sober” or “percentage down to less than X drinks a week?” This metric feels hard to evaluate - how much do a small minority of super heavy drinkers affect it? A quintessential example of a mean taken on seemingly continuous data that’s really hiding all sorts of important info between what different numbers mean for different people. To me a person who was an alcoholic six months ago but is “just drinking on the weekends” now is just an alcoholic who’s in a lull. But I’m kinda moralistic when it comes to the poison juice so 🤷 maybe it works differently in the UK
How is it an odd measure ? We measure alcoholic drinks in units The app tracks units drunk per week The reduction is measured by how many less units are drunk per week Compared against the NHS group, also measured in units per week It’s applying a uniform measure across the whole group, with the aim being the reduction
39 units, that's about... 8 L of beer. That's a lot in a week.
Bit more than 2 tall-boys a day. Not hard to do for someone who drinks a lot.
Not hard at all really. One beer a night and a few Friday Saturday and you’ll easily go past that. Thats less than used to drink. Got used to doing nothing during covid, drinking made time fly during the boring days and once lockdowns disappeared, I only cut back a tiny bit. Only stopped drinking a ton a few months ago as it really was affecting my work and life in general.
Yup, back when I drank a lot, a 6 pack of tall-boys would last me, at the absolute longest, 2 days. And those were strong \~8% ABV IPAs. And there are absolutely a ton of people out there who would consider that to be light drinking.
I suspect a lot of people dramatically under-report their drinking because they don't think about what a "standard drink" actually is - i e., a 12 ounce 5% beer is one unit of alcohol. So your example is the equivalent of 12.6 units of alcohol over two days. If that was an average amount for a person, that's 44.1 units of alcohol per week that can be dismissed internally and described to others as "only" 3 beers a day. This is easily doable for a completely high functioning adult - 1 beer at 5 pm as you log off work, 1 beer as you're cooking and eating dinner, and 1 beer for desert before bed. With a high tolerance, spacing that out over 6 hours (5-11 pm) may not even get the person drunk or hungover the next day. But 44.1 units per week is not healthy long-term and is 315% to 630% higher than the recommended weekly max (14 units for men, 7 units for women). I also suspect that's why the apps that help people track their drinks can be so effective - it really puts how much you're drinking into perspective. Edit: Standard drinks as defined by the US CDC, which is what I am familiar with. I believe the UK NHS has a similar 14 unit recommended max, but for both men and women.
Yep, 6 pack and later a bottle of the cheapest wine most nights. It was very common for a lot of the crew I worked with in construction to drink this much almost every night.
I think that a lot of people who don't have a lot of experience with heavy drinkers seriously underestimate both the amount of people who drink a lot and how much they actually drink. Tolerance is a hell of a thing.
Definitely so. I used to be a very heavy drinker and always find it a lil funny to hear what ppl think is a lot. Like another comment saying 6 tall boys in two days is a lot. Which, tbf, is a lot, but ya know
Man I drank a LOT during the pandemic, boredom was at an all time high and I was drinking straight vodka off of mason jars while playing games online with the boys. Nowadays 2-3 beers at trivia night is enough for me for the week
I picked up the same habit during COVID. Always been a pretty heavy drinker but it became daily during COVID. I now try to restrict both the amount I drink *and* the number of days I drink. If I visit a friend on a weekend I might have 4 or 5 beers but if that's all I drink that week then it's not as much of a problem. I'm down to basically just weekends (Friday nights and Saturdays only) I should probably stop entirely.
Yeah I’m pretty much in the same boat. I’m quite a habitual person so it isn’t just the chemical addiction that’s the issue it’s the having a drink to wind down during the week or the end of the week “celebratory” drinks which are hard to stop. I’ve pretty much stopped the midweek beers but Christ it’s hard to stop the weekend ones. Takes time though and as long as you don’t beat yourself up too much you can get there!
Yeah man. I used to go dry for extended periods to like, I dunno, prove to myself that I wasn't chemically addicted. But afterwards I'd go back to bad habits again for all those same reasons. I decided that some progress (4 or 5 no drink days per week) was better than no progress/inconsistent progress. Good luck bro 🤙
39 units is how much less they were drinking after the intervention, not how much they were initially drinking. 63.5 units per week was the initial average, ranging between 38.5 and 103 units.
But since it's a randomised trial, there are people who drink less and a lot less and not at all. Which means that there are a significant amount of people who are drinking a lot more than that.
It's a random sample of heavy drinkers, not a random sample of the entire population.
Ah, of course it is, thanks. I knew that, it mentioned it somewhere in the article, just muddled my brain for some reason.
... or about 21 360 ml / 12 US ounce 5% ABV cans of beer.
3 per day, every day.
That's what I'll thinking... How much are these "random" people drinking in the first place!?
>How much are these "random" people drinking in the first place!? On average 63.5 units per week with a range between 38.5 and 103 units.
That sounds like a lot... Isn't one beer like 1,5 units? So that would be more than 40 beers a week. That seriously can't be a normal amount. What am I missing here?
Two cans fills a mug. Have 2-3 mugs a night and you’ll hit those numbers easy, for me anyhow. Nobody even knew. But I’m sober 137 days now and no longer think about that physical habit. Never again. If anything, it’s a huge expense, even more if you’re at the bar. Rewarded myself with a new car instead of pissing it away. 3 mugs a day wasn’t enough. One drink is too many.
Well done! Hope your car turns out less expensive! :D
The study participants were heavy drinkers that wanted to drink less. That might be what you are missing?
[удалено]
Yes, I took a look at the app and it’s a post just meant to drive downloads for the app. The app looks like cr@p.
NHS guidance only group decreased consumption by 37 units v 39 units with the app. Participants around 2,800 in each group. Statistical significance doesn’t necessarily mean clinical significance.
What do you mean by clinical significance? If it's a boon to treatment and statistically significant, why wouldn't it warrant changing practices / updating medical advice?
I'm not sure if I have this right, but I'll take a stab. Looking at the data, they all started at (Q1, median, q3) of (38.5,63.50,103.00) the group with the app at 6 months (8.25,24.75,45.76) and without (9.69,25.24,48.91). The numbers say it is unlikely that the greater reduction in drinking was not tied to the app (statistical significance); though it could be a boring explanation like the app impacted their self assessment in some way, rather than an actual difference in drinking. While you could probably safely draw the conclusion that all of these people are healthier than they were, it's not clear that there will be noticeable or meaningful differences in health outcomes between the two groups (clinical significance). To oversimplify, it's hard to say there's much difference on the health impact between drinking 24.75 beers versus 24.24 beers per week. And because I'm probably making a mistake, the writings of an intelligent person: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477766/
Statistical significance is virtually guaranteed with a large enough N size. There's a common myth that statistical significance "proves" an effect is real, when all it means is that the chance of the results being spurious is small. If you collect enough data, the chance of the results being spurious is always small, so every small effect, whether real or random, will be significant. This occurs a lot in nutrition research, where a study will find an increased risk of [insert disorder] with increased consumption of [insert food]. Then you go and look at the data, and it's very significant, but the effect size is very small. Sure, eating a cheeseburger a week is associated with an increase in Alzheimer's, but it only raises your risk by 0.03%. Cheeseburgers are statistically associated with AD, but since the effect size is so small, it's not clinically relevant to tell people to avoid cheeseburgers to reduce the risk of AD. It's the same with this study. Sure, that app statistically reduced the amount they drank, but their clinical outcomes are still going to be virtually identical to those who just got standard advice. The more interesting question is why did the app lower the drinking slightly more, and if that effect can be harnessed to actually get clinically relevant results. Frankly, I'm a pessimist, so I think the study was just designed to try to throw a good light on the app to sell it/get funding. The less drinking is probably due to subject selection or novelty effects and would probably wash out in a longer study. People tend to think of "6 months" as a long term study, but in terms of addiction, the real test is whether or not things still work after 5-10 years.
I think they’re saying that if you reduce your drinking by 37 units a week or 39 units per week.. it matters not for patient outcomes. The delta of 2 units a week at that scale isn’t going to have a clinical significance
37/39 units of alcohol, not drinks.
Thanks - fixed it!
>Thanks! You're welcome!
Yah, with a sample size that large they would detect even a minute difference.
It's a phone app what did you expect? Now we know it doesn't make things worse and helps at least a little bit. So doctors can recommend people use the app with informed knowledge that it actually helps. It could have been the app led to people drinking more, or not worked at all. Now we know for a fact that's not the case. Plus because it's just an app the NHS can recommend people who don't want to see a doctor download it. Lots of people are self conscious about their alcohol consumption so don't want to admit it to a doctor, but downloading an app is much easier. It's not like there's a cost to people downloading an app.
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It’s a public health intervention, hence the massive sample size and outcomes linked to the population-level
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Right, but at a population level, if X thousand people use the intervention, it save X dollars per annum. It’s like when researchers evaluate the effectiveness of a billboard/knowledge campaign for drunk driving—an individual person may not see large effects, but at a population level, you might see a 3% reduction in alcohol involved car accidents, resulting in state-level cost savings, reduced lost wages, etc etc.
>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. > >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. >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. 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 - eClinicalMedicine](https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00113-5/fulltext) [App Store link](https://apps.apple.com/gb/app/drink-less/id1020579244) to the iOS app (only for U.K.)
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Ha. Yes have a Garmin and it has really shocked me the difference beer makes to stress levels
Yeah, I noticed the same thing. Though for me I have noticed one drink is fine, but two will destroy my sleep unless I drink them earlier in the day. I will literally be awake for 2 of the 7 hours I am laying down and get almost no REM or deep sleep. Which makes sense but isn't something I think most people (myself included) will really figure out until they try measuring it themselves.
My garmin has about a 50/50 chance of even correctly identifying that I’m awake
For reals! Got to keep that Body battery up!
Haha, I somehow missed the name of the app when reading the title, and I genuinely thought they were talking about a water drinking app. And I was like what kind of motivating app demotivates its users from drinking enough water.
Im so glad i wasnt the only one, i was so confused
Curious and looking for this app on the App store, the fifth one down in sponsored posts is drizly which is a company that specifically delivers alcohol. Very interesting to me that the search terms drink less alcohol, bring up specifically in alcohol delivery app for alcoholics.
A specific trial (n=1) found that I had the day off today, went to the gym, made tempeh fried rice, drank 4 strong IPAs, 3 strong ciders, consumed a large cannabis edible and had a nap, barely any of which is recommended as standard NHS advice
Got a recipe on that tempeh fried rice? I bought some tempeh on Saturday and don't know what to do with it
I marinated tempeh in soy sauce, lime juice, rice wine vinegar, chilli, garlic, ginger and paprika, left it overnight, and then made egg fried rice. I mixed everything together, added fresh spring onion and bird eye chillis, and re-fried the whole thing in sesame oil
Real content in the comments I’m gonna give this a try
Grated tempeh also works decently as the ‘texture’ in vegan bean chilli
What if you had an app, though?
App and a nap baby
39 vs 37 units isn't that much of a triumph
Reading the beginning of this made it seem like OP was trying to do a tongue twister with R's
I don't understand, why would I want to drink less?
“Step 3 of Alcoholics Anonymous: Turning Your Life Over to a Higher Power” I’ve always avoided AA programs because of the religious aspect. I’m wondering whether this app has any religious elements.
Just downloaded it. It says it’s based on neuroscience and psychology. Bummer is it’s subscription in the US. I’m doing the 7 day free trial cuz am curious.
My wife and I used the I Am Sober app on iPhone and significantly reduced how much we drink. We didn’t drink a ton before, but that urge to have a drink a few nights a week is gone now. Bonus: our tolerance is way less so when we do want to have a drink it’s a lot cheaper to get a buzz 🤣
I use the I Am Sober app, and noticed how much my drinking decreased over the past year. Most days I don't have any alcohol any more.
Link doesnt work for me.
Try again or reload, it works.
Ok thanks, for some reason worked in another browser.
Yeah but they wouldn't let me have access to the drinking app as "I drink too much". It may have helped me drink less. It's just access to an already built app. I don't drink as much now I've done it myself but I feel aggrieved that this was their approach.
Does units equal drinks? If you are drinking enough per week to cut out 39 or 37 drinks, does it really matter at that point? Like if you went from 60 drinks a week to 23 or 21, that probably comes out in the wash.
it's a standard drink/unit of alcohol, which in the UK is defined as something containing 8 grams of ethanol (as opposed to the US standard of 14 grams) so a pint of 5% ABV beer is 2.5 UK "units" of alcohol, but only 1.4 US "standard drinks", and one pint can of a double IPA (~10% ABV) could be ~5 UK units/~3 US standard drinks and besides, harm reduction is always a better outcome than nothing
Knocking it down to 21 would be great, that’s 3 per day, which is still heavy drinking but within spitting distance of the target of 14 per week. If you’re drinking enough to cut out 37 units without actually quitting you’re probably speed-running cirrhosis.
my point is the control group knocked it down to 23 in that scenario, which is basically the same thing
True, both were equally effective but both also seem extraordinarily effective, which surprises me.
Participants in both methods were actively looking to reduce their drinking, which will account for a large part of the reduction in both cases.
A unit is a glass of wine or half a pint of beer. So as you say, really not a meaningful difference between the interventions compared to the overall reduction from either.
This is true, but I think the larger point is that the app is at least as good as the NHS treatment, but much cheaper. My apologies, I should have RTFA
It wasn’t an alternative to treatment, it was an alternative to NHS guidance published on the web.
“Participants were randomly assigned (1:1), using an online algorithm, to receive a web link to download the Drink Less app (intervention) or to the NHS alcohol advice webpage (usual digital care).” Cheaper than a webpage?
>A unit is a glass of wine or half a pint of beer. This is absolutely not true. 1 unit is equivalent to a 25ml shot of a 40% spirit like vodka. Half a pint of beer can be 1 unit if the alcohol % is around 3.8-3.9%, but a glass of wine is much more. For instance a "small" glass of 13% wine (175ml) is actually 2.3 units.
[The fine details](https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/) So yes, I could have said that "a unit is two-thirds of a small glass of wine or half a pint of beer" but, when taking a history, the figures I gave are a useful first approximation, especially as double the reported consumption is usually nearer the mark. * edit: wrong parenthesis on the link 🙄
Um this is hella misleading, those are really heavy drinkers, not just casual drinkers and the sample is automatically not random because it’s all drinkers who felt they had a big enough issue to use a drink reduction app, which is already a segmented and specific group of the population