One-month alcohol abstinence national campaigns: a scoping review of the harm reduction benefits
Review article
Study Background and Aim
Public health campaigns, challenging the general public to temporarily stop alcohol consumption, have been spreading over recent years, as it has also been the case regarding tobacco consumption with the emergence of national and international contests for smoking cessation since the 1980s, and of national campaigns, such as the “Stoptober” in the UK since 2012 that promotes a cessation of tobacco smoking for at least 28 days.
Temporary alcohol-free campaigns aim to promote behavioral changes and general health improvements among participants, which can involve many dimensions of health, including improved sleep, weight loss, increased physical activity, or enhanced quality of life. As such, adding to these elements the fact that these campaigns do not necessarily promote a complete cessation of alcohol consumption in the long term, but rather encourage alcohol consumers to question the role alcohol plays in their lives and its consequences on their health, they can be conceived as harm reduction programs applied to the general population.
In practice, however, temporary alcohol-free campaigns have generally been implemented at a national level, and the way they have been set up may thus largely differ between countries. In particular, the time frame of the alcohol-free period challenge can be very variable, depending on the program. In some programs, this alcohol-free period is quite long, e.g., three months in the Buddhist Lent Dry Campaign in Thailand, or even twelve months. However, the longer the targeted alcohol-free period is, the more the participants’ characteristics may differ from the general population participating in shorter alcohol-free periods. For example, 95% of the people participating in the Australian Hello Sunday Morning (HSM) program, an online Australian program promoting sobriety for three or twelve months, reported a heavy alcohol use before engaging in the program.
By contrast, the most widespread prevention initiatives that promote temporary alcohol cessation within the general population consist of one-month-long alcohol-free campaigns. This is the case of one of the most popular of these programs, the Dry January challenge, launched in 2013 in the UK (“Dry January | Alcohol Change UK”). Similar January one-month-long alcohol-free campaigns now exist in
- Quebec (“Défi 28 jours sans alcool”),
- France (“Dry January | Le défi de janvier !”), and in
- the Netherlands (“IkPas”) [9].
Other months of the year have been chosen in other countries, i.e.,
- February in Belgium (“Tournée Minérale—Een maand zonder alcohol”) and New-Zealand from 2011 to 2015 (“FebFast NZ | NZ Drug Foundation”), and
- November in Hungary (“Száraz November”) [11].
In Australia, three campaigns have co-existed for ten years, the first, Dry July, started in 2008 and still exists (“Go Dry this July”) while the second, Febfast was established in 2007 in Australia and in 2011 in New Zealand and the third, Ocsober, was discontinued in 2019 after having been running for ten years (“Life Education”).
Another common feature of one-month-long alcohol-free campaigns is that participants can sign up on social media, and thus receive and post-supportive messages, which makes them belong to online communities that may foster their personal efforts. Other inconstant features are the fundraising aspect of some campaigns (in particular in the Australian programs) where the participants can buy one-day leave passes if they wish to withdraw from the program only for one day.
In this review, the researchers addressed the harm reduction benefits of one-month-long alcohol-free campaigns, that is, the features of participants, the rates and predictors of success, i.e., completing the alcohol-free challenge, and the health benefits reported by participants, including those who did not fulfill the challenge.
The aim of this review was to provide a state-of-the-art of the demonstrated evidence regarding the harm reduction benefits of one-month-long alcohol-free campaigns, but also to determine which additional research questions should be addressed in the upcoming years, and which populations should be more specifically targeted in future one-month-long alcohol-free campaigns, in particular those who have currently not been reached by the existing programs.
Key Findings
Success rates
Between 61 and 64% of registrants reported they had successfully completed Dry January whereas only 30.2% of the unofficial participants, i.e., participants who had not officially registered on the Dry January application or website, declared having completed it.
Outcomes reported by participants
25% percent of the Febfast registrants reported giving up alcohol for a month was difficult or very difficult, especially younger participants and participants with heavier alcohol consumption patterns.
Dry January registrants had a higher alcohol refusal self-efficacy score score at 1-month and 6-month follow-up when they were successful. This was also the case for those who were unsuccessful at 1 month, and there was a trend toward this at 6 months. The successful participants’ alcohol refusal self-efficacy score increased in all three dimensions, whereas only the social and emotional dimensions increased for the unsuccessful participants. No significant change in alcohol refusal self-efficacy was found among unofficial participants.
Among the successful registrants, there was a decrease in the AUDIT-C score from baseline, to the 6-month assessment, as well as significant reductions in the number of alcohol consumption days per week, number of alcoholic drinks per alcohol consumption day, frequency of alcohol inebriation at 6-month follow-up. The same improvements were found among unsuccessful registrants. However, unsuccessful registrants were more likely to report an increased frequency of alcohol inebriation after Dry January compared to those who were successful.
Only successful Dry January registrants had a higher general self-efficacy score at 1-month follow-up.
The Warwick–Edinburgh Mental Well-being Scale score was higher at 1-month follow-up for all participants and 6-month follow-up for both successful and unsuccessful registrants to Dry January. Self-rated physical-health was greater at both 1-month and 6-month follow-up for successful registrants.
Participants to Dry July reported having changed their diet, and having increased their current exercise program at the mid-year health check. 21% of 2019 Dry July participants reported feeling healthier.
Registrants reported other benefits of Dry January such as savings (63%), improved sleep (56%), more energy (52%), better health (50%), weight loss (38%). Improvement in all five of these domains was greater among successful participants. The most commonly reported benefits during Febfast were also savings (52.2%), improved sleep (40.5%), weight loss (38.1%) and improved overall health (35.3%). 46.5% of Febfast registrants reported a reduction of their tobacco consumption during the event.
In the UK, odds of high-risk alcohol users reporting a current attempt to restrict alcohol consumption was significantly higher in January compared to the other months, as were the odds of high-risk alcohol users citing Dry January as a motive in their most recent attempt to restrict consumption.
Abstract
Over the last decade, one-month alcohol-free campaigns have been implemented within the general population in an increasing number of countries.
The researchers identified the published studies reporting data on one-month alcohol-free campaigns to explore the following aspects: profile of participants, rates and factors associated with the completion of the alcohol-free challenge, and outcomes and harm reduction benefits in participating in the challenges.
The researchers screened 322 records, including those found in the grey literature, and reviewed 6 studies and 7 Dry July Annual Reports.
Compared to non-participating alcohol users, participants were more likely to be female, have a higher income, and a higher level of education. They were heavier alcohol users and were more concerned by the consequences of alcohol on health and by their health in general.
Participants who achieved the one-month alcohol-free challenge were lower alcohol This scoping review examines the harm-reduction benefits of one-month alcohol-free campaigns implemented in multiple countries, including Dry January and similar national initiatives. Across the limited available studies, participants—both those who completed the month and those who did not—reported short- and mid-term benefits such as improved sleep, reduced alcohol consumption, and increased confidence in refusing alcohol, with stronger and more sustained changes among registered participants. The review highlights consistent gaps in reach and evidence, underscoring the need for more robust, comparative research and greater attention to populations currently underserved by alcohol-free campaigns. and more likely to have registered on the campaign-related Internet communities.
Both successful and unsuccessful participants frequently reported health benefits, including sleep improvement and weight loss. Successful participants were more likely to durably change their alcohol consumption habits.
Overall, one-month alcohol-free campaigns provide short- or mid-term harm reduction benefits for both successful and unsuccessful participants. Findings were limited by the paucity of studies, their observational nature, and heterogeneity in the features of the different national campaigns, which would probably gain in enhanced internationalization.