Dry January: the evidence

Dr Richard Piper | December 2019 | 11 minutes

At Alcohol Change UK we value evidence; as a new decade approaches Chief Executive Dr Richard Piper summarises some of the research on Dry January’s effectiveness.

An evidence-based approach

With around four million UK adults trying a Dry January every year, it’s little wonder that the phenomenon has attracted the attention of researchers who are keen to understand it and assess its effectiveness.

There have been in-depth surveys of Dry January participants (de Visser 2015, 2016, 2018, 2019), studies into effects on the body of a month of abstinence (Mehta et al 2018, Field 2019), detailed analysis of data from the Try Dry app (forthcoming) and research into the discourses that surround the campaign (Yeomans 2019).

Alcohol Change UK runs Dry January. We value evidence. And we are ambitious about reducing alcohol harm as fast as possible. So naturally we are avid readers of such research and have commissioned some studies and undertaken others ourselves.

While we know that Dry January is life-changing for thousands of people, we are not complacent. We always want to know more about how well Dry January works, for whom, and how it can be continually improved to have even greater impact.

What does the research show?

As a new decade approaches, I thought now might be a good moment to summarise some of the things we know about Dry January’s effectiveness; and some of the things we’d like to know.

The first thing to say is that Dry January means different things to different people, so it is researched through very different lenses. Two approaches predominate.

Firstly and most commonly, Dry January has been seen as one amongst any number of ‘temporary abstinence restrictions’ (Field 2019). The simple fact of ‘going dry for a month’ is viewed as the ‘intervention’.

The second approach is to view Dry January as a specific intervention, taking into account its structured, psychology-informed support package and its distinctiveness from both a self-organised unsupported month off alcohol and a fundraising-centric campaign like Go Sober for October or Dryathlon, which do not have a support package and which are framed quite differently in terms of the motivations of the participants.

In this blog I will summarise some of the evidence produced by these two groups of studies.

Studies into a month-off alcohol generally

Benefits on the inside

Mehta et al (2018) took medical readings from 94 people before and after a month off alcohol, alongside readings for a control group. Participants were moderate to heavy non-dependent drinkers. They found that the group that abstained from alcohol had improved insulin resistance, lower weight, improved blood pressure and a reduction in cancer-related growth factors compared to the control group.

How much does staying completely dry matter?

The design of the official Dry January campaign means that it does not particularly focus on the degree to which people stay completely dry, although this is of interest to some researchers. Across a number of studies, de Visser (2015, 2016, 2018, 2019) has pioneered research into the degree to which people stay completely dry, the factors behind that and the consequences of that.

De Visser’s (2018) evaluation surveyed 2,800 Dry January participants and found that improvements in Drink Refusal Self-Efficacy and reductions in AUDIT (a measure of drinking risk) scores were present amongst participants of Dry January, whether or not they stayed completely dry throughout the month. However, his 2019 evaluation found that those who stayed completely dry had greater decreases in their AUDIT scores, bigger increases in wellbeing and Drink Refusal Self-Efficacy and more improved general health.

Studies of Dry January specifically

Who takes part?

More women than men sign up to do the official Dry January (Piper, forthcoming). The same is true for people taking on Dry January without support, but the difference isn’t large; 11% versus 8% of drinkers (YouGov 2019). The mean age of people who sign up for Dry January is 39. People with higher levels of education and income are more likely to sign up to Dry January (de Visser 2019). Those who sign up to the official Dry January are heavier drinkers (with an average AUDIT score of 9.1) than both the general population (average AUDIT score of 5.7) and those who do an unofficial dry January (average AUDIT score of 5.1) (de Visser 2019).

How does it work?

There has been little research into the mechanisms of Dry January. The primary evidence on this comes from the Dry January team at Alcohol Change UK, in the theory of change set out in its internal documents.

Yeoman’s (2019) qualitative assessment of the campaign’s own narrative about itself and the degree to which that is reflected in participants’ narratives on social media, show the extent to which the campaign is about positivity, embodied learning and self-formation. De Visser has shown (2018) how the various elements of the campaign – the app, the emails, the online community group, and so on – are used and valued by participants. His research also produces useful insights into ways that the support package can be further improved.

A forthcoming paper from Alcohol Change UK, using data from the Try Dry app, shows that exactly 54,000 people entered data into the app during the month of January 2019, with 21,715 entering data into the app every day during the month. 11,111 people stayed completely dry, or 51%. 17,736 (70.0%) drank three times or fewer, i.e., stayed dry for 28-31 days, while 19,373 (89.2%) managed 22 dry days or more. Before the challenge, participants drank on average 31.4 units per week – more than double the low-risk drinking guidelines, and significantly higher than the average for the UK population. By the end of January 4,051,695 fewer units had been consumed by app users than would have been at baseline drinking, and 67% of app users saw their AUDIT score drop.

Self-reported benefits

De Visser (2019) surveyed over 6,000 Dry January participants and found that 86% had saved money, 81% felt more in control of their drinking, 70% were sleeping better, 67% had better concentration, 66% had more energy, 65% had generally better health and 54% had lost weight.

Intended impacts

One of the most interesting questions that emerges when one looks across the various studies is, ‘What is Dry January for? What impact does it seek to make?’ Yeoman (2019) notes that its primary intended impact is people taking more control of their drinking for the longer-term, which is sometimes framed as “resetting your relationship with alcohol”. He gives examples of campaign participants positively reflecting that language back to the campaign.

Rebound effects

It has been suggested that a Dry January inevitably leads to binge February. However, the evidence (de Visser 2015) is that Dry January “is unlikely to result in undesirable rebound effects” and indeed such effects were seen to be negligible. Further research has suggested the same – see below.

Long-term change

The view is sometimes expressed that, rather than encouraging people to stay dry in January, Alcohol Change UK should focus on moderation over the long-term. However, the two are not mutually exclusive. Indeed, the long-term aim of the campaign is greater control over drinking, while the method for achieving that is a short-term period of abstinence combined with a package of support to enable reflection, learning and habit-breaking. In other words, a supported, official Dry January is a means to achieving long-term control of one’s drinking as the end.

But what is the evidence that such change happens? De Visser (2019) surveyed Dry January participants and compared them with a control group from the general population. He found that, six months later, Dry January participants had seen improvements in their AUDIT scores, wellbeing, and Drink Refusal Self-Efficacy that were not mirrored in the general population.

Comparisons between a supported and unsupported Dry January

Finally, de Visser’s 2019 study compared, for the first time, people who sign-up for the official Dry January with people who do their own Dry January without the support package. People who signed-up were twice as likely to stay dry throughout the month as those who didn’t. This reinforces the view that Dry January must be studied and evaluated as a specific intervention, independently of general, unsupported months of abstinence.

What next?

Dry January is just one of Alcohol Change UK’s programmes of work to end alcohol harm. We believe that only through action on multiple fronts – evidence-based policy change, effective and accessible treatment, and support for those affected by another’s drinking – can alcohol harm be reduced across society. However, we see Dry January as an essential component in this change, and the evidence to date supports the view that Dry January is an effective intervention for creating medium to long-term change among heavy drinkers.

At Alcohol Change UK we care deeply about the evidence and are always looking to improve, so we very much welcome further research into Dry January; its efficacy, mechanisms and potential.

References

Mehta G, Macdonald S, Cronberg A, et al (2018) Short-term abstinence from alcohol and changes in cardiovascular risk factors, liver function tests and cancer-related growth factors: a prospective observational study, BMJ Open 2018; 8:e020673

de Visser, RO, Robinson, E & Bond, R (2015) Voluntary temporary abstinence

from alcohol during “Dry January” and subsequent alcohol use, Health Psychology 35(3), Dec 2015

de Visser RO, Robinson E, Smith T, Cass G, Walmsley M.

The growth of 'Dry January': promoting participation and the benefits of participation, Eur J Public Health, 2017 Oct 1;27(5):929-931. doi: 10.1093/eurpub/ckx124.

de Visser RO and Lockwood, N (2018) Evaluation of Dry January 2018, School of Psychology, University of Sussex

de Visser RO (2019) Evaluation of Dry January 2019, School of Psychology, University of Sussex

Field, M (2019) Long-term benefits of temporary alcohol restriction: feasibility study, presentation, https://www.addiction-ssa.org/author-publications/long-term-benefits-of-temporary-alcohol-restriction-feasibility-study/

Piper, R (forthcoming) Using TryDry app data to interrogate Dry January behavioural change, Alcohol Change UK

Yeomans, H (2019) New Year, New You: a qualitative study of Dry January, self-formation and positive regulation, Drugs: Education, Prevention, Policy, 25 (6), 460-468, doi.org/10.1080/09687637.2018.1534944

YouGov (2017) Who intends to do a Dry January? YouGov

YouGov (2018) Who intends to do a Dry January? YouGov

Recent evaluations