It seems 2019 is to be another strong year for Dry January, with over four million people expected to take part according to Alcohol Change UK. However the campaign continues to face criticisms from some perhaps unexpected quarters.
Alcohol Change UK emphasise that going dry for the month leads people to drink less year-round, responding to the commonly raised issue of whether taking part may lead to more drinking pre or post January, with some arguing year round moderate drinking messages are preferable. Alcohol Change UK say new unpublished data on 2018 participants bolsters previous research by the University of Sussex which suggested 70% of risky drinking participants were still drinking less six months on. Participants also reported a wide range of other health and social benefits including saving money, better sleep and losing weight.
However a Conversation piece by Ian Hamilton, also published in the Inews, raises other challenges to Dry January, even suggesting 'the alcohol industry views it as a neat distraction from an inconvenient truth', referring to the 4% of the population who account for more than 30% of all the alcohol sold in the UK. Hamilton argues that Dry January does not target these 'high risk' drinkers, some of whom may be physically dependent and therefore in danger of potentially fatal withdrawal effects if suddenly stopping.
Hamilton therefore argues that 'Dry January might cause more harm than good, because it attracts those least at risk of developing problems due to alcohol, while neatly distracting attention from those at the greatest risk'. This group, he argues, need targeted specialist help but receive the least service provision as per the inverse care law. Hamilton says money would therefore be 'better spent on those who need support the most and on tackling the root causes of excessive drinking', whilst further robust evaluation is required, highlighting limitations to the current evidence in a BMJ opinion piece.
Dry January critiques - fair game?
How widely such concerns are supported amongst the academic and wider alcohol field is hard to gauge, though some have suggested that a lack of investment in interventions and support for more harmful drinkers should not mean other such campaigns should be halted. Indeed Alcohol Change UK has championed the need for further investment in declining alcohol services, and has articles seeking to address concerns, including how it sees Dry Janaury as part of its vision to reduce alcohol-related harm, and 'Dry January: a recipe for a February binge?'.
Some might also highlight that there are no clear dividing lines between different risk groups, and harmful drinkers reflect a rich tapestry of groups and behaviours. Whilst Dry January is not aimed at dependent drinkers, most dependence actually exists at milder psychological degrees where there is no risk of physical withdrawal.
For these drinkers, a period of abstinence may offer a useful 'litmus test', as perhaps exampled by personal accounts such as journalist Peter Oborne.
Writing in the Telegraph, Oborne has chronicled several Dry January efforts, posing ahead of his first attempt, "I admit that, while not an alcoholic, I am in danger of becoming alcohol-dependent". The following year, Oborne articulated both the health benefits and his downsides of undertaking the 'long chore', but later pledging that 'Every week there are going to be three days when I don’t have a drink. This might be harder than I think. But I have been shocked by how difficult I found it giving up booze.'
Such accounts suggest that there are indeed some harmful drinkers who engage with Dry January primarily out of concern about the often murky question of dependence. But indeed the extent of participation and outcomes amongst such drinkers is arguably another important question to be researched.
Love your liver?
Evidence may be considered somewhat more developed concerning the possible physiological benefits for at-risk drinkers taking part. Indeed, the desire to 'give the body a break' or improve health in the new year certainly appears more representative of most Dry January participants.
Last year a study reported in the BMJ found significant benefits from a month off amongst at-risk drinkers (averaging around 30 units/week) in terms of diabetes, cancer and insulin risks. Writing in an APUK guest post the author, Dr Gautam Mehta, said the study 'adds weight to the evidence for health benefits of even short-term abstinence amongst those drinking at risky levels' and spoke about the research on a recent episode of Radio 4's Inside Science.
As such, concerns that Dry January may do more harm than good arguably rely on assumptions about potential unintended consequences of a campaign focused on risky rather than harmful drinking, and indeed assumptions that heavier drinkers do not benefit. Most though are likely to agree that these are important questions and further independent research is warranted to assess outcomes in terms of health and other potential consequences.
Why so popular?
Meanwhile a new qualitative analysis of Dry January suggests its popularity may stem from the more positive approach to individual health and well-being gains when compared to other more negatively risk-framed messages, including of course the weekly guidelines. Analysis of Dry January discussions revealed largely positive experiences related to the commonly purported benefits such as improved sleep, mood or energy, albeit a minority described none of the benefits materialising, or seeing themselves as 'dull'. The author argues positive embodied effects in turn become important to participant's identities, with similarities drawn to the declining rates of drinking amongst younger people, which also remains a subject of ongoing attention.
Also linked to Dry January's popularity is likely to be the extent of media coverage, as indeed a host of TV, radio and other media have and continue to cover Dry January experiences and debate throughout the month. Channel 4's recent Food Unwrapped diet special included Matt Tebbutt's month off attempt, as have a range of other radio and TV programmes. Google's news search function reveals a near endless supply of Dry January articles, ranging from the encouraging to the outright cynical 'January is the worst time to give up booze'.
Also cropping up perhaps with increasing frequency are those preferring a moderation approach, such as '40 units a week' Rob Crosson's Esquire article, 'Why I'm Swapping 'Dry January' For A 'Damp 2019'. Crosson explains he's 'rejecting Dry January in favour of an entire year which I’m determined isn’t going to be as consistently sopping wet as the year before'. Moderation may be a more palatable concept for alcohol businesses taking a more straight forward view of Dry January, as certain venues seek to capitalise on lower strength offerings and their potential appeal. Virgin Atlantic has even launched its first in-flight menu dedicated to low and non-alcoholic drinks, whilst this weekend London hosts the next instalment of the Mindful Drinking Festival, showcasing a range of low and no alcohol drinks and activities.
Here to stay?
Dry January appears to be establishing itself as regular feature of the new year, which supporters will no doubt consider an important asset in securing further positive shifts in the nation's drinking culture at large. Indeed, the observed similarities to the decline in young people's drinking raise particularly interesting questions. For example, to what extent such campaigns - and indeed the growth in low/no alcohol drinks - may be considered responses to demand, or potentially contributory factors towards such shifts. Such questions may have important implications for groups where drinking changes have so far failed to materialise, notably in older and heavier drinking adults.
Further research is underway seeking to answer some of these questions. In the meantime, January may be becoming an increasingly accepted as a time to ‘go dry’, if not at least a more moderate time of the year.
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