Alcohol industry-funded (AIF) apps promoted to reduce alcohol consumption contain health misinformation and may encourage users to drink, potentially causing more harm than good, say researchers in a first-of-its-kind report.
In the study, published this month (October) in the journal Health Promotion International, researchers say industry-funded apps claim to help people make positive health decisions but are designed to undermine healthy behaviors for the sake of protecting profits. A 2015 review of alcohol-reduction apps similarly concluded the majority implicitly or explicitly promoted alcohol use, but it did not investigate their funding source.
Alcohol reduction tools typically allow users to monitor their alcohol consumption with blood alcohol calculators, AUDIT scores, and consumption trackers. However, researchers in the latest study show alcohol industry-backed apps provide significantly less accurate feedback and omit much more information on associated health risks, including cancer and cardiovascular disease, than apps that do not receive industry funding.
Apps to avoid
The industry-backed tools use “dark patterns“—which researchers say are strategies for influencing people to act against their best interests. This includes providing users with limited drink options in small serving sizes, which makes it impossible to check consumption against recommended guidelines. It also may lead users to believe they drink at lower risk levels than they actually are, at a time when more than 170,000 people die from excessive alcohol use each year in the US alone.
“Given their potential for direct harm and for replacing reliable sources, the public should be explicitly warned to avoid tools from industry-funded organizations like Drinkaware, Drinkwise, Cheers and Éduc’alcool,” says co-author Dr. Elliott Roy-Highley, a public health doctor and honorary lecturer at University College London’s Global Business School for Health.
“This study highlights how industry actors use digital behavior change tools to appear to be ‘doing good,’ while bypassing legitimate independent sources to promote industry narratives, spread health misinformation and nudge users towards increasing consumption.”
Several spokespeople for alcohol industry-funded digital apps denied the claims in news reports.
Problematic messaging
The latest study was conducted between June and August 2022. Researchers accessed alcohol consumption data (with a reported 738,000 downloads) from 15 of the most widely used apps promoted or developed by alcohol producers or organizations receiving alcohol industry funding. They compared data from 10 digital tools provided or referred by a national government or healthcare service (NGHS) not funded by the alcohol industry in the UK, the US, and four other countries. (Apple data was not available.)
Most tools provided self-control advice and non-personalized advice, such as eating before drinking alcohol and drinking slowly. But industry-backed tools, unlike independent sources, encourage “smart” or “responsible” drinking, which shifts responsibility away from the industry to users, researchers say.
The tools also downplay harms through problematic messaging, such as presenting happy images of people socializing and drinking, or pairing statements of risk with trivia.
Consider this example: “Serbia toasts with the word ‘Živeli!’ which means ‘Let’s live long!’” appears above “Alcohol is a depressant and…stops you doing things properly, like driving.”
Less info on serious health harms
Among other findings, researchers also reported alcohol industry-funded tools:
- Offer less information on “other” serious harms, such as liver damage, reduced fertility, and addiction
- Less likely to inform users about national low-risk drinking guidelines, including daily and weekly limits (one AIF tool erroneously provided “binge” limits as daily consumption advice)
- More likely to include features such as time-to-drive blood alcohol calculations, while independent sources focused more on reducing consumption and understanding risks
- Two-thirds less likely than independent alcohol reduction tools to provide users with links to services such as mental health, alcohol or financial support
Further research is needed, along with more regulation and oversight by public health departments and governments, researchers say. But enough evidence exists, they maintain, to raise serious concerns about alcohol industry-funded tools and organizations.
“We need to remember that these organizations are not health organizations,” says Prof. Mark Petticrew, who co-authored the study and the book The Commercial Determinants of Health. “Their covert (and sometimes overt) purpose is the marketing, promotion and normalization of alcohol, and they are also a key means by which the alcohol industry in different countries interferes with effective policies to reduce alcohol harms.”
Interview with lead researcher
References
Roy-Highley E, Körner K, Mulrenan C, Petticrew M. Dark patterns, dark nudges, sludge and misinformation: alcohol industry apps and digital tools. Health Promotion Int. 2024 Oct 8;39(5):daae037. doi.org/10.1093/heapro/daae037
Related
Babor TF, Robaina K, Brown K, Noel J, Cremonte M, Pantani D, Peltzer RI, Pinsky I. Is the alcohol industry doing well by ‘doing good’? Findings from a content analysis of the alcohol industry’s actions to reduce harmful drinking. BMJ Open. 2018 Oct 24;8(10):e024325. doi: 10.1136/bmjopen-2018-024325.
CDC. “Alcohol Use and Your Health.” Accessed Oct. 11, 2024.
Lim AWY, van Schalkwyk MCI, Maani Hessari N, Petticrew MP. Pregnancy, Fertility, Breastfeeding, and Alcohol Consumption: An Analysis of Framing and Completeness of Information Disseminated by Alcohol Industry-Funded Organizations. J Stud Alcohol Drugs. 2019 Sep;80(5):524-533. doi: 10.15288/jsad.2019.80.524.
Maani N, Ci van Schalkwyk M, Petticrew M. Under the influence: system-level effects of alcohol industry-funded health information organizations. Health Promot Int. 2023 Dec 1;38(6):daad167. doi: 10.1093/heapro/daad167.
Madden M, McCambridge J. Alcohol marketing versus public health: David and Goliath? Global Health. 2021 Apr 12;17(1):45. doi: 10.1186/s12992-021-00696-2.
Mialon M, McCambridge J. Alcohol industry corporate social responsibility initiatives and harmful drinking: a systematic review. Eur J Public Health. 2018 Aug 1;28(4):664-673. doi: 10.1093/eurpub/cky065.
National Institute on Alcohol Abuse and Alcoholism. “Alcohol’s Effects on the Body.” Accessed Oct. 11, 2024.
Peake L, van Schalkwyk MCI, Maani N, Petticrew M. Analysis of the accuracy and completeness of cardiovascular health information on alcohol industry-funded websites. Eur J Public Health. 2021 Dec 1;31(6):1197-1204. [Abstract]
Petticrew M, Maani N, Pettigrew L, Rutter H, VAN Schalkwyk MC. Dark Nudges and Sludge in Big Alcohol: Behavioral Economics, Cognitive Biases, and Alcohol Industry Corporate Social Responsibility. Milbank Q. 2020 Dec;98(4):1290-1328. doi: 10.1111/1468-0009.12475.