Alcohol Use Disorders (100) Alcohol industry and misinformation (9) A call to action

27 February, 2024

Dear Eduardo and colleagues,

You said: "But when I performed the AUDIT score, marking similar options, it gave me a result of 5 points, which implies a low risk, as the Drinkaware result."

Yes, I confirmed this also.

According to DrinkAware, if I enter 3 pints of beer per day (42 units per week), then I get the response: "Great news! You are at lower risk of alcohol-related problems"

And according to AUDIT, if I enter 3 pints of beer per day, I get this response: "Your score is 6 and places you in the low risk category for alcohol problems. Congratulations on this... ensuring it [your consumption] remains within the low risk range represents a great investment for your future."

Neither the DrinkAware test nor the AUDIT test advise you to reduce your intake. In fact the AUDIT test advises you to 'ensure your consumption remains within the low risk range'. In other words, carry on drinking 3 pints of beer a day!

The corresponding links are:

42 units of alcohol per week is defined as very heavy drinking by most authorities.

For example the (anachronistically named) US National Institute on Alcoholism and Alcohol Abuse defines heavy drinking as more than 15 units per week. And the UK National Health Service advises people not to drink more than 14 units per week. So our fictitious drinker is drinking 3X more than the recommended maximum.

When we first started to discuss this, I assumed that perhaps there was a temporary fault with the DrinkAware software. But no, I am shocked to learn this is not a fault, it is REAL deliberate advice. People who drink three times the recommended amount of alcohol are advised to celebrate and carry on, without even a hint of encouragement to cut down, and without any guidance on the fact that 42 units of alcohol per week is associated with an increased risk of cardiovascular disease and cancer. The alcohol industry must be laughing all the way to the bank, gleefully adding to their $1 trillion global turnover.

From where I see it, this is a gross case of misinformation. If you drink 42 units a week and you consult an online tool to check your drinking, then you should be told that your level of drinking is defined as 'heavy drinking', you should be told that you are at risk of cardiovascular disease and cancer, you should be advised to cut down. You should not be advised to celebrate and carry on.

These tests are used by thousands of people every day. Over a year, hundreds of thousands of people are probably being misinformed.

How on earth could public health professionals in the US and the UK have approved a tool that is so misleading?

Call to action: I invite HIFA colleagues to join me in calling for an urgent review of online drinking checks like DrinkAware and AUDIT. Currently they are surely not fit for purpose.

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: