Dear HIFA colleagues,
Further to our discussions on HIFA, in the past week DrinkAware HAS CHANGED THEIR ADVICE to people who drink 42 units per week (3X the recommended maximum). Questions remain about how many people were misled by previous advice, whether that advice was deliberate, and whether WHO's AUDIT test (currently used as the basis for the DrinkAware test) should continue to be used by anyone as an unsupervised self-evaluation tool.
BACKGROUND
On 22 February 2024 I reported on HIFA an apparent problem with DrinkAware, the UK's largest alcohol charity, funded by the alcohol industry. https://www.hifa.org/dgroups-rss/alcohol-use-disorders-79-role-alcohol-i...
I took their Drinking Check. I posed as a man who drinks 42 units per week (3X the recommended maximum) and DrinkAware told me: "Great news! You are at lower risk of alcohol-related problems. This means you are at lower risk of serious diseases such as stroke, heart and liver disease, and seven types of cancer and may already be noticing the benefits of lower risk drinking such as deeper sleep, more energy and brighter moods."
There was no advice to reduce my consumption.
This test was repeated by other HIFA members in subsequent days, with the same results.
On 4 March 2024 we reported our findings to the World Health Organization.
CHANGE IN ADVICE
Today, 10 March 2024, I took the test again. As before I posed as a man who drinks 42 units per week. This time I got a different result:
"You are on the right track. You are at lower risk of alcohol-related problems... To keep your health risks low, the UK Chief Medical Officers advice is to drink no more than 14 units a week. If you are regularly drinking above 14 units per week there are tips and advice below about how to cut down."
INTERPRETATION
Prior to 4 March 2024, DrinkAware was encouraging many heavy drinkers (up to 42 units per week) to continue drinking as they are.
DrinkAware claims that its Drinking Check tool was used by 250,991 people in 2021, so it appears that potentially tens or even hundreds of thousands of people drinking 14-42 units per week may have been misinformed.
At some point between 4 March and 9 March, Drinkaware changed their Drinking Check tool so that heavy drinkers (up to 42 units per week) are now advised to cut down.
SHOULD WHO's AUDIT TEST BE USED AS AN UNSUPERVISED SELF-EVALUATION TOOL?
Previous messages on HIFA have suggested that AUDIT should only be used as a clinical tool by health professionals, and not as an unsupervised self-evaluation tool. WHO's AUDIT manual notes: 'Care must be taken to tell patients why questions about alcohol use are being asked and to provide information they need to make appropriate responses. A decision must be made whether to administer the AUDIT orally or as a written, self-report questionnaire.' https://iris.who.int/bitstream/handle/10665/67205/WHO_MSD_MSB_01.6a-eng.pdf
NEXT STEPS
How many people were misled by previous advice, was that advice deliberate, and should WHO's AUDIT test (currently used as the basis for the DrinkAware test) continue to be made available as an unsupervised self-evaluation tool?
I invite HIFA members to suggest next steps. Are you a health journalist (or do you know a health journalist) who might be interested to look into this in more depth? Please pass this on and/or contact me: neil@hifa.org
Meanwhile I shall report this new finding to WHO.
I look forward to your comments and suggestions: hifa@hifaforums.org
Best wishes, Neil
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: neil@hifa.org
