A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial

In reply: Braillon1 questions the rationale for investigating brief alcohol interventions for reducing alcohol consumption among women attending breast screening. Our recent trial2 represents one example of the wider efforts to rethink potential applications of brief alcohol interventions3 — in this instance, within a national breast screening program.

An e‐health brief intervention was chosen based on meta‐analytic evidence supporting their effectiveness in reducing alcohol consumption among community populations,4 and with potential for wide‐scale implementation. The intervention was adapted to address alcohol literacy and consumption in the context of breast cancer risk reduction and was co‐produced with women to ensure its appropriateness for the breast screening setting.

The trial2 found that alcohol was largely a blind spot in women's awareness of breast cancer risk factors. The brief intervention improved knowledge of the alcohol–breast cancer link, and alcohol literacy more broadly. As discussed in the article, although brief intervention trials typically include only participants drinking at hazardous levels, our universal approach meant that women drinking at all levels (including low risk) received the intervention, expanding its utility as a health promotion intervention while discretely targeting harmful consumption. While not powered to detect change in alcohol consumption, this preliminary study provides data on consumption endpoints (and rates of missing data and participant attrition), providing important estimates for future, scaled‐up research.

We agree that brief interventions are not a panacaea for reducing alcohol consumption and related harms. As we emphasised, sustained, multifaceted strategies comprising alcohol policy measures, media/social media campaigns, and individual‐level interventions are needed to address the numerous cognitive and social influences on alcohol consumption, and to counterbalance the actions of the alcohol industry. We argue that the utility of brief alcohol interventions warrants continued exploration, as a frontline intervention that can be implemented in diverse clinical settings, complementing other public health and policy measures to increase alcohol literacy and empower people to make informed decisions about their alcohol use and health.