Institute of Epidemiology & Health Care


Ongoing Research Projects

Find out more about the projects ARIG researchers are working on..

Alcohol Toolkit Study (ATS)

Investigators: Jamie Brown, Loren Kock, Dimitra Kale, Emma Beard, Robert West, Alan Brennan, Colin Drummond, Matthew Hickman, John Holmes, Eileen Kaner, Susan Michie

Project summary: Timely tracking of national patterns of alcohol consumption is needed to inform and evaluate strategies and policies aimed at reducing alcohol-related harm. The ATS provides such tracking data and can link these with policy changes and campaigns

Aims: To monitor trends on alcohol consumption and alcohol-related behaviours in England

Methods: Cross-sectional, monthly household survey of a representative sample of adults in England (since March 2014). Each month involves a new representative sample of ~1700 adults. Questions cover alcohol consumption and related harm (AUDIT),socio-demographic characteristics, attempts to reduce or cease consumption and factors associated with this, and exposure to health professional advice on alcohol.

Suicidality, self-harm, and alcohol
Investigators: Dr Alexandra Pitman, UCL Division of Psychiatry; Prof David Osborn, UCL Division of Psychiatry; Sarah Ledden, UCL Division of Psychiatry; Dr Keltie McDonald,  UCL Division of Psychiatry; Dr Gemma Lewis,  UCL Division of Psychiatry
Project summary:  We are interested in the links between alcohol use and suicidality, including where alcohol misuse mediates risk of suicide in specific sub-groups (people exposed to trauma, people experiencing loneliness, people with chronic pain); the ways in which alcohol is used to self-medicate the effects of trauma, pain, loneliness, and mental illness; and how to motivate people to use alternative coping strategies.

Aims: To understand the pathways between alcohol use and suicide/self-harm.

Methods: epidemiological methods, using existing datasets (APMS, Danish registers, Swedish registers, ALSPAC) and qualitative methods (UCL Bereavement Study)

Smoking and drinking in Great Britain
Investigators: Dr Loren Kock, Prof Lion Shahab, Prof Jamie Brown
Project summary:  As part of the SPECTRUM consortium (a UKPRP funded research consortium focused on commercial determinants of health and health inequalities) UCL are leading a work package to develop and integrate responsive novel data sources to inform, refine and evaluate systems-level interventions in alcohol and tobacco control across and between nations in Great Britain.
Aims: First, to expand detailed monthly surveillance of tobacco and alcohol use across Great Britain and constituent nations using new participatory methods to refine data collection in response to evolving policymaker needs and public interest. Second, to develop and apply new methods from applied statistics and economics for integrating data and forecasting new trends.
Methods: We have expanded an existing representative data source in England – the Smoking and Alcohol Toolkit Study (STS/ATS) (www.smokinginengland.info and www.alcoholinengland.info) – to other nations in Great Britain. Expanding the STS/ATS to Wales and Scotland will also enable us to evaluate natural experiments created by heterogeneity in systems-level interventions across devolved nations, thus allowing us to identify emergent effects from divergent policy scenarios targeting unhealthy commodities.
Are alcohol reduction attempts motivated by Dry January associated with reduced alcohol consumption 6 months later? A prospective study of high-risk drinkers in England

Principal Investigators: Dr Sarah Jackson, Professor Matt Field, Philippa Case and Professor Jamie Brown 

Project summary:   Understanding the extent to which those who take part in Dry January achieve a long-term reduction in alcohol consumption, and how this compares with other alcohol reduction attempts, is important in evaluating its public health impact and guiding decisions on future investment.

Aims: To examine whether alcohol reduction attempts motivated by Dry January are associated with reduced alcohol consumption 6 months later, relative to (i)  attempts not motivated by Dry January and (ii) no attempt to cut down.

Methods: Prospective analysis of data from the Alcohol Toolkit Study, a monthly cross-sectional survey of a representative sample of adults in England.

Health Behaviours during the COVID-19 pandemic: HEBECO study (2020-2021) 

Principal Investigators: Dr Aleksandra Herbec, Dr Dimitra Kale & Professor Lion Shahab

Project summary: The COVID-19 pandemic has resulted in the introduction of a number of social distancing measures that may impact on a number of health related behaviours – some may act as catalysts to positive behaviour change (e.g. quitting smoking) but some may impede positive health behaviours and lead to sustaining or an increase in risky or unhealthy behaviours. Understanding these processes is paramount for us to deliver or create appropriate interventions.Furthermore, due to social distancing measures, the face-to-face behaviour change support (such as individual or group support from smoking cessation or alcohol abuse) are currently closed. In such context digital and remote interventions are the most feasible interventions.

Aims: This research aims to examine physical activity and diet, as well as the use and changes to the use of tobacco (e.g. cigarettes), nicotine (e.g. e-cigarettes) and alcohol consumption during the coronavirus  pandemic (Covid-19) and to understand how we could create or provide support that may help people to make changes to their behaviours and therefore their health.

Methods: This project utilises logitudinal design to investigate changes in health behaviours during the COVID-19 and the theoretically factors contributing them.



Evaluating the effectiveness of the smartphone app, Drink Less, compared with the NHS alcohol advice webpage, for the reduction of alcohol consumption among hazardous and harmful adult drinkers in the UK at 6‐month follow‐up: a randomised controlled trial (2020-2022) 

Funding: NIHR (127651). 

Principal Investigators: Dr Claire Garnett, Professor Jamie Brown, Dr Melissa Oldham & Gemma Loebenberg

Project summary: Health practitioners can help people to cut down by regularly asking about drinking and offering advice. Unfortunately, less than 1 in 10 hazardous and harmful drinkers in England receive this help due to barriers such as lack of time. Using digital technology, such as smartphone apps, provides support that can overcome these barriers and has the added advantages of being widely accessible and available. Health inequalities are a particular concern with regards to alcohol consumption as the most deprived groups in society suffer the most alcohol-related harm. Digital interventions have the potential to reduce health inequalities and help disadvantaged groups when designed with input from these user groups. A recent review of apps to help people reduce their drinking available on UK App Stores showed that none were based on scientific evidence or theory. The app, Drink Less, was developed to help people reduce their alcohol consumption using a systematic and iterative process drawing on evidence and theory to inform its content. The app consists of multiple modules with users being prompted to track their drinks and set goals, provided with feedback on their goals and how their drinking compares with others in the UK, as well as information on the UK drinking guidelines and links for additional support. 

Aims: This research aims to evaluate whether recommending the improved version of Drink Less is effective and cost-effective for helping hazardous and harmful drinkers to reduce their alcohol consumption. Hazardous and harmful alcohol consumption is a leading cause of avoidable deaths, ill-health, disability, and cancer in the UK.

Methods: A randomised controlled trial will be conducted in which participants will be randomly recommended either the improved version of the Drink Less app or the NHS webpage with alcohol advice. The trial will be conducted online with adults (aged 18+) in the UK who consume hazardous or harmful levels of alcohol. Participants will be followed-up via email with a survey on their drinking behaviour using validated measures at one, three and six months. The study findings will indicate whether investment in promoting the app is warranted. 


Determining Interactions of Alcohol Consumption and Metabolic Factors for the Development of Liver Disease: A Prospective Study (2019-2021) 

 Funding: NIHR (PB-PG-0418-20038). 

Principal Investigators: Professor Annie Britton & Dr Gautam Mehta 

Project summary: Liver disease is the 3rd most common cause of preventable death in the UK. The most common cause in the UK is alcohol-related liver disease, followed by non-alcoholic fatty liver disease (NAFLD). Pre-clinical and observational data support an interrelationship between alcohol use and NAFLD risk factors leading to an increased risk of advanced liver disease. Recent NICE guidance supports a policy of screening individuals drinking alcohol at harmful levels for cirrhosis with Fibroscan, although there is limited evidence to support these specific thresholds for screening. 

Aims: the primary aim of this study is to define risk thresholds for community screening for advanced liver disease, based on alcohol use and NAFLD (metabolic) risk factors 

Methods: The Whitehall II cohort study has thirty years of prospectively collected data on alcohol use and metabolic risk factors, collected at repeated phases every 2-3 years. During the most recent data collection phase, we are assessing liver fibrosis in all participants using Fibroscan. Alcohol and metabolic risk factors for advanced fibrosis will be analysed using linear mixed effects modelling to determine interactions between risk factors, and logistic modelling to determine thresholds of risk factors for screening. A further set of analyses will determine the impact of genetic factors (from previously collected DNA microarray data) on risk of advanced liver disease.