The Effectiveness of Mobile Health (mHealth) in Reducing Alcohol Consumption Among Adults in Developed Countries: A Systematic Review.

Alcohol use disorder (AUD) remains a major public health issue, contributing to significant morbidity, disability, and premature mortality. With the proliferation of mobile health (mHealth) technologies, smartphone applications have emerged as innovative platforms for delivering alcohol reduction interventions. Despite growing interest, existing evidence regarding their effectiveness is inconsistent and scattered, highlighting the need for a synthesis of the literature. A systematic review was conducted using multiple electronic databases, including the Cochrane Library, PubMed, and PsycINFO, with coverage extending through December 2024. Eligible studies included randomised controlled trials (RCTs) that assessed the impact of mobile application-based interventions on alcohol consumption. Screening followed predefined inclusion and exclusion criteria. Data extraction and critical appraisal were performed using the Cochrane risk of bias 2 (RoB 2) tool, the gold-standard framework for evaluating methodological quality in randomised studies. From an initial pool of 49 studies, eleven met the inclusion criteria and underwent full appraisal, with ten randomised controlled trials ultimately included in the synthesis, encompassing a total of 11,269 participants. One study was excluded due to a high risk of bias identified across multiple domains. The selected interventions were grounded in diverse behaviour change theories (BCTs), including brief intervention (BI), cognitive behavioural therapy (CBT), cue exposure therapy (CET), social cognitive theory, social norms theory, protective behavioural strategies (PBS), the information-motivation-behavioural skills (IMB) model, motivational interviewing (MI), and the capability, opportunity, motivation, and behaviour (COM-B) framework. Narrative synthesis revealed that individuals engaging with mHealth interventions tended to consume less alcohol compared to those in control groups or receiving minimal intervention. However, due to heterogeneity in theory application and outcome measures, further evidence is needed to identify which BCTs yield the most consistent and effective reductions. This review supports the potential of mHealth applications in facilitating reductions in alcohol consumption among adults in high-income settings. Nonetheless, the diversity of study designs, theoretical models, and outcome metrics underscores the need for greater methodological standardisation and extended follow-up periods. Future research should focus on refining intervention components, enhancing reporting transparency, and evaluating long-term effectiveness to better inform policy and practice in digital public health.