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This study aimed to test the consumption\u2010reducing effects of using two app\u2010based alcohol interventions as complement to treatment as usual (TAU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Three\u2010armed, parallel, randomised controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Specialised outpatient clinic within the Stockholm Centre for Dependency Disorders, Stockholm, Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>162 alcohol\u2010dependent adults (46% female), with no social problems or mental disorders, who had no other drug use, were included. Mean age was 50\u2009years, and the majority were highly educated, employed and had not previously received any alcohol treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were randomised to (1) TAU+drink\u2010counting app (Glasklart, <jats:italic>n<\/jats:italic>\u2009=\u200952), (2) TAU+app\u2010coupled breathalyser (iBAC Pro, <jats:italic>n\u2009<\/jats:italic>=\u200958) or (3) TAU only (<jats:italic>n<\/jats:italic>\u2009=\u200952). TAU included four sessions of clinician\u2010led psychological treatment based on motivational interviewing\/cognitive behavioural therapy, combined with pharmacotherapy when requested, for 12\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was past 4\u2010week heavy drinking days (HDD) at 26\u2009weeks post\u2010randomisation, adjusted for baseline HDD, and assessed by structured interviews using Timeline Followback. Secondary outcomes included weekly consumption, consumption patterns, phosphatidylethanol and dependence at 12 and 26\u2009weeks. Analyses compared TAU+drink\u2010counting app and TAU+breathalyser each with TAU alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>At 26\u2009weeks, participants with TAU+breathalyser had statistically significantly lower HDD [incidence rate ratio (IRR)\u2009=\u20090.67, 95% confidence interval (CI)\u2009=\u20090.49, 0.91] compared with those with TAU alone. There was no evidence of any effects on HDD for those with TAU+drink\u2010counting app, compared with TAU alone (IRR\u2009=\u20090.94, 95% CI\u2009=\u20090.70, 1.25) or of any other effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Sweden, treatment as usual (TAU) for alcohol dependence combined with a smartphone application coupled with a breathalyser was more effective than TAU alone in reducing self\u2010reported heavy drinking. There was no evidence that TAU combined with a smartphone application for drink\u2010counting was more effective than TAU alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16769","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T08:59:27Z","timestamp":1737017967000},"page":"905-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effectiveness of a drink\u2010counting and a breathalyser\u2010coupled smartphone application for reduced heavy drinking among alcohol\u2010dependent adults in Sweden: A randomised controlled trial"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7512-804X","authenticated-orcid":false,"given":"Josefine","family":"\u00d6sth","sequence":"first","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Lundin","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Centre for Epidemiology and Community Health Region Stockholm  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Wennberg","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Public Health Sciences Stockholm University  Stockholm Sweden"},{"name":"Department of Psychology Inland Norway University of Applied Sciences  Lillehammer Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Andr\u00e9asson","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4932-4607","authenticated-orcid":false,"given":"Anna\u2010Karin","family":"Danielsson","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Global status report on alcohol and health 2018","author":"World Health Organization","year":"2018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13757"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31310-2"},{"key":"e_1_2_11_5_1","volume-title":"Hazardous alcohol use in Sweden based on updated limits. 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