The effect of health behaviour interventions on alcohol consumption among people living with cancer: a systematic review

Abstract

PURPOSE: This systematic review synthesises data relating to the effectiveness of behavioural interventions aimed at reducing alcohol consumption among people living with cancer. METHODS: Five databases were systematically searched for randomised controlled trials (RCTs) published between January 2000 and April 2025 that reported behavioural interventions addressing alcohol consumption among people living with cancer. Evidence was assessed using the Cochrane Risk-of-Bias tool. Meta-analysis was not feasible due to substantial heterogeneity and few eligible studies. Instead, a TIDieR-guided narrative synthesis with vote-counting was performed. We conducted this systematic review according to the PRISMA 2020 statement. RESULTS: Eight RCTs (n = 1437) were included. Two trials targeted alcohol reduction, whereas the remaining six addressed alcohol use within broader multiple health-behaviour interventions. Alcohol intake was assessed via self-report using heterogeneous measures. At 2-3 months, all five reporting studies favoured the intervention (100%, 95% CI 57-100%; p = 0.063). At 5-6 months, 57% of seven studies indicated benefit (95% CI 25-84%; p = 0.125), and 67% of three studies favoured the intervention (95% CI 21-94%; p = 0.500) at 12 months. All studies were rated as having unclear or high risk of bias. These vote-counting results should be interpreted cautiously, as effect-direction methods do not confirm the presence or magnitude of a true intervention effect. CONCLUSIONS: Heterogeneity was substantial across the studies. There is insufficient evidence that health behaviour interventions effectively reduce alcohol consumption among people living with cancer. IMPLICATIONS FOR CANCER SURVIVORS: Further research should explore the behavioural mechanisms driving alcohol use among people living with cancer and prioritise the development of alcohol-specific interventions tailored to their unique needs. TRIAL REGISTRATION: PROSPERO (registration number CRD42023456578).