ArticleThe American journal of psychiatry2026
Mobile Health for Alcohol Use Assessment: Longitudinal Effects of Breathalyzer Self-Monitoring in Everyday Contexts.
Article in The American journal of psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAlthough mobile health-tracking technologies have burgeoned, offering objective health information to consumers on an unprecedented scale, opportunities to directly test effects of such monitoring have been limited. Low-cost mobile breathalyzers are one tool commonly employed for blood alcohol concentration (BAC) assessment. The authors explored outcomes linked with BAC-tracking technologies, examining effects on alcohol use and self-estimation of BAC levels in a large U.S. sample.
methodsParticipants (N=32,179) were individuals who voluntarily purchased a mobile breathalyzer and provided at least three ad-lib readings between 2016 and 2022. A paired smartphone application prompted users to enter a BAC self-estimate (a guess) before the measured BAC level was displayed. Analyses included observations collected during active consumption (BAC >0.00%) from breathalyzer users who opted to share anonymized data. Breathalyzer users who displayed inattentive patterns of guessing were excluded from self-estimation analyses. The final dataset comprised 787,393 BAC readings and 387,643 self-estimates.
resultsThe accuracy of BAC guesses increased by 2.38% over the course of breathalyzer use. Associations between breathalyzer use and BAC levels varied significantly according to participants' initial drinking levels (b=-0.0062, 95% CI=-0.0065, -0.0059). Among heavy-drinking participants, BAC levels decreased on average from 0.106% to 0.096%, whereas the reverse trend was observed for lighter-drinking participants, whose levels increased from 0.058% to 0.067%. A similar interaction emerged for BAC underestimation (b=-0.0058, 95% CI=-0.0066, -0.0049), with odds of underestimation decreasing among heavy-drinking and increasing among light-drinking participants.
conclusionsThe results indicate promise for mobile BAC-tracking technologies as a low-impact intervention with the potential to decrease drinking among individuals who drink heavily-a population particularly susceptible to alcohol-related problems. In contrast, inverted trends emerged for light-drinking individuals, highlighting the need for empirical research in the fast-moving landscape of digital health.
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