The “Ravages” prevention campaign, which addresses the risks of alcohol, was developed and launched following an expert report on public discourse regarding alcohol, published in 2017 (see box). This expert group had, in fact, issued several recommendations, including the importance of informing the public that the health risks associated with alcohol consumption increase with the amount consumed, emphasizing that there is no such thing as alcohol consumption without health risks, and that there are guidelines for lower-risk consumption. The 2019 campaign was the first by Santé publique France to address the long-term risks associated with alcohol and to publicize these guidelines for lower-risk consumption.

It thus had two main objectives:

• To improve the public’s understanding of the medium- and long-term risks associated with alcohol consumption. Three conditions were highlighted in the campaign: cancer, hypertension, and cerebral hemorrhage.

• To raise awareness of the new guidelines for lower-risk drinking, summarized as “alcohol is a maximum of 2 drinks per day, and not every day.”

Ultimately, the goal was to reduce the proportion of drinkers exceeding these guidelines in order to eventually lower alcohol-attributable morbidity and mortality.

The first rollout of the campaign in March–April 2019 was evaluated using a longitudinal follow-up of 4,002 drinkers (a sample selected using the quota method). They were surveyed online before the campaign (February 22–March 18), immediately after (April 17–May 12), and approximately six months later (September 25–October 15): 2,538 people responded to all three survey waves.

The main indicators of the evaluation were: awareness of the risks highlighted in the campaign (cancer, hypertension, cerebral hemorrhage), awareness of the guidelines, and self-reported alcohol consumption relative to the guidelines.

Following the campaign’s launch, among drinkers—including those who exceed the guidelines and therefore pose a greater risk to their health—a link was observed between exposure to the campaign and greater awareness of the “maximum 2 drinks per day” guideline, as well as greater knowledge of the risks of hypertension and cerebral hemorrhage. Another positive finding: there is an association between exposure to the campaign and a decrease in the proportion of at-risk drinkers across the entire sample. However, no association was observed between exposure to the campaign and awareness of the link between alcohol and cancer, or awareness of the guideline regarding the number of days without alcohol consumption.

More detailed analyses reveal differences based on respondent profiles: the link between exposure to the campaign and a decrease in the proportion of at-risk drinkers is driven by women, and the link with improved perception of the risk of alcohol consumption on high blood pressure is observed only among higher socioeconomic groups.

These positive results, however, diminish over time: the favorable effects observed are no longer significant after six months.
These findings contribute to the scientific literature showing that alcohol-related campaigns disseminated through mass media can be effective in improving public knowledge about alcohol and changing attitudes toward it.² Evidence regarding the effect on reducing alcohol consumption is, however, more limited³. Nevertheless, recent experimental studies have shown a potential impact on drinking behaviors from campaigns combining messages about long-term risks and consumption benchmarks. The strength of our study lies in demonstrating that, under “real-life” conditions, a social marketing campaign on alcohol can have effects on knowledge and behavior.

The fact that the campaign’s effects are no longer noticeable after a few months is consistent with the scientific literature (including for campaigns on topics other than alcohol) and supports the case for repeated rollouts of large-scale campaigns. The 2019 campaign was thus successively improved (creation of new visuals and more educational messages on risks and guidelines, adaptation of the media plan to ensure good visibility among target audiences) and rebroadcast six times over four years.

Today, our studies show that alcohol still enjoys a largely positive image among the general public, that guidelines for lower-risk consumption are still insufficiently known, and that the risks associated with even small amounts of alcohol are either misunderstood or dismissed as irrelevant to one’s own drinking habits. It therefore appears necessary to continue to demystify alcohol and remind people that it is a product that poses health risks, even in small doses. Changing perceptions takes time… and changing behaviors even more so.

To prevent the public from becoming desensitized to the Ravages campaign, we are developing new communication strategies. The campaign “Good health has nothing to do with alcohol,” launched in January 2023, highlights the long-term risks of alcohol and invites us to reflect on its place in our lives, pointing out a cultural absurdity that affects us all: the act of toasting and wishing each other “health / good health”… with alcohol.
January, a time for New Year’s resolutions, is an ideal moment to reflect on our drinking habits: hence the “Dry January” challenge, launched in France in 2020 by a coalition of organizations, based on a model that originated in the United Kingdom. It is a one-month alcohol-free challenge designed to examine one’s relationship with alcohol and observe the benefits to one’s quality of life. The evaluation conducted by the agency in 2020 revealed the value of this initiative in helping people step back and reduce their alcohol consumption.

To receive support in this process of reflection or reduction in consumption, the alcohol-info-service website (see box) offers advice and assistance if needed, and features a digital tool called the “alcoometer” that allows users to assess their consumption against benchmarks and understand the health risks involved.

Beyond social marketing aimed at the general public and the remote support tools offered by Alcool-info-service, Santé publique France is conducting other work on the topic of alcohol prevention: rollout of initiatives targeting specific audiences, such as young people, with the aim of reinforcing protective behaviors in party settings (Amis aussi la nuit), evaluation and dissemination of various interventions to strengthen psychosocial skills among adolescents, and advocacy for regulatory measures that create an environment conducive to reducing consumption (for example, by limiting advertising for alcoholic beverages). It is the combination of these efforts that can ultimately create an environment conducive to changing the image of alcoholic beverages and lead to a decline in alcohol consumption in France.