Mechanisms for the reduction of caffeine consumption: What, how and why.

BACKGROUND: Anecdotal evidence suggests consumers of caffeine self-administer strategies to reduce consumption, but little is known of what these strategies are or how they are implemented. This study aimed to understand the lived experience of reducing caffeine consumption including specific techniques (what) and implementation strategies (how), harm and withdrawal symptoms (why). METHODS: We developed a classification system through an inductive and deductive approach and applied it to a large dataset derived from online sources. RESULTS: A total of 112 internet sources were identified, containing 2,682 different strategies. The classification system identified 22 categories of Behaviour Change Techniques (BCT): 10 categories were directly aligned with a BCT, one was split into two categories (substance and behavioural substitution), six represented a cluster of BCT's (e.g., withdrawal management and maintaining momentum) and four appeared to uniquely represent a consumer perspective (e.g., realisation of a problem). The most common techniques were substance substitution, seek knowledge and information, avoidance of caffeine and identify prompts for change. The most frequently perceived benefit was the stimulating effects of caffeine and a feeling of mental alertness. The most frequently cited harms were sleep problems including insomnia and concerns about dependence (or addiction) to caffeine. We found 16 categories of withdrawal symptoms. The most frequently endorsed symptom was headaches, followed by fatigue, exhaustion and low energy. CONCLUSIONS: Consumers use a wide range of techniques when attempting to reduce caffeine consumption. Treatment approaches are focused on fading, but the current study found consumers most frequently focus on substance and behavioural substitution.

I was truly addicted to sugar: A consumer-focused classification system of behaviour change strategies for sugar reduction.

The reduction of free sugars has been identified as a priority issue internationally. A range of public health initiatives have been recommended, including the provision of information and support for sugar reduction. To inform these approaches, it is important to know what people actually do in real world settings to reduce their consumption. This study documents and defines the range of consumer-based behaviour change strategies for sugar reduction. A total of 1145 strategies were extracted from 47 internet sources (i.e., consumer, popular and professional). Using a pragmatic content analysis, hundreds of strategies were organized into 25 discrete categories of strategies. Categories were grouped into the Rubicon Model of Action Phases and classified as pre-decisional (i.e., decisional balance, feedback, realisation, seek knowledge and information), post-decisional (i.e., action planning, coping planning, set goal intention, sugar guidelines) and actional phase. Actional strategies were the most prolific and included avoidance, consumption control, consumption planning, environmental restructuring, healthy eating focus, maintain readiness, professional support, refocusing, self-monitoring, social support, substance substitution, tapering, address underlying issues, urge management, well-being and withdrawal management. There was one post-actional strategy which was associated with self-evaluation (i.e., reviewing a change attempt in order to plan for the future). Four categories of strategies differed according to the source. Substance substitution was substantially less frequently discussed by consumers than professionals and few professional sites acknowledged or advised strategies to manage the struggle of maintaining readiness following a change attempt. Hundreds of individual strategies are discussed or promoted in online settings, and more information is needed on the effectiveness of these self-initiated approaches.