Alcoholics Anonymous (AA) is an international mutual aid fellowship founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio. AA's stated "primary purpose" is to help alcoholics "stay sober and help other alcoholics achieve sobriety". With other early members, Bill Wilson and Bob Smith developed AA's Twelve Step program of spiritual and character development. AA's initial Twelve Traditions were introduced in 1946 to help the fellowship be stable and unified while disengaged from "outside issues" and influences.
The Traditions recommend that members remain anonymous in public media, altruistically help other alcoholics, and that AA groups avoid official affiliations with other organizations. They also advise against dogma and coercive hierarchies. Subsequent fellowships such as Narcotics Anonymous have adopted and adapted the Twelve Steps and the Twelve Traditions to their respective primary purposes.
According to AA's 2014 membership survey, 27% of members have been sober less than one year, 24% have 1–5 years sober, 13% have 5–10 years, 14% have 10–20 years, and 22% have more than 20 years sober. Studies of AA's efficacy have produced inconsistent results. While some studies have suggested an association between AA attendance and increased abstinence or other positive outcomes, other studies have not. A 2006 Cochrane Review both states that "No experimental studies unequivocally demonstrated the effectiveness of AA or TSF (Twelve step Facilitation) approaches for reducing alcohol dependence or problems" and that "Severity of addiction and drinking consequence did not seem to be differentially influenced by [twelve-step programs] versus comparison treatment interventions, [...] and no conclusive differences in treatment drop out rates were reported."
The first female member, Florence Rankin, joined AA in March 1937, and the first non-Protestant member, a Roman Catholic, joined in 1939. The first Black AA group was established in 1945 in Washington DC by Jim S., an African American physician from Virginia. AA membership has since spread internationally "across diverse cultures holding different beliefs and values", including geopolitical areas resistant to grassroots movements. Close to 2 million people worldwide are members of AA as of 2016.