While exposure to alcohol marketing is prevalent, and associated with both initiation and progression of alcohol use in underage youth, exactly how it works is not well understood. A new study of alcohol-specific cognitions – whether someone thinks of him/herself as a drinker or having a favorite brand of alcohol – has found that drinker identity and brand allegiance are indeed factors linking alcohol marketing and problematic drinking among experimental underage drinkers. * Underage youth are regularly exposed to alcohol marketing. * New research has examined associations between alcohol marketing and binge drinking by youth. * Results indicate these associations are mediated by drinker identity and brand allegiance, which are actively cultivated by alcohol marketers. Results will be published in a special online issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View. "There is growing evidence that alcohol marketing is reaching adolescents and young adults, that they respond to it, and that their response is associated both with initiation of alcohol use and with progression to problem drinking," said Auden C. McClure, assistant professor of pediatrics at the Geisel School of Medicine at Dartmouth as well as lead author for the study. "Early onset of alcohol use is linked to alcohol dependence later in life, making both prevention and early intervention of risk behaviors important." "The connection between alcohol marketing and the initiation/progression of alcohol use among underage youth is understudied but quite robust," added Kristina M. Jackson, associate professor in the department of behavioral and social sciences at Brown University. "The magnitude of the associations between marketing exposure and heavy drinking is equivalent to that of other well-established risk factors; moreover, the marketing effects hold even after accounting for several of these risk factors. That is, we cannot attribute the association between marketing and heavy drinking to factors such as a sensation-seeking personality, low self-esteem, having peers who drink, or socioeconomic status." McClure and her colleagues analyzed data gathered on 1,734 (882 males, 852 females) 15-to-20-year-olds earlier recruited for a national study of media and substance use in the U.S. Participants were asked about exposure to a number of alcohol-marketing variables, including television time, Internet time, favorite alcohol advertisement, ownership of alcohol-branded merchandise (ABM), and exposure to alcohol brands in movies. Relations between these exposures and current binge drinking were assessed, as were mediators of these relations such as drinker identity, favorite brand to drink, favorable alcohol expectancies, and alcohol norms. "We found that youth with a higher receptivity to alcohol advertising are more likely to report binge drinking – more than five drinks in a row – and that this association is mediated, at least in part, by self-identification as a drinker and having a favorite brand of alcohol to drink," said McClure. "Further longitudinal studies are needed to determine whether advertising exposure precedes the development of these cognitions and influences future drinking behavior. If confirmed, the findings would support the plausibility of a causal relationship between marketing exposures and underage drinking." "We can see that alcohol use in young persons is influenced by alcohol marketing at levels both proximal, such as ownership of ABM, and distal, such as alcohol advertising in the media," said Jackson. "Establishing an identity as a drinker and seeking out specific brands of alcohol is a mutually reinforcing process that has an influence across progressively more severe stages of drinking, ranging from early experimentation with alcohol to regular drinking to heavy, addicted use." Both McClure and Jackson noted the careful attention that marketers pay to their audience. "Marketing theory suggests that advertising serves to develop brand identity for particular products and ultimately brand allegiance in customers," said McClure. "Specific brands identify and develop unique characteristics to give the brand attributes or 'personality.' A brand could be free-spirited, adventurous, or sophisticated and marketers often reinforce that identity through affiliations with cultural role models, events, or trends in music, movies, or sports to extend the image and its appeal. Thus, alcohol advertising often portrays a culture that youth may aspire to join and see themselves as a part of." "Marketers exploit the power of the popular media on adolescent identity," added Jackson. "Marketers carefully craft the content of the marketing, the images, and the medium, merchandise items that appeal to adolescents, as well as films featuring attractive, popular role models, to appeal to this age group. These cognitions can exist even among youth who are experimental or naïve drinkers, and become cemented as youth begin drinking more heavily." "In 1999, tobacco companies gave up distribution of branded merchandise because of studies that showed a link between ownership of such merchandise and smoking among adolescents," said James Sargent, professor of pediatrics at the Geisel School of Medicine at Dartmouth and co-author of the study. "It is time for alcohol companies to do the same, because it is abundantly clear that ownership of ABM is associated with teen drinking." Jackson agreed. "Given the effects of alcohol on the young adolescent brain, and the acute and long-term harms associated with youth drinking, it will be critical to establish policies to mitigate marketing influences on adolescent-age youth," she said. "Establishing and enforcing minimum ages to purchase ABM seem critical. The importance of requiring the film and television industries to limit alcohol advertising in movies and shows whose target audiences contain underage youth cannot be overstated. Access to merchandise on the Internet is particularly troublesome, as the Internet is relatively unmonitored; youth can establish a brand identity simply by visiting a website. Here, media-literacy campaigns would seem to be most promising." Both McClure and Jackson say that parents can play a key role. "Given that youth are broadly exposed to alcohol marketing and influenced by it, it is also important for parents to monitor exposure to media and marketing in order to help youth navigate the deluge of media and marketing influences and make good choices about alcohol use," said McClure. "A better understanding of the path between marketing and risk behaviors could help parents, health care providers, clinical psychologists, and substance use treatment specialists to identify and intervene when an adolescent is at risk."