Readership: Are Underage Youth Disproportionately Exposed?

Background: The question of whether underage youth are disproportionately exposed to alcohol advertising lies at the heart of the public health debate about whether restrictions on alcohol advertising are warranted. The aim of this study was to determine whether alcohol brands popular among underage (ages 12 to 20 years) drinkers (“underage brands”) are more likely than others (“other brands”) to advertise in magazines with high underage readerships.
Methods: We analyze the advertising of 680 alcohol brands in 49 magazines between 2006 and 2011. Using a random effects probit model, we examine the relationship between a magazine’s underage readership and the probability of an underage or other brand advertising in a magazine, controlling for young adult (ages 21 to 29 years) and total readerships, advertising costs and expenditures, and reader-ship demographics.
Results: We find that underage brands are more likely than other brands to advertise in magazines with a higher percentage of underage readers. Holding all other variables constant at their sample means, the probability of an “other” brand advertising in a magazine remains essentially constant over the range of underage readership from 0.010 (95% confidence interval [CI], 0.007 to 0.013) at 5% to 0.012 (95% CI, 0.008 to 0.016) at 35%. In contrast, the probability of an underage brand advertising nearly quadruples, ranging from 0.025 (95% CI, 0.015 to 0.035) to 0.096 (95% CI, 0.057 to 0.135), where underage brands are 7.90 (95% CI, 3.89 to 11.90) times more likely than other brands to advertise.

Alcohol brands popular among underage drinkers are more likely than other brands to advertise in magazines with high underage readerships, resulting in the disproportionate exposure of underage youth. Current voluntary advertising industry guidelines are not adequate to protect under-age youth from high and disproportionate exposure to alcohol advertising in magazines. To limit advertising exposure among underage youth, policy makers may want to consider regulation of alcohol advertising in magazines.
Key Words: Alcohol, Advertising, Marketing, Magazines, Youth.

Alcohol use among underage (under 21 years old) youth remains an important public health problem (Department of Health and Human Services, 2016).
Although youth alcohol use has declined in the past decade, the prevalence of current (past 30 days) drinking among high school seniors in 2016 was 33.2%, and the prevalence of
binge drinking (5 or more drinks in a row) in the past 2 weeks was 15.5% (Monitoring the Future Survey, 2016).
The alcohol beverage industry denies that it promotes to underage youth (Beer Institute, 2017; Distilled Spirits Council of the United States, Inc, 2011; Wine Institute, 2017), but
underage alcohol use remains a persistent problem, giving rise to concerns about underage exposure to alcohol marketing. The alcohol beverage industry spent at least $3.45 billion
in marketing expenditures in 2011 (Federal Trade Commission, 2014). As multiple longitudinal studies show that exposure to alcohol advertising is associated with underage
drinking behavior (Anderson et al., 2009; de Bruijn et al., 2012, 2016; Gordon et al., 2010; Grenard et al., 2013; Jernigan et al., 2017; Morgenstern et al., 2017; Smith and Fox-
croft, 2009; Tanski et al., 2015), the question of whether underage youth are disproportionately exposed to alcohol advertising lies at the heart of the public health debate about whether restrictions on alcohol advertising are warranted.
Most previous research on this question examines the relationship between alcohol advertising placement in magazines and the underage audience of those magazines (Garfield et al., 2003; Nelson, 2006, 2008; Nelson and Young, 2008; Ross et al., 2014; Siegel et al., 2008). 
From the Pleiades Consulting Group, Inc. (CK), Lincoln, Massachusetts; Department of Community Health Sciences (MS), Boston University School of Public Health, Boston, Massachusetts; Department of Epidemiology (CSR), Boston University School of Public Health, Boston, Massachusetts; and Department of Health, Behavior, and Society
(DHJ), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Received for publication June 9, 2017; accepted August 4, 2017.
Reprint requests: Michael Siegel, MD, MPH, Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, CT438, Boston, MA; Tel.: 617-638-5167; Fax:617-638-4483; E-mail: mbsiegel@bu.edu
Copyright © 2017 by the Research Society on Alcoholism.
DOI: 10.1111/acer.13477
Alcohol Clin. Exp. Res, Vol 41, No 10, 2017: pp 1775–1782 1775

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