The pilot study by Jernigan and others (2017), focused on digital and social media and compared young people with adults on the amount of alcohol marketing they recalled seeing. Youth reported greater exposure to alcohol marketing and promotional content than adults in most media, including on the Internet. Furthermore, youth reported greater engagement with alcohol marketing online. This stresses the need to assure compliance with voluntary industry standards and to improve monitoring of alcohol marketing, especially regarding youth and the new media online.
A sample of 1,192 underaged youths and 1,124 adults completed an online survey, with questions about alcohol marketing in online as well as traditional media. A distinction in the questions was made between exposure (how often) and content (type) of alcohol marketing, and engagement with alcohol marketing.
Youth reported exposure to alcohol marketing in the last month was almost twice as much as exposure of adults on the Internet (29.7% versus 16.8%, p < 0.001). Youth interacted with alcohol-related online content in greater proportions than adults, such as celebrities using alcohol, celebrities wearing alcohol-branded items, pictures of celebrities showing the negative effect(s) of using alcohol, pictures of friends/peer using alcohol and pictures of friends/peers showing the negative effect(s) of using alcohol. Regarding the content of alcohol marketing, the difference between youth and adults was the most significant with content related to celebrities and alcohol.
The results show that youth were significantly, and twice as likely than adults to see or hear alcohol marketing on the TV, radio, billboards and especially the Internet. They also show that youth were more likely than adults to interact with online content of alcohol marketing.
These results are concerning, since youth in particular are vulnerable and susceptible to alcohol marketing, and age-gating on digital media are not that effective.
Title: Early Adolescent Exposure to Alcohol Advertising and its Relationship to Underage Drinking
Journal: Journal of Adolescent Health, 2007, 40, 527-534. Abstract Objective: The study examines whether the exposure to alcohol marketing affects adolescents' beer use.
Design: Prospective study (longitudinal study)
Setting: 39 schools in South Dakota, US
Participants: Sixth grade students between 11 and 12 years old (N=1786). One of the youngest groups sampled (grade 6). A majority of these early adolescents have not started drinking yet (respectively 15 and 17 percent).
Methods: It is examined whether the level of exposure to television beer advertisements, alcohol ads in magazines, in-store beer displays, beer concessions, radio listening time, ownership of beer promotional items in grade 6 affect beer drinking in grade 7 and drinking intentions in grade 7. Logistic regression analysis is performed to calculate odds ratios adjusted for covariates (parental monitoring, adult drinking, peer drinking, parent approval, friend approval, school grades, low religiosity, depressed mood, deviance, impulsivity, sports participation, parent education, gender, ethnicity, frequency of beer drinking in grade 6).
Findings: 17% reported past year beer drinking at grade 7. The odd ratios (95%CI) for drinking beer of the complete model in which all the ad variables are included together with the joint effects for beer drinking were: ESPN cable network 1.08 (0.83-1.42); other sports beer ads 1.19 (1.01-1.40); other TV beer ads 1.13 (0.95-1.34); magazine reading 0.96 (0.87-1.06); radio listening 1.17 (1.00-1.37); beer concessions 1.01 (0.91-1.13); in-store beer displays 1.03 (0.92-1.14); beer promotional items 1.76 (1.23-2.52). Joint effect of exposure to ads from all sources: F(8,28)=8.36, p<0.0001, and from 3 TV sources: F(3,33)+3.35, p<0.05. 20% of youth in 75th percentile of alcohol marketing exposure at grade 6 reported past year beer drinking at grade 7, compared with 13% in 25th percentile.
Conclusions Authors: Children at extremely high levels of overall advertising exposure were subsequently 50% more likely to drink and 36% more likely to intend to drink as those at low levels. These results are in line with Stacy et al (2004) but contradict the findings of Ellikson et al (2005).
Remarks of EUCAM:
This seems a thoroughly conducted study which is focused on more types of alcohol marketing than only televised alcohol advertisement. It is interesting to see the large effect of ownership of promotional items and drinking beer at a later age. The study finds a small but significant effect for the joint effect of exposure to televised beer ads in all models. As the authors already conclude, this is in line with the findings of Stacy et al (2004), but not with the findings of Ellikson et al (2005). The design of measurement of the main variables was similar to the other studies, but small differences in the specific questionnaires could explain these varying results. Alternatively, the older sample of Ellickson could explain the differences in results. It is important to test in further research what could explain these differences in findings.
Title: Exposure to Televised Alcohol Ads and Subsequent Adolescent Alcohol Use
Journal: American Journal Health Behaviour, 2004, 28 (6), 498-509. Abstract Objective: The study examines whether the exposure to television alcohol advertisements affects adolescents' alcohol use. The study differs from most other studies by measuring the exposure to television alcohol advertisement in different ways.
Design: Prospective study (longitudinal study) which differs from other studies by taking into account many confounders and multiple measurements of exposure to televised alcohol ads. Respondents are asked to indicate how often they have watched specific television series. This data is multiplied by the number of alcohol commercials broadcasted during these series. Because the broadcasting of alcohol advertisements occurs much more frequently during televised sporting events, the amount of televised sporting events viewed is reported separately by the respondents. In addition, respondents are asked to self-report the frequency of alcohol advertisements they are exposed to. The memorability of alcohol advertisements by the respondents is measured by a cued-recall memory test in which respondents are asked whether they recognized specific commercials and a draw-an-event memory test in which respondents are asked to draw a sketch of the first commercial that come to their mind.
Setting: 20 middle in Los Angeles, California, US.
Participants: Seventh grade students between 12 and 13 years old (N=2250)
Methods: It is examined whether the level of exposure to alcohol advertisement on television affect drinking behaviour at the 12-month follow-up. Logistic regression analysis is performed to calculate odds ratios adjusted for covariates (general television viewing, participation in team sports, perception of friends' alcohol use, perceived peer approval alcohol use, intentions to use alcohol, perceptions of adults' alcohol use, gender, ethnicity, school).
Findings: The watched TV shows exposure index shows that each 1 standard deviation increase in alcohol advertising exposure is associated with 44% increase in odds of beer drinking (95% CI=27%, 61%), 34% increase in odds of wine/liquor drinking (95% CI=17% , 52%), and 26% increase in odds of consuming 3 or more drinks on one occasion (95% CI=8% , 48%) during previous 30 days. However, the amount of viewed TV sport events and the self-reported frequency only have a significant effect on the beer consumption and do not affect the consumption of wine/liquor or the risk of binge drinking. The Memory tests showed no effect on the drinking behaviour with the exception of the score on the draw-an-event memory test. Each 1 standard deviation increase in the draw-an-event memory test is associated with 14% decrease in odds of beer drinking (95% CI=-25%, -1%).
Conclusions Authors: The strength of the associations between exposure of alcohol ads on television and alcohol use varied across exposure measures and was most consistent for beer.
Remarks of EUCAM:
The effects of the watched TV shows exposure index on adolescents' alcohol use seems strong even if we control for main confounders. However, other measurements of exposure in the study show more mixed results, which make the interpretation of the findings more difficult. This study suggest an effect of televised alcohol advertisement exposure on especially using beer, but makes clear that is very important how we measure televised alcohol ad exposure. The authors are very precise in addressing limitations in their study. The limitations they address can be found in most other longitudinal studies on the effects of alcohol marketing. This study is innovative in the assessment of confounders, however, it is impossible to include every possible confounder in an observational study. Another limitation is the geographical limitation of the study. The study is conducted in only one region in the US. Like most other observational studies, alcohol use is only measured by self-report and is not biochemically validated.