The Monitoring Alcohol Marketing Practices in Africa (MAMPA) Project was a public health surveillance program devoted to monitoring alcohol marketing activities in the African region as well as youth exposure to these marketing activities. Data on alcohol marketing was collected in Ghana, Nigeria, Uganda, the Gambia, Kenya, Malawi and Namibia. The main conclusions of this independent analysis of this MAMPA data are:
  • The findings of the report provide evidence of violations of industry self-regulation codes in the seven countries studied
  • The findings points to the need for systematic surveillance of alcoholic beverage marketing to protect vulnerable populations, such as youth, who may already be experiencing problems related to their alcohol use.
  • The report underscores the need for policy strategies to more effectively monitor and regulate alcohol advertising across all media outlets.
  • The report points out that a variety of options exist, including complete bans on alcohol advertising.
  This secondary analysis of the original MAMPA marketing data confirms the conclusions of the original MAMPA report, in that it provides strong evidence of code violations in all media evaluated, and suggests that exposure to potentially harmful alcohol marketing content is widespread in six of the seven countries studied. These reports also raise questions about the effectiveness of current industry efforts to regulate alcohol marketing. The report (full text, including an executive summary) can be downloaded via this link. 

Authors: Kate Robaina, MPH, Thomas Babor, PhD, MPH & Jonathan Noel, MPH (2016).

Title: Evaluating compliance with alcohol industry self-regulation in seven countries in Africa. An external evaluation of the MAMPA (Monitoring Alcohol Marketing Practices in Africa) project. OLYMPUS DIGITAL CAMERA

Executive summary

Introduction
The Monitoring Alcohol Marketing Practices in Africa (MAMPA) Project was a public health surveillance program devoted to monitoring alcohol marketing activities in the African region as well as youth exposure to these marketing activities. The first project report was the subject of a World Health Organization (WHO) technical meeting in Brazzaville in 2012, where it was recognized that MAMPA had methodological limitations that precluded definitive conclusions about the extent to which alcohol marketing in four countries within Africa violated international guidelines regarding the exposure of young persons to potentially harmful advertising content. It was recommended that content of advertisements should be analyzed using a coding scheme developed by a panel of experts.

Following the meeting, the WHO Regional Office for Africa asked researchers from the University of Connecticut School of Medicine to systematically evaluate the marketing materials collected as part of the MAMPA project, and to expand the study to include the second wave of data collected from three other sub-Saharan African countries: Kenya, Malawi, and Namibia.

The purpose of this report is to describe the results of an independent analysis of the MAMPA data. The specific aims of the re-analysis of the MAMPA marketing data were: 1) to provide estimates of the prevalence of code violations in alcohol advertisements within and across these seven African nations, 2) to determine which sections of the Code were violated most often; 3) to determine if different producers and media had more violations than others; and 4) to test the feasibility of a new standardized rating procedure to evaluate code violations in alcohol marketing materials (Babor, Xuan & Damon, 2013a). Developed initially for television and print media, the procedure is applied for the first time in this study to radio ads and outdoor advertisements.

Methods
Ethnographic field methods were used to collect marketing materials from rural and urban areas of seven countries: Ghana, Nigeria, Uganda, the Gambia, Kenya, Malawi and Namibia. These countries were selected to provide a range of social availability climates (according to religion and culture) and regulatory environments (ranging from a ban on alcohol advertising to only partial restriction).

Examples of unique marketing materials (N=282) used by both domestic and foreign alcohol producers were obtained by trained observers recruited from public health NGOs and research NGOs working on alcohol prevention and operating at the national level within each country. Observers were trained to collect digital recordings of visual stimuli across four types of media: TV, radio, print and outdoor advertising. In order to conduct this secondary analysis of the data collected in the original four MAMPA countries and in the three additional countries, all unique alcohol ads from each country were identified from the available recordings and abstracted into individual video, audio, or image files.

Because of between-country variation in alcohol marketing regulations, a set of guidelines developed by the alcohol industry (ICAP’s Guiding Principles: Self-Regulation of Marketing Communications for Beverage Alcohol) were chosen as the standard code to compare all advertisements. Using an objective Delphi rating procedure developed and validated in prior alcohol marketing research (Babor, Xuan & Proctor,
2008; Babor et al., 2013a), the ads were subjected to an evaluation by 9 trained raters across two rounds, the second of which allowed the raters to see the average ratings of the group. Each rater had experience in public health, substance use, or public health, and was considered to have the necessary expertise to protect vulnerable populations. Raters were from Kenya, Malawi, Nigeria and the US. Interrater reliability between the raters was assessed using violation level and item-level data and was found to be high.

Results
In total, 282 unique examples of alcohol advertising were analyzed. Observers collected the largest number of marketing examples in Uganda (25.2% of all examples) and Nigeria (24.8%). The Gambia, where there is a ban on alcohol advertising, contributed only 1.4% of the total ads collected. Over seventy percent (70.6%) of ads collected from all countries were obtained from outdoor media (billboards, posters, signage, etc.).

Overall, 78 advertisements (27.7%) were found to contain at least one violation, representing an industry compliance rate of 72.3%. Advertisements collected from Kenya were the most likely to contain a violation. Guiding Principle 5, which refers to “the effects of alcohol,” accounted for the largest number of violations (77 ads). This guideline was most often scored as a violation because of the suggestion that alcoholic beverages can enhance attractiveness and/ or remove social or sexual inhibitions (n=51) and/ or presenting alcohol as necessary for social success or acceptance (n=63). The second most frequently violated guideline was Guiding Principle 3 (69 ads), which speaks to health and safety aspects in marketing communications. This principle was most often violated for presenting alcohol as a stimulant, sedative or tranquilizer (50 ads), and suggesting that alcohol can “prevent, treat or cure illness or resolve personal problems” (29 ads).

Violation rates significantly differed between media (p = <.001), with television ads having the highest proportion of violations (72.2%) and outdoor ads having the lowest (21.6%). Certain types of outdoor ads, however (e.g. billboards and posters), contained higher violation rates (37.3% and 30.8%, respectively).

Conclusion
The findings suggest that code violations of the ICAP Guiding Principles were prevalent in the four types of media sampled during the MAMPA project in the seven countries. It is interesting to note that the country with the fewest marketing materials recorded (n = 4) was The Gambia, which is a Muslim country with a ban on most forms of advertising. Despite the limitations of the prior MAMPA project and the current re-analysis, this research establishes a basis for a monitoring and regulating alcohol advertising in African countries. The methodology offers a systematic way to evaluate media advertisements of alcoholic beverages to determine whether their contents comply with generally accepted guidelines for responsible advertising practices.

Based on the evidence described above, governments and policymakers should give serious consideration to the key messages emerging from the Consultative meeting on addressing alcohol marketing in the African Region (WHO, 2012) and from the PAHO Expert Meeting on Alcohol Marketing Regulation (PAHO,
2016), which are consistent with the well-documented premise that alcohol is not an ordinary commodity (Babor et al., 2010) and should not be marketed as such.

These findings provide evidence of violations in the seven countries studied and the need for systematic surveillance of alcoholic beverage marketing to protect vulnerable populations such as youth, who may already be experiencing problems related to their alcohol use.

Our secondary analysis of the original MAMPA marketing data confirms the conclusions of the original MAMPA report, in that it provides strong evidence of code violations in all media evaluated, and suggests that exposure to potentially harmful alcohol marketing content is widespread in six of the seven countries studied. These reports also raise questions about the effectiveness of current industry efforts to regulate alcohol marketing.

The report (full text) can be downloaded via this link. 

Complaints to the Swedish Consumer Agency about alcohol advertising have gone up by 800% after sobriety organization IOGT-NTO introduced their Alcohol Bothers campaign last summer. This explosive growth, compared to the same period last year, can be ascribed to an online service making it very easy for people to report their complaint through social media. “When we spoke to the Swedish Consumer Agency last year they told us they weren’t very busy with alcohol adverts, because they did not have the resources and because people did not file many complaints. They received approximately 60 per year,” explains IOGT-NTOs European officer Irma Kilim. “We at IOGT-NTO were certain that people were bothered by alcohol advertisements but that they did not always know that what they saw is illegal or even where to report it.” This motivated the organization formerly known as the International Organisation of Good Templars to create a tool for people to easily report alcohol advertisements and to show the prevalence of alcohol advertisements. The tool works very easy through social media. Anytime an Instagram or Twitter message contains the hashtag #alkoholstör it is automatically entered into IOGT-NTOs database. The organization filters the incoming ads and publishes the relevant ones on the alcohol bothers website. Kilim ads that:”We also trained four ambassadors who looked through all the pictures and reported them to the Swedish office of consumers. If we compare the campaign period to the same period last year, we can see a raise in reports with 800%.” The reporting tool however is only one tier of the Alcohol Bothers campaign. Before IOGT-NTO started reporting on alcohol advertisements, they gathered the email addresses of all candidates for the Swedish elections. Through the Alcohol Bothers website, people can contact any of the candidates to ask them, ”Do you think that the Swedish legislation for alcohol advertising should be more restrictive?” ”We knew that the Swedish people had a strong opinion in this but we wanted to show that there is a great political will as well”, Kilim explains. In this the campaign has already succeeded, with over 70% of the political response being in favor of further restrictions. The Alcohol Bothers website includes a bit of information on every candidate and the possibility to directly ask them the above mentioned question. Additionally, anyone interested could go to the website, find the candidate they are interested in and click on their name. This will present them with a pre-written post card asking you only to fill in your contact information and hit "send”. "Our goal was that every candidate should be asked at least once, that half of the candidates answered our question and that the majority of those who answered would say 'Yes'. We reached all these goals, and got more candidates to answer than the biggest political surveys in Sweden,” Irma Kilim told EUCAM. ”It’s a big success!” Besides these local and national Swedish parts of the campaign, IOGT-NTO is also planning a global Alcohol Bother campaign. For more information, or to send an example of Swedish alcohol marketing that bothers you, go to the Alcohol Bothers website>>