Authors: M. Petticrew, N. Douglas, P. D’Souza, Y.M. Shi, M.A. Durand, C. Knai, E. Eastmure, N. Mays Title: Community Alcohol Partnerships with the alcohol industry: what is their purpose and are they effective in reducing alcohol harms? Journal: Journal of Public Health, pp. 1–16, doi:10.1093/pubmed/fdw139 Abstract: Background: Local initiatives to reduce alcohol harms are common. One UK approach, Community Alcohol Partnerships (CAPs), involves partnerships between the alcohol industry and local government, focussing on alcohol misuse and anti-social behaviour (ASB) among young people. This study aimed to assess the evidence of effectiveness of CAPs. Methods: We searched CAP websites and documents, and databases, and contacted CAPs to identify evaluations and summarize their ﬁndings. We appraised these against four methodological criteria: (i) reporting of pre–post data; (ii) use of comparison area(s); (iii) length of follow-up; and (iv) baseline comparability of comparison and intervention areas. Results: Out of 88 CAPs, we found three CAP evaluations which used controlled designs or comparison areas, and further data on 10 other CAPs. The most robust evaluations found little change in ASB, though few data were presented. While CAPs appear to affect public perceptions of ASB, this is not a measure of the effectiveness of CAPs. Conclusion: Despite industry claims, the few existing evaluations do not provide convincing evidence that CAPs are effective in reducing alcohol harms or ASB. Their main role may be as an alcohol industry corporate social responsibility measure which is intended to limit the reputational damage associated with alcohol-related ASB. The article (full text) can be downloaded via this link.
For the first time, the costs of alcohol consumption in the Netherlands have been mapped. The National Institute for Public Health and the Environment published an extended cost-benefit analysis, showing that alcohol consumption costs the Dutch society yearly 2,3 to 2,9 billion euro. If all costs and all benefits of alcohol are expressed in monetary terms, the net costs were 2,3 to 2,9 billion euro in 2013. Examples of the costs of alcohol are less productivity at work, costs of police and justice and traffic accidents. Alcohol also has benefits, for instance excise tax income for government. The feeling of wellbeing that consumers may experience from drinking alcohol has also been expressed in monetary terms. The monetary benefits of alcohol have been subtracted from the costs of alcohol to arrive at the final estimate of net costs for society. Regulatory policies aimed at reducing the amount of alcohol consumed, such as a further increase of excise taxes, a reduction of the number of sales venues and a total mediaban, will result in savings for society at large. Some examples of such positive effects are less mortality and improvement of quality of life because some diseases associated with alcohol are prevented, more productivity, less traffic accidents and less efforts to be taken by police and justice. In the long run, over a period of 50 years, an increase in excise taxes of 50% will result in societal benefits of 14 to 20 billion euro, an increase of excise taxes of 200% will result in societal benefits of 37 to 47 billion euro. The societal benefits of closure of 10% of sales venues are estimated at 3 to 5 billion euro after 50 years, and at 8 to 12 billion euro when 25% of sales venues would be closed. The societal benefits of a mediaban would amount to 7 billion euro after 50 years, but there is more uncertainty about this result. This appears from a study led by RIVM. The three regulatory policies have been modelled using the Social Cost-Benefit Analysis (SCBA) approach. By expressing the net welfare effect of government policies and interventions, SCBAs can support policy makers in taking decisions on implementation of future policies. Click here to download the report.
The more brand-specific alcohol advertising that young drinkers are exposed to, the higher their consumption of those brands, according to a new study led by researchers from the School of Public Health and School of Medicine. The study, in the Journal of Studies on Alcohol and Drugs, found an association between past-year exposure to advertising, measured in what the researchers called “adstock” units, and consumption of the brands advertised. Every 100 adstock-unit increase in exposure was associated with an increase of six drinks consumed during the past 30 days, while exposures of 300 or more adstock units were associated with an increase of 55.7 drinks. The study examined links between exposure to brand-specific TV advertising and drinking among a national sample of more than 1,000 youths, ages 13 to 20, who reported drinking in the past 30 days. Participants were surveyed about their past-month viewership of the 20 most popular non-sports shows that contained alcohol ads. They also were asked about their past-month consumption of the 61 brands in those advertisements. The study estimated that the advertised brands accounted for almost 47 percent of all alcohol consumed by the young drinkers, and that there was a “dose-response” relationship between exposure to ads and drinking levels. “The exposure-consumption relationship was particularly strong among those with 300 or more adstock units of exposure,” the researchers said. “There were fewer youth with these higher levels of advertising exposure, but they consumed a disproportionately large amount of the alcohol consumed by the entire youth sample.” The research team noted that while alcohol advertising has been linked with youths’ brand choices in past studies, alcohol marketing remains self-regulated by the industry. Manufacturers have guidelines saying that ads should be limited to media that have a mostly adult audience. But alcohol companies don’t always follow their own guidelines, and there is no penalty for violations. The current study confirms that under-21 audiences are seeing plenty of alcohol ads, the authors said. “Although previous studies have shown that exposure to advertising is related to which brands underage youths drink, few studies have assessed whether the quantity of exposure is associated with the total quantity of alcohol consumed by these youths,” said lead author Timothy Naimi, associate professor of community health sciences and of medicine at BUSM, and a physician at Boston Medical Center. Michael Siegel, the study’s co-principal investigator and professor of community health sciences, said the study suggests that advertising influences “how much kids drink, not just what they drink. “This has important implications because we know that the amount of alcohol consumption is associated with increased risks of harm, including motor vehicle fatalities, suicide and violence. We believe these findings should prompt a reevaluation of the industry’s self-regulatory framework, in order to reduce advertising exposure among underage youth,” he said. Among study participants, the median number of drinks consumed in the past 30 days was five. The average number of drinks consumed increased from 14 to 33 per month as advertising exposure increased from zero to 300 adstock units. For participants exposed to 300 or more adstock units, per-person consumption skyrocketed from 33 drinks to more than 200 drinks consumed in the past 30 days. The authors said they hoped the study would prompt research that further examines the exposure-consumption relationship, especially among youths who have high exposure to ads on TV and in other media. Naimi said that, for parents, the findings offer extra motivation to curb kids’ time in front of the TV, particularly for programming with alcohol advertising. In general, experts recommend that children and teenagers spend a limited amount of time each day in front of a “screen”—whether a TV, computer, or phone. “This could be yet another reason to limit screen time,” Naimi said. Co-authors on the study were: William DeJong, professor of community health sciences; David Jernigan of the Johns Hopkins Bloomberg School of Public Health; and Craig Ross of Fiorente Media, Inc., also research assistant professor of epidemiology at SPH. The above is a verbatim copy of the press release by Boston University Medical Campus Full text: http://www.jsad.com/doi/abs/10.15288/jsad.2016.77.723 The article has been included in our online databases of scientific publications: http://eucam.info/2016/09/12/naimi-et-al-2016/
Author: Timothy Naimi, Craig Ross, Michael Siegel, William de Jong & David Jernigan Title: Amount of televised alcohol advertising exposure and the quantity of alcohol consumed by youth Journal: Journal of studies on alcohol and drugs (2016), 77(5), 723-729 Abstract Aims: Although studies demonstrate that exposure to brand-specific alcohol advertising is associated with an increased likelihood of youth consuming particular brands, the relationship between quantity of brand-specific advertising exposure and quantity of brand-specific consumption has not been firmly established. Methods: Using the Alcohol Brand Research Among Underage Drinkers (ABRAND) national sample of 1,031 young drinkers (ages 13–20), this study examined the relationship between their aggregated past-year exposure to advertising (in adstock units, a measure based on gross rating points) for 61 alcohol brands that advertised on the 20 most popular nonsports television programs viewed by underage youth and their aggregated total consumption of those same brands during the past 30 days. Predictive models adjusted for other media exposure, predictors of youth’s alcohol consumption, and the consumption of brands not advertised on the 20 shows. Results: For the fully adjusted models, each 100 adstock unit increase in exposure (about 1 SD) was associated with an increase of 5.9 drinks (95% CI [0.9, 11.0 drinks]) consumed during the past 30 days among those with less than 300 units of advertising exposure, and an increase of 55.7 drinks (95% CI [13.9, 97.4 drinks]) among those with 300 or more adstock units of exposure. Conclusions: Among underage youth, the quantity of brand-specific advertising exposure is positively associated with the total quantity of consumption of those advertised brands, even after controlling for the consumption of non-advertised brands. Future research should examine exposure–consumption relationships longitudinally and in other media. Full text: http://www.jsad.com/doi/full/10.15288/jsad.2016.77.723
EUCAM is constantly looking out for interesting scientific publications on the subject of alcohol marketing in the broadest sense. A number of articles that have been published over the last six months prompted us to disseminate their conclusions in news articles. However, there has been such a great number of important studies that we have decided to round them up in a single overview of the recent literature. Systematic Reviews Since systematic reviews are regarded as the "Gold Standard" of evidence in the literature, this article will start with 3 systematic reviews. Early this year Addiction published ‘How does the alcohol industry attempt to influence marketing regulations? A systematic review.’ In this review Emily Savell (University of Bath & UK Centre for Tobacco and Alcohol Studies) and co-authors reviewed seventeen papers and concluded that:
“The industry's opposition to marketing regulation centres on claims that the industry is responsible and that self-regulation is effective. There are considerable commonalities between tobacco and alcohol industry political activity, with differences due potentially to differences in policy contexts and perceived industry legitimacy.”Earlier this month BMC Public Health published ‘Immediate effects of alcohol marketing communications and media portrayals on consumption and cognition: a systematic review and meta-analysis of experimental studies.’ Lead authors Kaidy Stautz and Kyle G. Brown of the University of Cambridge’s Behaviour and Health Research Unit searched for experimental studies assessing immediate effects of exposure to alcohol marketing communications on objective alcohol consumption (primary outcome), explicit or implicit alcohol-related cognitions, or selection without purchasing (secondary outcomes). They identified 24 studies which met the inclusion criteria. Their meta-analysis of 758 participants (all students) shows that viewing alcohol advertisements (but not alcohol portrayals) may increase immediate alcohol consumption by small amounts, equivalent to between 0.39 and 2.67 alcohol units for males and between 0.25 and 1.69 units for females. The authors remark:
“Whilst the evidence from experimental studies is currently limited, the results of this systematic review do, in our view, lend some qualified support to the public health case for restrictions, bans, or other policies that would reduce exposure to alcohol advertising on visual broadcast media to reduce alcohol consumption. Importantly, whilst the individual-level immediate effects found here may be small, such effects could, if sustained in response to overall reduced exposure over time, have a meaningful impact on consumption at the population level.”Just as this systematic review was published a new experimental study appeared, which may have also met the inclusion criteria. In ‘Saw It on Facebook, Drank It at the Bar! Effects of Exposure to Facebook Alcohol Ads on Alcohol-Related Behaviors,’ Saleem Alhabasha and his colleagues from Michigan State University, through an experimental setting show the effects of exposure to Facebook alcohol advertisements on intentions to consume alcohol and alcohol-related behaviours. 121 participants were exposed to ads on Facebook, one group viewing ads for a brand of beer, the other a brand of bottled water. At the end of the study, as an incentive for taking part, the participants were offered one of two gift cards – one for a bar, the other for a coffee shop. Of those who saw the beer ad, 73 percent chose the bar card. Of those who saw the water ad, only about 55 percent chose the bar card.
“What this tells us is there is an effect and it can be attributed to the sheer exposure to these messages,” said Alhabasha in a press release accompanying the publication.Sports Sponsorship Another systematic review considered sports sponsorship. Alcohol and Alcoholism published ‘Association Between Alcohol Sports Sponsorship and Consumption: A Systematic Review.’ In which the Institute for Alcohol Studies’ Kathryn Brown included seven studies on the impact of exposure to alcohol sports sponsorship and outcomes relating to alcohol consumption. The review presents data on 12,760 participants from Australia, New Zealand, the UK, Germany, Italy, Netherlands and Poland. All studies report positive associations between exposure to alcohol sports sponsorship and self-reported alcohol consumption. Brown concludes:
“The relationship between alcohol sports sponsorship and increased drinking amongst schoolchildren will concern policymakers. Further research into the effectiveness of restrictions on alcohol sports sponsorship in reducing harmful drinking is required.”Addiction published online a new study from the dataset that the team of Thomas Babor compiled from monitoring international broadcasts of the 2014 FIFA World Cup tournament. In ‘Alcohol Marketing in the Americas and Spain during the 2014 FIFA World Cup Tournament,’ lead author Jonathan K. Noel performed a qualitative analysis of 87 alcohol advertisements from 20 world cup matches. This analysis found that 86.2% of all unique alcohol advertisements contained at least 1 violation of the industry’s self-regulation codes, with violation rates ranging from 72.7% (Mexico) to 100% (Brazil). Countries with the least restrictive marketing policies had a higher prevalence of violations in guidelines designed to protect minors. Spotlight on online alcohol advertising Our EUCAM colleague Avalon de Bruijn published a study on the effects of online exposure to alcohol advertising in Alcohol and Alcoholism. In ‘Exposure to Online Alcohol Marketing and Adolescents’ Drinking: A Cross-sectional Study in Four European Countries, ’ de Bruijn and her colleagues surveyed more than 9,000 students around the age of 14 at schools in Germany, Italy, the Netherlands and Poland. The study found that online alcohol marketing exposure was found to be related to the odds of starting to drink and the odds of binge drinking in the past 30 days. This study is the first that has examined the impact of different levels of frequency of exposure to (online) alcohol marketing practices and the first cross-country study that examined the impact of alcohol advertising on adolescents’ drinking behaviour.
The author notes that: “…alcohol marketing on the Internet can be seen as a serious but avoidable danger to adolescents’ health. The consistency of this effect and the size of the effect among the four European countries seriously raise the demand for legal restrictions of the volume of alcohol marketing in online media in European countries.”The Journal of Substance Use published ‘Potential youth exposure to alcohol advertising on the internet: a study of internet versions of popular television programs.’ A quantitative study in which Michael Siegel and his co-authors had three underage coders (ages 10, 13, and 18) analyse web sites of television networks which stream television programs popular among youth to assess the volume of alcohol advertising. The study found that alcohol advertisements are highly prevalent on these programs, with nine of the 12 shows carrying alcohol ads, and six programs averaging at least one alcohol advertisement per episode. Novel method of measuring TOTAL exposure ‘Alcohol Advertising Exposure Among Middle School–Age Youth: An Assessment Across All Media and Venues.’ Is a particularly interesting American exposure study published in the Journal of Studies on Alcohol and Drugs. Rebecca Collins and her colleagues of the Rand Corporation outfitted 589 children between the ages of 11-14 with a handheld computer to log their exposure to all kinds of alcohol advertising for 14 days straight. This makes it the first study to estimate total amount of alcohol advertising exposure among youth. The study found that African American and Hispanic youth are exposed to an average of 4.1 and 3.4 advertisements per day, respectively, nearly two times as many as non-Hispanic White youth. Girls were exposed to 30% more advertisements than boys. Most exposures were to outdoor advertisements, with television advertisements a close second.
Source: CCTV America
On 4 March 2016, the European Commission (DG Connect) published the final report of the study on the exposure of minors to alcohol advertising on linear and non-linear audio-visual media services and other online services, including a content analysis. The research was conducted by the consortium partners Ecorys and the National Institute for Health and Welfare (THL) in close collaboration with the following subcontractors: CentERdata, GfK Belgium and individual experts in the field (Prof. Peter Anderson and Prof. David Jernigan). The study found that approximately 7.3% of the total number of alcohol impacts on linear AV media services in 2013 were seen by minors. In absolute terms this means that, on average, a minor saw 200 alcohol impacts, while an adult saw over 450. According to the report, online services and the alcohol industry try to ensure minimal exposure through the implementation of measures and self-regulation, however, minors surveyed perceived a substantial level of exposure, while self-reported exposure increased with age and online activity. The study also found that the most common themes employed in alcohol advertisements include the association of alcohol with sociability and the depiction of drinking with humorous tones. Respectively, 87% and 63% of 90 analysed TV advertisements and 33 online alcohol advertisements contained at least one element that can be considered appealing to minors. In addition, it was found that 25% of the analysed advertisements reflect at least one of the criteria prohibited in the AVMSD. The full report can be found here>> A summary is available here>>
A new systematic literature study by the Institute of Alcohol Studies (IAS) concludes that international studies found a significant link between sports sponsorship and increased alcohol consumption, including among schoolchildren. In Ireland this news has drawn attention back to earlier cancelled plans by the government to ban alcohol sports sponsorship. The study, authored by IAS director Kathrine Brown, was published in the journal Alcohol and Alcoholism. In it, Brown points out that the association between alcohol sports sponsorship and alcohol use among minors “warranted close attention from public health policymakers”. The research reviewed studies in seven countries, including five in the EU. “All studies report positive associations between exposure to alcohol sports sponsorship and self-reported alcohol consumption,” states the report. “Two studies found indirect exposure to alcohol sports sponsorship was associated with increased levels of drinking amongst schoolchildren, and five studies found a positive association between direct alcohol sports sponsorship and hazardous drinking amongst adult sports-people.” Among the studies included in the review is a study by EUCAMs Avalon de Bruijn from 2012. This Amphora study among 6,650 young students in Germany, Italy, the Netherlands, and Poland found that “exposure to branded sports sponsorship increased the odds of drinking”. A 2009 study among 320 students from Welsh schools found that “awareness of alcohol sponsorship predicted likelihood of boys drinking and of both boys and girls getting drunk the following weekend”. The article notes that France and Norway already have a ban in place against alcohol branded sports sponsorship, while countries such as Ireland and New Zealand are considering this policy intervention. Ireland Irish newspaper the Irish Examiner picked up the publication of the article and said that: ‘Given the lack of Irish research on the matter, it will be of interest to health experts and departmental officials here.’ The Examiner describes the history of the ambitious plans to ban alcohol sports sponsorship and what ended up happening. It starts with referring to a report of the government’s National Substance Misuse Strategy Steering Group which in February 2012 recommended that alcohol sponsorship of sports events be phased out by 2016. This recommendation was strongly opposed by sporting organisations and the alcohol industry. Accordingly, a decision on the subject was postponed by the Government’s action plan on alcohol, which in October 2013 left the issue to a working group. This group in turn reported at the end of 2014 that evidence of the links between sponsorship and consumption was limited. The major sporting bodies argued that they would suffer a significant loss of revenue if sports sponsorship were to be banned. In reaction to this conflicting views came up on alternative sources of sponsorship and the work group said further work was needed to identify the options for Government. The issue of alcohol branded sports sponsorship is not covered in the Public Health (Alcohol) Bill 2015, which was published in December, other than prohibiting alcohol advertising in sports grounds for events where a majority of participants are children. The abstract of the systematic literature study can be found here>> The full text is available on the website of Alcohol and Alcoholism>> Source: Irish Examiner 03/01/16 For more information on the Irish debate about sports sponsorship also see: ALCOHOL ADS ON THE SIDE OF SPORTS FIELDS TO BE BANNED IN IRELAND? 11/08/15 VIDEO: DR. PAT KENNY DISCUSSING ALCOHOL MARKETING BEFORE THE OIREACHTAS 08/02/15 IRISH BAN ON ALCOHOL SPORTS SPONSORING TO BE DROPPED 01/25/15 TEENS PREFER ALCOHOL BRANDS THEY KNOW THROUGH SPONSORSHIP 12/16/14 EUCAM COMMENTARY IN UPCOMING ISSUE OF ADDICTION: REFUTING ARGUMENTS AGAINST A BAN ON ALCOHOL SPORT SPONSORSHIP 08/29/14 IRISH GOVERNMENT FINALIZES ALCOHOL STRATEGY: NO BAN ON SPORTS SPONSORSHIP 10/24/13 IRELAND: REVIEW COMMITTEE OPPOSES BAN ON ALCOHOL BRANDED SPORT SPONSORSHIP 07/08/13 IRISH MEDIA REPORT BAN ON ALCOHOL BRANDED SPORT SPONSORING WILL BE APPROVED 07/29/13 RESEARCH SHOWS THAT ALCOHOL MARKETING IS NOT HARMLESS 06/26/13 IRELAND: POLICY MAKERS NOT PREPARED TO DO WHAT NEEDS TO BE DONE AGAINST ALCOHOL 03/16/13 FEATURE OF IRISH ALCOHOL STRATEGY UNCERTAIN AS MINISTER RESIGNS 10/01/12 MINISTER DEDICATED TO BANNING ALCOHOL SPORT SPONSORING IN IRELAND 05/25/12 IRELAND TO BAN ALCOHOL SPORTS SPONSORSHIP? 02/07/12 IRISH DEBATE ABOUT ALCOHOL MARKETING FLARES UP 11/201/11
Overall exposure to brand-specific alcohol advertising is a significant predictor of underage youth alcohol brand consumption, with youth ages 13 to 20 more than five times more likely to consume brands that advertise on national television and 36 percent more likely to consume brands that advertise in national magazines compared to brands that don't advertise in these media. The report, which will be published online on Oct. 20 by the American Journal of Drug and Alcohol Abuse, is from researchers with the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health. It is believed to be the first study to examine the relationship between brand-specific advertising and brand-specific consumption of alcohol among underage drinkers using the 898 brands that were available on the U.S. market in 2011. While previous studies relied on self-reporting by youth to measure their exposure to alcohol advertising, this report used U.S. national population exposure estimates from media research firms, specifically, underage youth exposure to alcohol advertising by brand in national magazines from GfK MRI, and on national television programs from Nielsen. As for alcohol consumption, researchers asked 1,031 underage drinkers which of the 898 brands they had consumed in the past thirty days using an online national survey conducted between December 2011 and May 2012. "Marketing exposure is increasingly recognized as an important factor in youth drinking, yet few studies have examined the relationship between overall advertising exposure and alcohol consumption at the brand level," says lead study co-author David Jernigan, CAMY director and an associate professor in the Bloomberg School's Department of Health, Behavior and Society. "These findings indicate that youth are in fact consuming the same alcohol brands that they are most heavily exposed to via advertising." The researchers note that they reached their conclusions after accounting for potentially confounding factors such as price per ounce, which influences affordability, and overall market share as explanations for the correlation between exposure to brand-specific alcohol advertising and underage youth consumption. Previous studies linking youth alcohol advertising exposure to alcohol consumption have generally found small but significant associations between how much advertising young people see, hear or read, and how likely they are to start drinking or to drink more. This new research, which explores the relationship at the brand level, strongly suggests that the smaller effects found in earlier research may be a result of grouping all alcohol brands together or in broad categories of beer, wine and spirits. "Until research showed the effects of the Joe Camel advertising campaign on what cigarette brands youth smoked, it was controversial to say that a relationship between cigarette marketing and youth cigarette consumption existed," said lead study author Michael Siegel, MD, MPH, professor of Community Health Sciences at the Boston University School of Public Health. "Once the relationship between cigarette ads and the brands that youth were smoking was established, significant policy shifts occurred as state and federal policy makers took the issue of advertising exposure to youth much more seriously." Alcohol is the number one drug consumed by youth and is responsible for approximately 4,300 deaths per year. Alcohol advertising in the U.S. is primarily regulated by the industry itself through a set of voluntary codes, which includes not placing any ads on television programs where a disproportionate share of the audience is younger than 21. In 2011, the alcohol industry spent at least $3.5 billion in advertising and promotional expenditures, much of it in media venues in which youth compromise a disproportionate share of the audience.
The above is copied verbatim from the media release provided by our colleagues at Johns Hopkins University Bloomberg School of Public Health. For the abstract, please go here>>
The above is copied verbatim from the media release provided by our colleagues at Johns Hopkins University Bloomberg School of Public Health. For the abstract, please go here>>