Alcohol Focus Scotland, 2022
In June 2022, Alcohol Focus Scotland and a group of international experts published a report highlighting the high visibility of alcohol marketing in our lives and calling on the Scottish Government to introduce statutory restrictions on how alcohol is marketed in a bid to improve the health of people in Scotland. A literature review on the effect of alcohol marketing on people with or at risk of an alcohol problem was also commissioned to support this work. We asked lead author Professor Rachael Murray from the School of Medicine, University of Nottingham, for a blog summarising the research.
Why is this important?
Harmful use of alcohol results in millions of deaths around the world and costs the NHS and society billions of pounds each year. Alcohol use disorder (AUD) is a term which describes a number of medical conditions characterised by an inability to stop or control alcohol use despite negative social, occupational and health consequences.[i] AUDs are the biggest risk factor for early death and disability among 15-49 year olds.[ii]
Alcohol marketing contributes to the problem of AUDs by influencing the availability and advertising of alcohol products. There has been a lot of research looking at how alcohol marketing impacts children and young people, which has concluded that alcohol marketing lowers the age at which individuals start drinking, increases their intention to drink, the amount they drink and leads to higher levels of dangerous drinking.[iii] [iv] Overall the evidence has been judged strong enough to be able to say that alcohol marketing causes drinking in young people.[v]
There has been less research as to the effect of alcohol marketing in adults. Adults with AUDs may be more influenced by and vulnerable to alcohol marketing; heavy alcohol users are more likely to be exposed to and notice alcohol adverts[vi] and react strongly to alcohol cues.[vii] Protecting this group is not currently considered under alcohol marketing regulations.
We therefore conducted a rapid review of research studies which investigated the effect of alcohol marketing on people with or at risk of an AUD. We included both quantitative studies (which describe how many people think or act in a certain way) and qualitative studies (which describes peoples’ thoughts, feelings and experiences) and separated our findings according to whether study participants were currently experiencing or were at risk of developing an AUD (5 studies), or if they were in recovery from an AUD (6 studies).
Findings – People with or at risk of an AUD
A small number of studies have looked at the effect of alcohol advertising on people with or at risk of an AUD. One study assessed the direct effect of advertising on alcohol consumption and found no effect. However, all the studies reported outcomes which could potentially lead to increased consumption. These included experiencing more positive emotions relating to alcohol, being more likely to consume alcohol in preference to water, a greater awareness of alcohol branding in newspapers and magazines and a greater appeal of alcohol adverts in heavy drinkers. No qualitative studies in this group were found.
Findings – People in recovery from an AUD
A small number of studies suggest an effect of alcohol advertising in this population, with around three quarters of participants in one study recalling seeing alcohol marketing and around one quarter reporting that this marketing was influential. Another study reported increased alcohol craving after exposure to alcohol advertisements. Qualitative studies reported that individuals in recovery from problematic drinking felt that alcohol adverts triggered a desire to drink, particularly where the advert contained their preferred drink. Some even reported the adverts to be responsible for their relapse to drinking. Television advertising was reported as being particularly powerful as it was felt that the television intruded into their home. The same was said of adverts containing party scenes as they created an association with good times. Conversely, adverts were often reported as creating feelings of loss, anger, sadness, guilt and exclusion from the norm in this population. Finally, in-store advertising and high visibility of alcohol products were identified as a risk to recovery.
Conclusion
Taken together, the results from the identified studies suggest that there is likely an effect of alcohol marketing in people with or at risk from an AUD. Further research in this area is needed; however, this risk should be a concern for marketing regulators.
[i] American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed. Washington DC). 2013.
[ii] GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Psychiatry. 2018;5(12):987-1012.
[iii] Jernigan D, Noel J, Landon J, Thornton N, Lobstein T. Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008. Addiction. 2017;112 Suppl 1:7-20.
[iv] Anderson P, de Bruijn A, Angus K, Gordon R, Hastings G. Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol and Alcoholism. 2009;44(3):229-43.
[v] Sargent J, Babor T. The Relationship Between Exposure to Alcohol Marketing and Underage Drinking Is Causal. Journal of Studies on Alcohol and Drugs. 2020;Sup 19:113-24.
[vi] Petersen Williams P, Morojele N, Londani M, Harker Burnhams N, Parry C. Alcohol Advertising, Affordability and Availability, and the Effect on Adult Heavy Drinking and Symptoms of
Alcohol Problems: International Alcohol Control Study (South Africa). Substance Use and Misuse. 2019;54(11):1751-62.
[vii] Noel J, Xuan Z, Babor T. Perceptions of Alcohol Advertising among High Risk Drinkers. Substance Use and Misuse. 2018;53:1403-10.