Alcohol health harm remains at an unacceptably high level in many countries including in Scotland where, as elsewhere in Europe and North America, alcohol specific deaths rose during the COVID-19 pandemic as consumption increased in those already drinking heavily.1,2,3,4
The Scottish Government recently undertook a public consultation on possible measures to restrict alcohol advertising and promotion,5 which (along with reducing affordability via taxation and minimum unit pricing and restricting availability via licensing laws) is recommended by the World Health Organization (WHO) as one of the three ‘best buys’ to reduce alcohol harm. These proposals were welcomed by health campaigners (including Scottish Health Action on Alcohol Problems, a coalition of the medical royal colleges and faculty of public health in Scotland which is hosted by the Royal College of Physicians of Edinburgh) but vigorously opposed by the drinks industry and some sporting bodies. The government is currently analysing the consultation responses with a view to bringing forward concrete proposals within this parliamentary term. So what is the evidence?
The evidence linking alcohol marketing to consumption and harm is strongest in young people and those in recovery from alcohol use disorder. Exposure to alcohol marketing is causally associated with the initiation of drinking, an increase in alcohol consumption (including binge drinking) and an increased risk of relapse for those in recovery.612 There are also good grounds to assume an effect on the general population. With global investment in alcohol marketing expected to exceed £7.7 billion in 2023,13 most people are exposed to high volumes of alcohol marketing, and there is evidence linking such exposure to increased consumption, often through the targeting of heavy drinkers and recruitment of new drinkers.1416
One of the measures considered is restricting alcohol sponsorship of sporting events. Sports sponsorship is a powerful and prevalent marketing tool for alcohol companies, which allows brands to form attractive associations and capitalise on fans’ emotional connections with sport and sports teams. A causal relationship has been established whereby alcohol sports sponsorship influences consumption rates not only amongst fans but also in those who play sports.17
Currently, the UK relies on self-regulation by the alcohol companies themselves, but this is ineffective. For example, their code claims to protect children from exposure to alcohol advertising by not permitting advertising at events where more than a quarter of attendees are children. But a recent study demonstrated that during a Scotland vs England rugby match watched by an audience including many thousands of children, an alcohol advert was visible every 20 s.18 Children in Scotland as young as 10 years of age demonstrate excellent alcohol brand recognition19.
Several European countries already have restrictions on alcohol advertising in sport, including France, several Nordic countries and most recently Ireland. Unfortunately, companies sometimes circumvent these restrictions by so called ‘alibi marketing’, most recently by ostensibly advertising the brand’s low or zero alcohol product: by utilising a near-identical appearance to the alcohol brand, it is in fact alcohol which is being promoted. Such tactics undermine the effectiveness of the restrictions, and any new legislation must address this loophole.
Many of the alcohol companies’ predictions of disaster if marketing restriction were to be imposed do not stand up to scrutiny. For example, whisky producers claim restricting advertising their product would result in significant loss of jobs and revenue – hard to believe when just 1% of Scotch whisky is in fact sold in Scotland. Such Cassandra-like predictions were rife during the arguments over the introduction of minimum unit pricing, none of which have in reality come to pass. Some sporting bodies are concerned about loss of revenue from the alcohol industry, but we know that when tobacco advertising was banned from sport, alternative sponsors filled the gap, and in fact only 6.4% of sponsors of Scottish football teams are from the alcohol industry.20
The magnitude of the alcohol problem – in Scotland and elsewhere – justifies public health measures. Restricting alcohol advertising is recommended by WHO, is supported by evidence, takes account of the rights of individuals not to be exposed to harm and appeals to our common sense. Nobody seriously questions the effectiveness of marketing and advertising, and when it comes to sport, it is inherently flawed to link a healthy and beneficial activity such as sport to a health-harming product such as alcohol.
Scotland should follow the example of our neighbours Ireland by placing restrictions on alcohol marketing and advertising, including the banning of alcohol sponsorship in sport.

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