Youth drinking cultures, social networking and alcohol marketing: implications for public health

Denial, Attention-Seeking, and Posting Online While Intoxicated: Three Key Predictors of Collegiate Sadfishing

Sadfishing, or the exaggeration of one's emotional state online to generate sympathy, is a maladaptive behavior that can negatively affect mental health. A better understanding of the characteristics of individuals who sadfish could inform tailored interventions to decrease sadfishing and improve quality of life. However, to date, the phenomenon of sadfishing remains understudied. Thus, the current project was designed to identify some of the key psychological and behavioral characteristics that may be associated with sadfishing. Undergraduate college students (N = 374) recruited from introductory psychology courses at a large, Hispanic-serving institution completed an anonymous online survey assessing sadfishing and other online behaviors, psychological characteristics (coping, stress, resilience, and social support), and alcohol use. Both univariate and multivariate statistical analyses were conducted. Results of the binary logistic regression analysis found that students who reported using denial as a coping strategy (p = 0.005), who endorsed the attention-seeking behaviors associated with histrionic personality disorder (p = 0.021), and who used social media while intoxicated (p = 0.017) were most likely to report sadfishing. This study furthers our knowledge of the maladaptive online behavior of sadfishing and identifies several key predictors that could become targets for tailored interventions. In particular, our results highlight the importance of coping skills training for individuals who sadfish.

Alcohol consumption and its associated factors among adolescents in a rural community in central Thailand: a mixed-methods study

Early onset of alcohol use was associated with alcohol dependence and other health problems. We aimed to identify the prevalence and factors associated with alcohol consumption among adolescents in a rural community in Thailand. A mixed-methods study was carried out in 2021 using an explanatory sequential design. The study enrolled a total of 413 adolescents. On average, young adolescents initiated alcohol consumption at age 13. The lifetime drinking prevalence among adolescents was 60.5%, while the 1-year drinking prevalence was 53.0%. The prevalence of hazardous drinking among current drinkers was 42.0%. Alcohol consumption was associated with females (adjusted prevalence ratio (APR): 1.19; 95% CI 1.01-1.41), age ≥ 16 years (APR: 1.28; 95% CI 1.09-1.50), having close friends consuming alcohol (APR: 1.75; 95% CI 1.43-2.14), night out (APR: 1.93; 95% CI 1.53-2.45), being a current smoker (APR: 1.39; 95% CI 1.15-1.69), and having relationship (with boyfriend/girlfriend) problems (APR: 1.18; 95% CI 1.01-1.38). Qualitative data demonstrated that individual and environmental factors, including friends, family, social media use, and alcohol accessibility, affect alcohol use in this population. Therefore, effective strategies should be implemented across multiple levels of the socio-ecological model simultaneously to alleviate alcohol consumption and attenuate its complications.

Development and validation of the Alcoholic Beverage Identification Deep Learning Algorithm version 2 for quantifying alcohol exposure in electronic images

BACKGROUND

Seeing alcohol in media has been demonstrated to increase alcohol craving, impulsive decision-making, and hazardous drinking. Due to the exponential growth of (social) media use it is important to develop algorithms to quantify alcohol exposure efficiently in electronic images. In this article, we describe the development of an improved version of the Alcoholic Beverage Identification Deep Learning Algorithm (ABIDLA), called ABIDLA2.

METHODS

ABIDLA2 was trained on 191,286 images downloaded from Google Image Search results (based on search terms) and Bing Image Search results. In Task-1, ABIDLA2 identified images as containing one of eight beverage categories (beer/cider cup, beer/cider bottle, beer/cider can, wine, champagne, cocktails, whiskey/cognac/brandy, other images). In Task-2, ABIDLA2 made a binary classification between images containing an "alcoholic beverage" or "other". An ablation study was performed to determine which techniques improved algorithm performance.

RESULTS

ABIDLA2 was most accurate in identifying Whiskey/Cognac/Brandy (88.1%) followed by Beer/Cider Can (80.5%), Beer/Cider Bottle (78.3%), and Wine (77.8%). Its overall accuracy was 77.0% (Task-1) and 87.7% (Task-2). Even the identification of the least accurate beverage category (Champagne, 64.5%) was more than five times higher than random chance (12.5% = 1/8 categories). The implementation of balanced data sampler to address class skewness and the use of self-training to make use of a large, secondary, weakly labeled dataset particularly improved overall algorithm performance.

CONCLUSION

With extended capabilities and a higher accuracy, ABIDLA2 outperforms its predecessor and enables the screening of any kind of electronic media rapidly to estimate the quantity of alcohol exposure. Quantifying alcohol exposure automatically through algorithms like ABIDLA2 is important because viewing images of alcoholic beverages in media tends to increase alcohol consumption and related harms.

[Public Health Policies for Youth - Bibliometric Study and Research Agenda based on the Web of Science]

The scope of this research outlines the field of study on public health policies for youth supported by bibliometric maps, from the perspective of identifying research gaps. VOSviewer software was used based on the exploratory-descriptive profile, with data located in October 2021, using the key words "public", "youth", "health" with the connecting "and", which resulted in 172 articles. The following groupings were located: co-authorship by country; co-authorship by key words; co-quote by article; co-quote by reference cited; bibliographic coupling; co-quote of authors. The results reveal an interdisciplinary field, represented by studies in the areas of education, social work, law, and social sciences, with a significant recurrence of the themes of mental health, violence, and obesity, as well as discussions on substance use and abuse, such as cigarette smoking for example. Debates about the social configuration, defined by the idea of community, as well as its prevalence and prevention are present in the scope of these studies. Finally, eight research agenda topics are derived from the discussion about the growing movement towards health promotion as a public policy, while socio-economic and cultural aspects are presented with greater emphasis, in the quest to understand the impacts of this scenario for youth.

Instabrand courtside: a content analysis of marketing strategies by food and beverage brands during the 2021 Australian Open tennis tournament

OBJECTIVE

To examine the marketing techniques food and beverage brands use on Instagram, as part of their sport sponsorship strategy.

METHODS

We conducted a qualitative content analysis of 31 Instagram accounts during the 2021 Australian Open tennis tournament. Branded food and beverage posts with tennis-linked content were coded based on an initial screening and previously published frameworks.

RESULTS

Of the 152 included posts, 92% were made by food and beverage companies that were official 'partners' of the Australian Open. Products in posts were mostly discretionary foods and alcohol. The most frequently used strategies were 'Engagement' (89%) and 'Branding' (80%) and nearly half (45%) of alcohol posts invited direct consumption of their product.

CONCLUSIONS

The powerful combination of sport and social media are utilised by brands to interact and build relationship with consumers while promoting the consumption of alcohol and discretionary foods - products which impede rather than promote health. The indirect marketing techniques favoured by brands make this form of advertising difficult to identify and control.

IMPLICATIONS FOR PUBLIC HEALTH

These results highlight the need for counter-marketing, policy and regulatory actions to remove unhealthy food and alcohol from sport and reorient sponsorship of sporting events towards products that promote health.

Using Geovisualization Tools to Examine Attitudes towards Alcohol Exposure in Urban Environments: A Pilot Study in Madrid, Spain

Pervasiveness of alcohol products and their promotion in the urban landscape may normalize alcohol consumption. This study aims to utilize geovisualization-based methods to assess attitudes towards different levels of alcohol exposure in the urban environment. We selected a typical downtown location, Lavapiés Square in Madrid, Spain, to conduct our study. First, we designed and created realistic 3D models simulating three different urban scenes with varying degrees of exposure to alcohol in the environment. Second, we used a survey on 159 adults to explore the level of acceptance of, attitudes towards, and perceptions of alcohol exposure in each scene. Participants reported a higher level of comfort in the scene with null alcohol exposure compared with the other scenes (p < 0.001). Acceptance towards alcohol exposure decreased as the level of alcohol elements increased in the scenes (p < 0.01). Acceptance also decreased when children were present in the scenes (p < 0.01). This study demonstrated that geovisualization tools provide a useful and well-suited approach to analyze perceptions of the alcohol environment. The use of geovisualization can help understand attitudes and perceptions towards the alcohol environment and may offer a way to simulate different scenarios prior to development or retrofitting.

A Parent-Based Intervention for Reducing High-risk Social Media Cognitions, Alcohol Use, and Negative Consequences Among Adolescents: Protocol for a Randomized Controlled Pilot Study

BACKGROUND

The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. Extensive research in this area has resulted in parent-based intervention (PBI) efforts to prevent or reduce adolescent alcohol use. However, one major limitation of PBIs is that they do not currently consider the large role that social media plays in adolescents' lives and in relation to their alcohol use. We will add to the literature by developing and refining a web-based PBI designed to reduce both high-risk social media cognitions and alcohol use among adolescents.

OBJECTIVE

The central goal of the proposed study is to develop, refine, and pilot a web-based PBI to reduce both high-risk social media cognitions and alcohol use among adolescents.

METHODS

A total of 100 parent-teen dyads will be randomly assigned to one of the following 2 conditions: intervention or control. Parents in the intervention group will be given access to the web-based PBI and suggestions for working through the PBI modules with their teens. The parent-teen dyads will fill out 3 questionnaires: a baseline questionnaire, 1-month questionnaire, and 6-month questionnaire.

RESULTS

Recruitment and enrollment will begin in August 2022. Upon completion of the intervention trial, we will examine the feasibility, acceptability, and preliminary effect sizes of the newly developed web-based PBI.

CONCLUSIONS

This study has the potential to open doors for future studies examining the clinical implications of an efficacious web-based PBI to reduce alcohol use and high-risk cognitions about alcohol displays on social media.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04333966; https://clinicaltrials.gov/ct2/show/NCT04333966.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/38543.

Likelihood of Posting Alcohol-Related Content on Social Networking Sites - Measurement Development and Initial Validation

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sharing different types of ARC associates differentially with alcohol use and consequences. Objective: The goal of the current project was to develop a measure of the likelihood of posting key types of ARC posted by adolescents and young adults and to examine their associations with SNS use patterns and actual alcohol-related behavior. Method: Participants were 15-20 years of age (n = 306; 46.7% male; 56.6% Caucasian/White; 27.0% Asian) who completed a battery of self-report measures. Results: Results from an exploratory factor analysis revealed four types of ARC: (1) self and friend consumption, (2) memes and viral photos, (3) status updates: others' drinking and consequences, and (4) pictures: others' drinking and consequences. Conclusions: Participants' likelihood of posting self and Friend Consumption was significantly associated with heightened Snapchat use, typical drinks per week, peak drinking, and negative drinking consequences. Whereas youth appear to share more readily alcohol-related viral posts and memes, it seems that the sharing of ARC that is specifically related to the participants' own use or friends' use is salient concerning alcohol use and problems. Therefore, interventions might consider sending targeted prevention messages to individuals who share certain types of ARC which are more associated with problematic alcohol behaviors.

Associations between social media usage and alcohol use among youths and young adults: findings from Understanding Society

BACKGROUND AND AIMS

Given the decline in alcohol consumption and rise in technological use among young people, there is a need to investigate whether technology use might influence how young people drink. This study explores how social media use and changes in social media use over time could affect alcohol use among youths.

DESIGN

The UK Household Longitudinal Study (Understanding Society).

SETTING

United Kingdom.

PARTICIPANTS

Participants aged 10-15 (n = 4093) and 16-19 (n = 2689) from the youth and main survey interviewed in 2011-13, and followed-up in 2014-16 (aged 10-15 n = 2588, aged 16-19 n = 1057).

MEASUREMENTS

Self-reported social media usage on an average day (no profile/non-daily/less than an hour/1-3/4+ hours use), drinking frequency (never/one to three times/weekly) and binge drinking frequency (never/one to two/three/more than three times) in the past month. Covariates included sex, age, educational status, household income, urban/rural, number of friends and life satisfaction.

FINDINGS

Among 10-15-year-olds, compared with those who used social media for less than an hour, those with no profile [odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.25-0.67] and non-daily users (OR = 0.49, 95% CI = 0.33-0.72) had a lower risk of drinking at least monthly, whereas those with 1-3 hours' use (OR = 1.44, 95% CI = 1.14-1.81) and 4+ hours' use (OR = 2.08, 1.47-2.95) had a greater risk. Among participants aged 16-19, a lower risk of binge drinking three or more times per month was found for those with no profile [relative risk ratios (RRR) = 0.29, 95% CI = 0.17-0.48] and a higher risk for those with 4+ hours' use (RRR = 1.47, 95% CI = 1.03-2.09). Longitudinally, among 10-15-year-olds, those who had increased their social media usage versus no change were more likely to have increased their drinking frequency (OR = 1.89, 95% CI = 1.45-2.46). Some social media use at baseline (rather than none) was predictive of increased drink and binge drinking frequency over time among youths and young adults.

CONCLUSIONS

Heavier social media use was associated with more frequent alcohol consumption among young people in the United Kingdom.

[National efforts for alcohol prevention by the Federal Center for Health Education (BZgA)]

Alcohol consumption in Germany continues to be high relative to its European neighbors. A long-term reduction of alcohol consumption can result in a reduction of the morbidity and mortality associated with alcohol. For many years now, the Federal Centre for Health Education (BZgA) has directed its focus in the field of addiction prevention on alcohol prevention and implemented three national multilevel campaigns intended for this target group. "Null Alkohol - Voll Power" (No Alcohol - Full Power) addresses adolescents between the ages of 12 and 16 and the campaign "Alkohol? Kenn dein Limit." (Alcohol? Know Your Limit.) comprises two separate campaigns dedicated to adults and 16- to 20-year-olds, respectively. Further, the BZgA provides sports clubs with the opportunity to participate in a program entitled "Alkoholfrei Sport genießen" (Enjoying Sports Without Alcohol). In this contribution, these measures and their foundational concepts are presented.The campaigns are interconnected to form a prevention chain that serves to bundle the individual efforts. All are based on the principles of social marketing and are continually quality checked. At the center of these efforts lies internet communication, complemented by direct communication in the lives of the target groups as well as mass communication in the form of billboards, TV and radio spots, ads, and print media. The BZgA is able to implement these programs in schools, clubs, and at the municipal level because of the good cooperation and coordination it maintains with the individual federal states. For decades now, the BZgA has conducted monitoring in the form of regular representative surveys, among others, on the subject of alcohol consumption behavior among 12- to 25-year-olds in Germany. The results show that although overall alcohol consumption may be on the decline over the long term, it still remains high.

Combined Associations of Smoking and Bullying Victimization With Binge Drinking Among Adolescents in Beijing, China

Background: Binge drinking and smoking among adolescents are serious public concerns. However, very few studies have explored the reinforcement of bullying victimization by such behavior. Our study aimed at examining the individual and combined associations of smoking and bullying victimization with binge drinking among adolescents in Beijing, China. Methods: A total of 33,694 students aged 13-17 years old in Beijing, China were anonymously investigated via the cross-sectional Chinese Youth Risk Behavior Surveillance Survey from April to May 2014. A three-stage stratified sampling was used to select participants. Factors such as sociodemographic variables and indicators of smoking, bullying victimization, and binge drinking were analyzed with multiple logistic regressions, and joint and additive interaction effects were tested. Results: Overall, ever-drinking prevalence was 59.1% (boys: 64.4%; girls: 53.7%). Past 30-day binge drinking was 11.5% (boys: 15.6%; girls: 7.4%) and frequent binge drinking was 2.3% (boys: 3.3%; girls: 1.0%). Past 30-day smoking was 10.7% (boys: 16.4%; girls: 5.0%) and past 30-day bullying victimization was 48.7% (boys: 57.3%; girls: 40.1%). The combined effects of smoking and bullying victimization on occasional binge drinking (OR = 6.49, 95% CI = 5.60-7.52) and frequent binge drinking (OR = 10.32, 95% CI = 7.52-14.14) were significant, and the additive interaction effect was significant for current smoking and bullying victimization on frequent binge drinking (OR = 10.22, 95% CI = 9.43-11.07). The additive interaction effect for current smoking and bullying victimization on frequent binge drinking was significant among boys. Conclusion: Bullying victimization reinforced the association of smoking with frequent binge drinking, especially with findings specific to boys. Programs to prevent smoking or bullying or both may reduce binge drinking among adolescents in China.

Shaping Alcohol Health Literacy: A Systematic Concept Analysis and Review

Background:

This study uses an innovative methodology to understand the implications of applying the emerging concept of health literacy to other contexts using the example of alcohol.

Methods:

An evolutionary concept analysis combined with the principles and standards of the systematic review process enables a rigorous analysis of the conceptual representation of alcohol health literacy.

Key Results:

Alcohol health literacy includes a wide range of attributes that encompass many different health literacies beyond simply the capacity to understand alcohol-related harms and use that information in decision-making. Alcohol health literacy empowers people to understand alcohol marketing and messages and how alcohol information is distributed through social networks. It is an outcome of media-related alcohol education, and its consequences include health action skills and realistic expectancies of alcohol.

Discussion:

The focus on health literacy, which emphasizes not only individual skills but also draws attention to the social determinants of alcohol use and how alcohol health literacy is shaped by social networks and interactions, provides important lessons for alcohol health promotion interventions. Health literacy when applied to alcohol includes many different domains and the innovative method used here provides a framework to develop interventions that build health literacy in different contexts. [HLRP: Health Literacy Research and Practice. 2020;4(1):e3–e20.]

Qualitative exploration of the intersection between social influences and cultural norms in relation to the development of alcohol use behaviour during adolescence

OBJECTIVES

Few contemporary studies have examined peer and social drivers of alcohol use during mid-adolescence. We sought to explore young people's perspectives on socio-cultural influences relating to alcohol use behaviour during this period.

DESIGN

Qualitative research study.

METHODS

Semi-structured one-to-one (n=25), paired (n=4) or triad (n=1) interviews and one focus group (n=6) were conducted with 30 young people aged 14 to 15 (13 males, 17 females) recruited from 4 schools, and 12 participants (aged 14 to 18, 8 males, 4 females) recruited from two youth groups in an urban centre in the West of England. Nineteen participants abstained from alcohol use, 9 were occasional or moderate drinkers and 14 drank alcohol more regularly. Interviews were audio-recorded, transcribed verbatim and analysed thematically using NVivo V.10, through a lens of social influence and social norms theories.

RESULTS

Alcohol consumption was associated with being cool, mature and popular, while enabling escape from reality and boosting confidence and enjoyment. Positive expectancies, alongside opportunity, contributed to motivating initiation, but social influences were paramount, with participants describing a need to 'fit in' with friends to avoid social exclusion. Such influences positioned drinking at parties as a normative social practice, providing opportunities for social learning and the strengthening of peer norms. Social media presented young people with positive alcohol-associated depictions of social status, enjoyment and maturity. This intersection of influences and norms generated a pressurised environment and a sense of unease around resisting pressures, which could elicit stigmatising insults.

CONCLUSIONS

Cultural norms, social influences and social media intersect to create a pressurised environment around alcohol use during mid-adolescence, driving the escalation in the prevalence of excessive consumption at this stage. New interventions need to address normative influences to enable the prevention of excessive alcohol use during adolescence.

Exploring health behaviours: understanding drinking practice using the lens of practice theory

Research suggests that there is no safe amount of alcohol but despite this alcohol consumption remains an important part of many [young] people's lives. Viewed as an inherently social activity, drinking alcohol provides an opportunity for socialising and connecting with friends. This study is one of the first to draw on practice theory to explore one type of intoxicated drinking occasion engaged in by young people; framed in this article as a 'proper night out'. This article argues that this hybrid entity is made up of a series of interconnected social practices that have come and now hang together to serve to normalise and routinise intoxicated drinking occasions. The operationalisation of practice theory has enabled an in-depth exploration of intoxicated drinking and provides the potential for new ways of intervening in harmful drinking practices by refocusing attention away from individual level decision-making to drinking practices.

The Association Between Social Media Use and Hazardous Alcohol Use Among Youths: A Four-Country Study

Aims

To examine the continuing role of daily popular social media use in youth hazardous alcohol consumption in four countries across continents.

Methods

A web-based survey was given to youths aged 15–25 in the USA (n = 1212), South Korea (n = 1192), Finland (n = 1200) and Spain (n = 1212). Hazardous alcohol use (alcohol use disorders identification test-C) was the dependent variable. Main independent variables measured daily use of different social media services. Controls included compulsive Internet use, offline belonging, psychological distress, impulsivity, risk-taking, age and gender. Linear regression models and mediation analyses with bootstrapping were done for each country.

Results

Daily use of Facebook and Instagram was associated with higher hazardous alcohol use among youths in Finland, South Korea and Spain. Daily instant messaging was related to higher hazardous alcohol use among South Korean and Finnish youths. Daily YouTube use was associated with higher hazardous alcohol use among youths in South Korea, but lower hazardous alcohol use among youths in the USA and Finland. Daily Twitter use was related to lower hazardous drinking among youths in Finland but higher hazardous drinking among youths in Spain. The mediation analyses revealed that uploading pictures to social media is a possible facilitator of social media-related hazardous alcohol use among youths in the USA and Spain.

Conclusion

Certain social media platforms might inspire and/or attract hazardously drinking youths, contributing to the growing opportunities for social media interventions.

Content, perceptions and impact of alcoholic drink promotions in nightlife venues that are targeted towards students

Background

Binge drinking is generally considered socially acceptable for students across Western culture. Social norms within the student population have meant that excessive drinking plays a key role in socialising and reinforcing peer group identity. Research has highlighted the United Kingdom (UK) as having elevated levels of alcohol consumption especially within the student population, and the role that drink promotions have in influencing consumption practices. This paper considers promotions of alcoholic drinks in UK nightlife venues and student perceptions of these promotions. Bourdieu's concepts of social and cultural capital are applied to the findings.

Method

Content analysis of social media posts by nightlife venues (n = 12), observations of nightlife venues (n = 20) and semi-structured focus groups and paired interviews with 32 undergraduate students, from one city in the North West of England.

Results

Nightlife venues target promotions of alcoholic drinks at students through social media, advertisements throughout nightlife venues, and by promoters outside of venues. These promotions will often influence the course of a night out in terms of venues visited and the drinks consumed. Alcohol holds importance within mainstream student culture; it plays a key role in achieving cultural capital and is a means for students to obtain social capital through the creation of shared experiences, which are key for those who are new to university.

Conclusions

Nightlife venues will target alcoholic drink promotions at students and will use the notion of creating a shared experience as part of this targeted promotion. This contributes to the overall social and cultural capital that alcohol holds within the student population. This is an important consideration for alcohol policy - it demonstrates how prevention activities need to take into consideration the importance of shared experiences for the students; alternatives to excessive alcohol consumption need to offer a similar opportunity.

Alcohol Advertising on Social Media: Examining the Content of Popular Alcohol Brands on Instagram

BACKGROUND

There is considerable evidence that exposure to alcohol marketing increases the likelihood of adolescents initiating and engaging in alcohol consumption. There is a paucity of research, however, specifically examining industry generated alcohol marketing occurring on social media/networking platforms.

OBJECTIVE

The purpose of this investigation was to analyze the content of promotional advertisements by alcohol brands on Instagram.

METHODS

For a 30-day period, Instagram profiles of 15 distinct alcohol brands were examined. Pictorial posts/updates from each profile were screen captured and individually documented. Approximately 184 distinct posts constituted our final sample. The Content Appealing to Youth Index was independently employed by two raters to assess each post. For each characteristic, Cohen's Kappa measures, and associated 95% confidence intervals, were calculated. Descriptive statistics were performed.

RESULTS

Posts increased throughout the week and peaked on Thursday and Friday. The production value of the posts examined was generally high, frequently featuring color, texture, shine, contrast, faces, and action. Character appeals and use of youth-oriented genres were uncommon. Many of the posts used product appeals and physical benefits to consumption. The posts also emphasized the following rewarding appeal characteristics: positive emotional experiences, achievement, individuality, and camaraderie. The most commonly coded risk-related feature was inappropriate use. Conclusions/Importance: This investigation represents an initial attempt to provide insights into the content alcohol brands are including in their promotional materials on social networking sites.

#drunktwitter: Examining the relations between alcohol-related Twitter content and alcohol willingness and use among underage young adults

PURPOSE

Despite the importance of social networking sites on young adult alcohol use, few studies have examined Twitter as a conduit for sharing drinking behavior. However, this work generally uses random samples of tweets and thus cannot determine the extent to which Tweets correspond with self-reported drinking cognitions or behaviors. The primary aims of the present study were to (1) document basic patterns of alcohol-related Twitter activity in a subsample of young adult drinkers, and (2) examine whether willingness to drink, alcohol use, and negative consequences are associated with alcohol-related tweeting behavior.

METHODS

186 young adults age 18-20 completed an online survey and provided Twitter handle information. From these participants, a random sample of 5000 Tweets was coded by a trained team to determine whether tweets were related to alcohol use or not. Ordinary least squares regression analyses were conducted to determine whether the proportion of alcohol-related Tweets is associated with self-reported alcohol use willingness, behaviors, and negative consequences.

RESULTS

Results indicated that not only are alcohol-related tweets common among young adults, but that the proportion of one's overall tweets that are related to alcohol is significantly associated with willingness to drink, alcohol use, and negative consequences.

CONCLUSIONS

The results of this study are an important step to understanding how digital behavior (e.g., posting about alcohol on Twitter) is related to an individual's self-reported drinking cognitions, alcohol use, and negative consequences and has implications for the way Twitter data can be used for public health surveillance and interventions.

Self-Persuasion on Facebook Increases Alcohol Risk Perception

In this experiment, we examined if participating in a Facebook group by generating antialcohol arguments (self-persuasion) is more effective than reading antialcohol posts of others (direct persuasion) in changing alcohol consumption, risk perception, and attitudes. In addition, it was examined if submitting posts moderated these effects. Participants logged into their Facebook account and joined a group that contained posts with antialcohol arguments. They either generated their own arguments with or without posting them, or read those present in the group with or without posting that they had read them. Next, participants rated movie clips in a 30-minute ad libitum drinking session in dyads, and their alcohol consumption was measured. Finally, measures of alcohol risk perception and attitudes were completed. Results show that generating antialcohol arguments-regardless of whether they are posted online-is effective in increasing alcohol risk perception but does not affect immediate alcohol consumption.

Peer, social media, and alcohol marketing influences on college student drinking

OBJECTIVE

To investigate how alcohol marketing and peers may promote college students' alcohol use through social media.

PARTICIPANTS

College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014.

METHODS

Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race.

RESULTS

Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects.

CONCLUSIONS

College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.

Changes in the Sociodemographic Factors of Tobacco and Alcohol Consumption in Chinese Adolescents from 2004 to 2011

Finding ways to reduce tobacco and alcohol consumption among adolescents has been a major public health challenge in China. In relation to this issue, the current study evaluated the changes in the sociodemographic factors of tobacco and alcohol consumption among Chinese adolescents who are 12–18 years old. Trends in sociodemographic factors associated with tobacco and alcohol consumption were investigated based on the 2004–2011 China Health and Nutrition Survey data. Questionnaires that extracted data on tobacco and alcohol consumption (i.e., prior experience of smoking cigarettes and drinking alcoholic beverages) were distributed. Additional variables (e.g., age, residence, gender, etc.) were used in the analyses. Firth penalized logistic regression was conducted with drinking and smoking status variables as the dependent variables. Male adolescents were more inclined to smoke in 2004, 2006, 2009, and 2011 (p < 0.05 for all). Adolescents aged 15–16 years were more inclined to smoke compared with those aged 12–14 years in 2004, 2006, and 2011 (p < 0.05 for all). Among adolescents aged 15–18 years, older ones were more inclined to not smoke in 2004 (odds ratio (OR) = 0.531, 95% confidence interval (CI) 0.343–0.821). Adolescents who did not attend school were more inclined to smoke in 2004, 2006, 2009, and 2011 (p < 0.05 for all). Adolescents who were drinkers were more inclined to smoke in 2004, 2006, 2009, and 2011 (p < 0.05 for all). Male adolescents were more likely to drink in 2004, 2006, and 2009 (p < 0.05 for all). In 2006 and 2009, adolescents aged 15–16 years were more inclined to drink compared with those aged 12–14 years (p < 0.05 for all). Among adolescents aged 15–18 years, older ones were less inclined to drink in 2004 (OR = 0.719, 95% CI 0.527–0.980) and 2006 (OR = 0.716, 95% CI 0.527–0.972). Adolescents who smoked were more likely to drink in 2004, 2006, 2009, and 2011 (p < 0.05 for all). The prevalence of tobacco and alcohol consumption among adolescents has not changed significantly. The current study identified adolescent high-risk groups for tobacco and alcohol consumption.

Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults

Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r = 0.36, 95% CI: 0.29 to 0.44, p < 0.001) and alcohol-related problems (r = 0.37, 95% CI: 0.21 to 0.51, p < 0.001). There was significant heterogeneity among studies. Two significant predictors of heterogeneity were (i) whether there was joint measurement of alcohol-related social media engagement and drinking behavior or these were measured on different occasions and (ii) whether measurements were taken by self-report or observation of social media engagement. We found moderate-sized effects across the 19 studies: Greater alcohol-related social media engagement was correlated with both greater self-reported drinking and alcohol-related problems. Further research to determine the causal direction of these associations could provide opportunities for social media-based interventions with young drinkers aimed at reducing alcohol consumption and alcohol-related adverse consequences.

The role of alcohol in constructing gender & class identities among young women in the age of social media

Research suggests young women view drinking as a pleasurable aspect of their social lives but that they face challenges in engaging in a traditionally ‘masculine’ behaviour whilst maintaining a desirable ‘femininity’. Social network sites such as Facebook make socialising visible to a wide audience. This paper explores how young people discuss young women’s drinking practices, and how young women construct their identities through alcohol consumption and its display on social media. We conducted 21 friendship-based focus groups (both mixed and single sex) with young adults aged 18–29 years and 13 individual interviews with a subset of focus group respondents centred on their Facebook practices. We recruited a purposive sample in Glasgow, Scotland (UK) which included ‘middle class’ (defined as students and those in professional jobs) and ‘working class’ respondents (employed in manual/service sector jobs), who participated in a range of venues in the night time economy. Young women’s discussions revealed a difficult ‘balancing act’ between demonstrating an ‘up for it’ sexy (but not too sexy) femininity through their drinking and appearance, while still retaining control and respectability. This ‘balancing act’ was particularly precarious for working class women, who appeared to be judged more harshly than middle class women both online and offline. While a gendered double standard around appearance and alcohol consumption is not new, a wider online audience can now observe and comment on how women look and behave. Social structures such as gender and social class remain central to the construction of identity both online and offline.

Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis

BACKGROUND

Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let's Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can $0.05 for each interaction with a campaign-specific username (@Bell_LetsTalk).

OBJECTIVE

The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada.

METHODS

Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health-related physician visit.

RESULTS

The inclusion of Twitter into the 2012 Bell Let's Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, P<.001), whereas males of the same age cohort experienced a monthly increase from 9.7/1000 to 9.8/1000 (slope change of 0.052 following campaign, P<.001). Outpatient psychiatric services visit rates also increased for both male and female adolescents aged 10 to 17 years post campaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following campaign, P<.001).

CONCLUSIONS

The 2012 Bell Let's Talk campaign was temporally associated with an increase in the rate of mental health visits among Ontarian youth. Furthermore, there appears to be an upward trend of youth mental health utilization in the province of Ontario, especially noticeable in females who accessed primary health care services.

Policy-relevant behaviours predict heavier drinking and mediate the relationship with age, gender and education status: Analysis from the International Alcohol Control Study

Introduction and Aims

To investigate behaviours related to four alcohol policy variables (policy‐relevant behaviours) and demographic variables in relation to typical quantities of alcohol consumed on‐premise in six International Alcohol Control study countries.

Design and Methods

General population surveys with drinkers using a comparable survey instrument and data analysed using path analysis in an overall model and for each country. Measures: typical quantities per occasion consumed on‐premise; gender, age; years of education, prices paid, time of purchase, time to access alcohol and liking for alcohol advertisements.

Results

In the overall model younger people, males and those with fewer years of education consumed larger typical quantities. Overall lower prices paid, later time of purchase and liking for alcohol ads predicted consuming larger typical quantities; this was found in the high‐income countries, less consistently in the high‐middle‐income countries and not in the low middle‐income country. Three policy‐relevant behaviours (prices paid, time of purchase, liking for alcohol ads) mediated the relationships between age, gender, education and consumption in high‐income countries.

Discussion and Conclusions

International Alcohol Control survey data showed a relationship between policy‐relevant behaviours and typical quantities consumed and support the likely effect of policy change (trading hours, price and restrictions on marketing) on heavier drinking. The path analysis also revealed policy‐relevant behaviours were significant mediating variables between the effect of age, gender and educational status on consumption. However, this relationship is clearest in high‐income countries. Further research is required to understand better how circumstances in low‐middle‐income countries impact effects of policies.

New Zealand adolescents' concerns about their alcohol use and access to services: Associations with ethnicity and other factors

Using a national survey of 8,500 New Zealand high school students, we investigated adolescents' concerns about their drinking, associated factors including help-seeking preferences and access to health care services, and how these varied by ethnicity and level of socioeconomic deprivation. Approximately 23.9% of the 3,704 current drinkers reported concerns (i.e., being worried about their drinking and/or having tried to cut down). Regression analyses revealed that Māori and Pacific youth were more likely than their New Zealand European peers to be concerned about their drinking. Concerned drinkers were more likely than nonconcerned drinkers to report hazardous drinking behaviors and alcohol-related problems, but these associations varied by age, ethnicity, and socioeconomic deprivation. Help-seeking preferences differed strongly by ethnicity. Concerned drinkers, and Māori and Pacific drinkers, were more likely to report difficulties accessing health care and alcohol and drug services. The factors associated with adolescents' drinking concerns and paradoxical difficulties accessing health care highlight the importance of engaging adolescents in developing responsive and equitable services.

"I Wouldn't Be Friends with Someone If They Were Liking Too Much Rubbish": A Qualitative Study of Alcohol Brands, Youth Identity and Social Media

The consumption of alcohol by young people remains a major public health concern at both the national and international level. Levels of drinking among 15-yearolds in the United Kingdom (UK) remain significantly higher than the European average. This study explored how alcohol brands are used by young people to develop their desired identities and how these acts of consumption extend to young people's profiles on social media. It also deepens understanding of how alcohol brands are connected to young peoples' concerns about image and peer group dynamics. This involved qualitative focus groups with young people aged 14-17 in Central Scotland. Certain alcohol brands were approved and viewed as socially acceptable by young people, while others were rejected. Children as young as 14 were selecting products to portray a drinking identity that was appropriately aligned to their gender and sexuality. Participants displayed a desire to associate themselves with the mature drinking culture personified by some brands, whilst simultaneously distancing themselves from immature drinking practices associated with others. Publicly associating with alcohol brands on social media carried with it potential risks to peer group acceptance. Understanding how young people perceive alcohol brands, the importance of social media in communicating that identity to their peers and the role that alcohol brands play in adolescent identity formation is an important first step to reforming alcohol marketing regulations.

The Effects of Digital Marketing of Unhealthy Commodities on Young People: A Systematic Review

The marketing of unhealthy commodities through traditional media is known to impact consumers’ product attitudes and behaviors. Less is known about the impacts of digital marketing (online promotional activities), especially among young people who have a strong online presence. This review systematically assesses the relationship between digital marketing and young people’s attitudes and behaviors towards unhealthy commodities. Literature was identified in June 2017 by searches in six electronic databases. Primary studies (both qualitative and quantitative) that examined the effect of digital marketing of unhealthy food or beverages, alcohol and tobacco products on young people’s (12 to 30 years) attitudes, intended and actual consumption were reviewed. 28 relevant studies were identified. Significant detrimental effects of digital marketing on the intended use and actual consumption of unhealthy commodities were revealed in the majority of the included studies. Findings from the qualitative studies were summarized and these findings provided insights on how digital marketing exerts effects on young people. One of the key findings was that marketers used peer-to-peer transmission of messages on social networking sites (e.g., friends’ likes and comments on Facebook) to blur the boundary between marketing contents and online peer activities. Digital marketing of unhealthy commodities is associated with young people’s use and beliefs of these products. The effects of digital marketing varied between product types and peer endorsed marketing (earned media) may exert greater negative impacts than owned or paid media marketing.

Parental Mediation in the Digital Era: Increasing Children's Critical Thinking May Help Decrease Positive Attitudes toward Alcohol

We demonstrate in our research that discussion-based parental mediation may successfully decrease the negative effects that youth's engagement with alcohol brands on social media may have on attitudes toward alcohol through its effects on critical thinking. A clear pattern was found with positive mediation leading to unhealthy outcomes and negative mediation predicting healthier behaviors. Youth whose parents critiqued media messages reported more critical thinking skills, which predicted less interaction with alcohol brands on social media and fewer expectancies toward alcohol. On the other hand, youth whose parents endorsed media portrayals of drinking reported fewer critical thinking skills and were thus more likely to interact with alcohol brands on social media. Including a media literacy component in alcohol education that target parental strategies and that are conducive to discussion may lead to beneficial health outcomes in the digital era.

Digital Media and Risks for Adolescent Substance Abuse and Problematic Gambling

Digital media provide increased opportunities for both marketing and social transmission of risky products and behavior. We briefly review what is known about adolescent exposure to favorable presentations of addictive substances, such as alcohol, tobacco, and marijuana, as well as behaviors such as gambling, on social and other online media. Our understanding of these influences and whether they require greater regulation is still developing, and recommendations for future research to address these gaps in our understanding are described. Potential strategies to intervene in these environments to protect adolescents and young adults from the adverse effects of these products are described, as well as future challenges for developing interventions.

'Hidden Habitus': A Qualitative Study of Socio-Ecological Influences on Drinking Practices and Social Identity in Mid-Adolescence

This study explored mid-adolescents' views and experiences of socio-ecological influences on their drinking practices in order to help inform the development of interventions to reduce alcohol-related risk. We conducted 31 in-depth interviews with young people aged 13-17 in North East England. Verbatim interview transcripts and field notes were coded systematically and analysed thematically, following the principles of constant comparison. We adopted Bourdieu's idea of social game-playing and elements of his conceptual toolkit (particularly habitus, capital and field) during analysis. Analysis yielded three intersecting themes: (1) 'drinking etiquette': conveying taste and disgust; (2) 'playing the drinking game': demonstrating cultural competency; (3) 'hidden habitus'-the role of alcohol marketing. Our work demonstrates that there is a nexus of influential factors which come together to help shape and reinforce mid-adolescents' behaviour, norms and values in relation to alcohol consumption. Drinking practices are not just formed by friendships and family traditions, these are also subject to wider cultural shaping including by the alcohol industry which can encourage brand identification, and gear specific products to add 'distinction'. However young people are not inactive players and they use aspects of capital and social games to help cement their identity and present themselves in particular ways which in turn are influenced by age, gender and social status. Guided by promising work in the tobacco field, interventions which focus on critical awareness of the framing of alcohol products by key stakeholders, such as policymakers, commercial industry and public health professionals, and by wider society may facilitate behaviour change among young people.

An examination of how alcohol brands use sport to engage consumers on social media

INTRODUCTION AND AIMS

To examine how alcohol brands use sport in their communication activities on social media. Despite extensive research exploring alcohol advertising and sponsorship through sport, minimal attention has been given to digital platforms.

DESIGN AND METHODS

This study undertakes a qualitative content analysis to examine the social media activity of alcohol brands sponsoring the three largest spectator sports in Australia: Australian rules football, rugby league and cricket.

RESULTS

Four sport-related social media strategies are identified through which alcohol brands solicit interaction with consumers, often involving co-creation of content and social activation. These strategies act as 'calls to action' and through the association of sport and alcohol encourage consumers to engage in competition, collaboration, celebration and consumption. These strategies are further strengthened by communications which draw upon themes of identity and camaraderie to resonate with the consumer.

DISCUSSION AND CONCLUSIONS

Sport-linked social media strategies utilised by alcohol brands extend beyond just promoting their product. They seek higher levels of engagement with the consumer to amplify and augment the connection between alcohol and the sport spectator experience. The discussion highlights the powerful combination of sport and social media as a mechanism by which these brands seek to interact with consumers and encourage them to both create and promote content to their social networks. These strategies allow alcohol brands to extend their marketing efforts in a manner which can elude alcohol codes and prove difficult for regulators to identify and control. [Westberg K, Stavros C, Smith ACT, Munro G, Argus K. An examination of how alcohol brands use sport to engage consumers on social media. Drug Alcohol Rev 2018;37:28-35].

'If I don't look good, it just doesn't go up': A qualitative study of young women's drinking cultures and practices on Social Network Sites

BACKGROUND

Young women in the UK often partake in a culture of intoxication in the pursuit of pleasure and friendship fun. Experiences of intoxication and drinking spaces remain highly gendered, and relative to men, women continue to find their behaviours in drinking spaces more constrained and scrutinised. Simultaneously, young women now express themselves via Social Network Sites (SNS), where they display drinking experiences and where they perform, negotiate and display contemporary femininities.

METHODS

The research explored young women's experiences of drinking and intoxication, the use of SNS in their drinking cultures and the display of drinking practices on SNS through group interviews (n=12) with women (n=37) aged 16-21 from one city in the North-West of England, UK.

RESULTS

The practice of uploading drinking photographs to SNS played an important role in displaying young women's popularity, enhancing friendship fun and belonging, and in positioning the hyper-sexual feminine look as the norm in drinking spaces. Both intoxication and the hyper-sexual and feminine look challenged traditional notions of respectable femininity, while the highly groomed feminine look itself was threatened by drunkenness. As such, young women invested much work and effort in self-surveillance and in managing the display of their drinking behaviours on SNS.

CONCLUSION

The dilemmas in contemporary femininity created by the juxtaposition of hyper-sexual femininity and the culture of intoxication are reproduced on SNS. Controlling and restricting certain content on SNS with the aim of achieving the 'right' feminine self-presentation resulted in a narrowly set of body oriented and behavioural feminine attributes being presented as the norm, and an overly positive online representation of young women's drinking experiences.

The Social Construction of Inflammatory Bowel Disease Using Social Media Technologies

Many people with inflammatory bowel disease (IBD), sometimes lacking adequate face-to-face sources of support, turn to online communities to meet others with the disease. These online communities are places of support and education, but through the use of social media communication technologies, people with IBD are redefining what it means to live with the disease. This ethnographic study followed 14 online communities to understand how people with IBD used social media technologies to construct their own meanings about living with the disease. The following redefinitions were observed: the refiguring of the body is beautiful; inflammatory bowel disease is serious and deadly; inflammatory bowel disease is humorous; the disease makes one stronger; and the disease is invisible, but needs to be made visible. This study will help health communication scholars understand how technology is appropriated by patients, and will help practitioners understand how their patients conceptualize their disease.

Policy-Relevant Behaviors Predict Heavier Drinking in Both On and Off Premises and Mediate the Relationship Between Heavier Alcohol Consumption and Age, Gender, and Socioeconomic Status-Analysis from the International Alcohol Control Study

BACKGROUND

Our goal was to investigate the role of behaviors amenable to policy change in mediating the relationship between alcohol consumption in off and on premises, age, and 2 measures of socioeconomic status (education and income).

METHODS

A cross-sectional general population survey was analyzed by using Bayesian path analysis to understand direct and mediating pathways. A total of 1,900 drinkers (past 6 months), aged 18 to 65 years, living in households with landline phones participated in the study. Measures were as follows: typical quantities of alcohol consumed per occasion, frequency of drinking, both off and on premise; gender, age groups; and years of education, personal income, prices paid, time of purchase, and liking for alcohol advertisements.

RESULTS

Later times of purchase predicted larger quantities consumed (on and off premise) and more frequent drinking (on premise only). Younger people and males purchased later, and this mediated their heavier consumption. Lower prices paid predicted larger quantities consumed (on premise) and higher frequency of drinking (off premise). Younger and male respondents paid lower prices, and this mediated larger quantities consumed on premise and more frequent drinking off premise. Less well educated paid lower prices, and this mediated drinking more frequently off premise among this group. Liking for alcohol ads predicted drinking larger quantities and higher frequency both off and on premise. Younger and male respondents reported greater liking for ads, and this mediated their consumption of larger quantities and more frequent drinking both on and off premise. Those with higher income drank larger amounts on premise and more frequently on and off, but there were no mediating effects from the policy-relevant variables.

CONCLUSIONS

Heavier drinking patterns by young people and those less well educated could be ameliorated by attention to alcohol policy.

Association Between Young Australian's Drinking Behaviours and Their Interactions With Alcohol Brands on Facebook: Results of an Online Survey

AIMS

To examine the association of alcohol-brand social networking pages and Facebook users' drinking attitudes and behaviours.

METHODS

Cross-sectional, self-report data were obtained from a convenience sample of 283 Australian Facebook users aged 16-24 years via an online survey.

RESULTS

More than half of the respondents reported using Facebook for more than an hour daily. While only 20% had actively interacted with an alcohol brand on Facebook, we found a significant association between this active interaction and alcohol consumption, and a strong association between engagement with alcohol brands on Facebook and problematic drinking.

CONCLUSIONS

The findings of this study demonstrate the need for further research into the complex interaction between social networking and alcohol consumption, and add support to calls for effective regulation of alcohol marketing on social network platforms.