Patterns of media use and alcohol brand consumption among underage drinking youth in the United States

Correlates of U.S. Young adults’ awareness of alcohol use as a behavioral risk factor for cancer

Although alcohol increases the risk of cancer, awareness of alcohol-related cancer risks is low. Alcohol use is prevalent among young adults, and understanding factors associated with awareness and perceptions of alcohol-related cancer risks in this group is critical for cancer prevention efforts. We examined the demographic, tobacco, and alcohol related correlates of young adults’ awareness and perceptions of alcohol as a behavioral risk factor for cancer. We completed a secondary analysis of data collected in February 2020 in the U.S. from 1,328 young adults (ages 18–30) who completed a cross-sectional online survey. Participants reported (1) awareness of alcohol as a risk factor for cancer and (2) perceived risks of serious disease such as cancer. We analyzed demographic characteristics, alcohol use, and tobacco use associated with these outcome variables using multivariable regression. Overall, 18.5% of participants believed that alcohol does not increase cancer risk. Perceived cancer risk associated with alcohol use was moderate (M 3.2, SD 1.6, 1–7 scale). In multivariable analysis, awareness of risk was significantly higher among those with higher socioeconomic status. Perceived risk was significantly greater among those with higher socioeconomic status, higher alcohol consumption, and a history of tobacco use. These findings indicate research is warranted to better understand awareness of alcohol as a behavioral risk factor for cancer and associated beliefs in subgroups of young adults to help guide the development of interventions to raise awareness of the risks of cancer associated with alcohol use.

Typology of Adolescents Exposed to Non-medical Cannabis Marketing and Associations with Consumption Patterns

Latent class analysis (LCA) identified subtypes of cannabis marketing exposure among adolescents and assessed whether the classes were associated with three cannabis use outcomes: past 28-day use, poly-cannabis use, and symptoms of cannabis use disorder (CUD). Survey data were from 471 adolescents (aged 15-19 years) who lived in four states with legal non-medical cannabis in 2018. Measures included social media engagement and cannabis outcomes. LCA with robust maximum likelihood estimation identified latent classes. Chi-squared tests assessed whether empirically derived classes differed across demographics, and logistic regression tested associations with cannabis use outcomes. Three classes were identified: digitally engaged (35.5%), digitally unengaged (36.5%), and traditional (28.0%). Both digitally engaged and unengaged classes were exposed to marketing on social media platforms, but youth in the engaged class interacted with posts and brands. Class membership differed by age (χ² = 14.89, p < 0.001) and school type, with the digitally engaged group older and not in school or in non-traditional schools (χ² = 16.22, p=0.01). As compared to the traditional class, youth in the digitally engaged class had 10.63 times the odds of past 28-day cannabis use (95% CI: 5.25, 21.51), 7.84 times the odds of poly-cannabis use (95% CI: 3.54, 17.33), and 13.85 times the odds of symptoms of CUD (95% CI: 3.96, 48.48). Youth in the digitally engaged class had higher odds of all cannabis use behaviors than the traditional class. These findings point to the possible use of algorithmic marketing to adolescents and suggest a need for monitoring and possible restrictions on digital cannabis marketing.

Psychological Processes Underlying Effects of Alcohol Marketing on Youth Drinking

OBJECTIVE

Evidence increasingly suggests that alcohol marketing plays a significant role in facilitating underage drinking. This article presents a review of empirical studies and relevant theoretical models proposing plausible psychological mechanisms or processes responsible for associations between alcohol-related marketing and youth drinking.

METHOD

We review key psychological processes pertaining to cognitive mechanisms and social cognitive models that operate at the individual or intrapersonal level (attitude formation, expectancies) and the social or interpersonal level (personal identity, social identity, social norms). We use dominant psychological and media theories to support our statements of putative causal inferences, including the Message Interpretation Processing Model, Prototype Willingness Model, and Reinforcing Spirals Model.

RESULTS

Based on the evidence, we propose an integrated conceptual model that depicts relevant psychological processes as they work together in a complex chain of influence, and we highlight those constructs that have received the greatest support in the literature.

CONCLUSIONS

The evidence to date suggests that perceptions of others' behaviors and attitudes in relation to alcohol (social norms) may be a more potent driver of youth drinking than evaluations of drinking outcomes (expectancies). Considerably more research--especially experimental research--is needed to understand the extent to which theoretically relevant psychological processes have unique effects on adolescent and young adult drinking behavior, with the ultimate goal of identifying modifiable intervention targets to produce reductions in the initiation and maintenance of underage alcohol use.

Beer advertisements and adolescent drinking knowledge, expectancies, and behavior

OBJECTIVE

(1) To examine the degree to which overall beer advertising expenditure is related to youth brand awareness, preferences, and drinking behavior, and (2) to use multiple methods, including individual brand awareness and expectancies, to gain a broader understanding of the effects of alcohol advertising on youth alcohol-related expectancies and behavior.

METHOD

Mixed psychological and advertising methods were used to examine how beer advertising is related to adolescents' beer brand awareness, expectancies, and behavior. 1588 7-12th graders were surveyed in two U.S. states.

RESULTS

The amount of money spent advertising beer brands was positively correlated with adolescents' brand awareness, preference, use, and loyalty behavior (all correlations above 0.65). Moreover, beer advertising-related variables predicted adolescents' intention to drink and actual alcohol consumption, independent of peer and parent alcohol-related behavior and attitudes.

CONCLUSIONS

The results show that overall levels of advertising expenditures were strong predictors of adolescents' beer brand awareness, preferences, use, and brand loyalty. Moreover, advertising-related variables were substantial predictors of adolescents' intention to drink as an adult and current underage drinking behavior. Together, the present findings suggest that previous work may have underestimated the relationship between alcohol advertising and adolescents' drinking behavior.

Media/Marketing Influences on Adolescent and Young Adult Substance Abuse

PURPOSE OF REVIEW

We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations made for effective prevention strategies for mitigating the influence of these portrayals.

RECENT FINDINGS

There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use.

SUMMARY

Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.

Media/Marketing Influences on Adolescent and Young Adult Substance Abuse

PURPOSE OF REVIEW

We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations made for effective prevention strategies for mitigating the influence of these portrayals.

RECENT FINDINGS

There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use.

SUMMARY

Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.

European longitudinal study on the relationship between adolescents' alcohol marketing exposure and alcohol use

BACKGROUND AND AIMS

This is the first study to examine the effect of alcohol marketing exposure on adolescents' drinking in a cross-national context. The aim was to examine reciprocal processes between exposure to a wide range of alcohol marketing types and adolescent drinking, controlled for non-alcohol branded media exposure.

DESIGN

Prospective observational study (11-12- and 14-17-month intervals), using a three-wave autoregressive cross-lagged model.

SETTING

School-based sample in 181 state-funded schools in Germany, Italy, Netherlands, Poland.

PARTICIPANTS

A total of 9075 eligible respondents participated in the survey (mean age 14 years, 49.5% male.

MEASUREMENTS

Adolescents reported their frequency of past-month drinking and binge drinking. Alcohol marketing exposure was measured by a latent variable with 13 items measuring exposure to online alcohol marketing, televised alcohol advertising, alcohol sport sponsorship, music event/festival sponsorship, ownership alcohol-branded promotional items, reception of free samples and exposure to price offers. Confounders were age, gender, education, country, internet use, exposure to non-alcohol sponsored football championships and television programmes without alcohol commercials.

FINDINGS

The analyses showed one-directional long-term effects of alcohol marketing exposure on drinking (exposure T1 on drinking T2: β = 0.420 (0.058), P < 0.001, 95% confidence interval (CI) = 0.324-0.515; exposure T2 on drinking T3: β = 0.200 (0.044), P < 0.001, 95% CI = 0.127-0.272; drinking T1 and drinking T2 on exposure: P > 0.05). Similar results were found in the binge drinking model (exposure T1 on binge T2: β = 0.409 (0.054), P < 0.001, 95% CI = 0.320-0.499; exposure T2 on binge T3: β = 0.168 (0.050), P = 0.001, 95% CI = 0.086-0.250; binge T1 and binge T2 on exposure: P > 0.05).

CONCLUSIONS

There appears to be a one-way effect of alcohol marketing exposure on adolescents' alcohol use over time, which cannot be explained by either previous drinking or exposure to non-alcohol-branded marketing.

The relationship between brand-specific alcohol advertising on television and brand-specific consumption among underage youth

BACKGROUND

Being able to investigate the relationship between underage drinkers' preferences for particular brands and their exposure to advertising for those brands would represent a significant advance in alcohol marketing research. However, no previous national study has examined the relationship between underage youth exposure to brand-specific alcohol advertising and consumption of those brands.

METHODS

We conducted a cross-sectional, Internet-based survey of a national sample of 1,031 youth, ages 13-20, who had consumed at least 1 drink of alcohol in the past 30 days. We ascertained all alcohol brands consumed by respondents in the past 30 days. The main outcome measure was brand-specific consumption during the past 30 days, measured as a dichotomous variable. The main predictor variable was exposure to brand-specific alcohol advertising on television. The respondents reported which of 20 television shows popular with youth they had watched during the past 30 days. For each respondent, we calculated a standard measure of potential exposure to the brand-specific alcohol advertising that aired on those shows during the preceding 12 months, based on Nielsen (New York, NY) estimates of the youth audience for each show's telecasts.

RESULTS

Compared to no brand-specific advertising exposure, any exposure was associated with an increased likelihood of brand-specific consumption (adjusted odds ratio 3.02; 95% confidence interval: 2.61-3.49) after controlling for several individual- and brand-level variables. When measured as a continuous variable, the relationship between advertising exposure and brand consumption was nonlinear, with a large association at lower levels of exposure and diminishing incremental effects as the level of exposure increased.

CONCLUSIONS

There is a robust relationship between youth's brand-specific exposure to alcohol advertising on television and their consumption of those same alcohol brands during the past 30 days. This study provides further evidence of a strong association between alcohol advertising and youth drinking behavior.