Content Themes of Alcohol Advertising in U.S. Television-Latent Class Analysis

Alcohol Social Media Marketing in Hong Kong: A Content Analysis of Facebook Posts

PURPOSE

The near universal use of social media by young people in many parts of the world has led to increased exposure to alcohol social media marketing (SMM). This study aimed to examine the content of SMM posts from alcohol brands and venues in the southern China region.

METHODS

This study randomly sampled posts from Hong Kong Facebook pages of 10 well-known alcohol brands (n = 639) and four popular drinking venues (n = 335) between 2011 and 2019. Content analysis, using deductive and inductive coding, was conducted on SMM posts to identify common marketing strategies (e.g., promotional giveaways) and themes.

RESULTS

Alcohol SMM posts increased eight-fold during this period and showed continuous adaptation to regional tastes and drinking culture. Alcohol SMM strategies included explicit encouragement to drink, real-world event tie-ins (e.g. concerts, sporting matches), and special postings during local holidays such as Chinese New Year. Viewers were actively encouraged to interact through "likes", shares, and comments on SMM posts. Alcohol brands had substantially higher user interactions than drinking venues (mean = 228.7/post vs. 19.0/post; p < .05). Alcohol SMM themes included celebratory events, friendship, cultural heritage, and popular music. SMM also promoted an exclusive, aspirational lifestyle, and emphasis on the high quality of their products. Only 8.1% of the brand posts and none of the venue posts contained responsible drinking messages.

DISCUSSION

Alcohol SMM has been increasingly promoting social norms that encourage heavy drinking in young people. Future policy discussions in this emerging alcohol market region should consider regulation of alcohol SMM.

Drinking Expectancies among Chinese Young Adults: A Qualitative Study from Hong Kong

BACKGROUND

Alcohol expectancies, i.e., the perceived consequences of drinking, have been reported to be important factor in predicting drinking behaviors. However, studies in the Asia region were largely limited to school-based samples. This study aimed to be the first to explore drinking expectancies among urban Chinese young adults.

METHODS

In 2020, eight focus group discussions were conducted with Hong Kong Chinese young adults aged 18-34 (n = 53). The participants included heavy drinkers, light drinkers, and non-drinkers from a wide range of occupations and educational backgrounds. Thematic analysis was conducted to uncover common alcohol expectancies.

RESULTS

Six themes emerged from this study. Four themes that were commonly reported in the literature were the negative consequences of drinking, social bonding, confidence enhancement, and tension reduction. The study also uncovered two culturally relevant alcohol expectancies: health benefits and business drinking expectancies. In contrast to Western samples, Chinese young adults did not report drinking expectancies related to cognitive enhancement or increased sexual interest.

CONCLUSION

Alcohol harm reduction strategies will need to address the positive drinking expectancies uncovered in this study. Future policy discussions in this emerging alcohol market region should consider greater scrutiny of the role of alcohol marketing in the propagation of positive drinking expectancies.

A Qualitative Analysis of Sexual Consent among Heavy-drinking College Men

The current study sought to examine how heavy-drinking college men describe communication of sexual interest and sexual consent. Thematic analysis of semi-structured interviews with 12 heavy-drinking college men identified three themes. Themes included: (a) expectations about parties and sexual activity, (b) observing and communicating sexual interest, and (c) communication of sexual consent. Men reported visiting drinking environments to locate women who they assumed would be open to sexual advances. In these environments, sexual interest was inferred indirectly through shared alcohol use. Anticipating token resistance men reported "trying and trying again" to pursue escalating types of sexual activity. Consent was inferred when participants did not hear "no" from a sexual partner, highlighting the importance of continued education on verbal consent in the context of sexual assault prevention programs.

30+ years of media analysis of relevance to chronic disease: a scoping review

BACKGROUND

Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area.

METHODS

We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies.

RESULTS

Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work.

CONCLUSIONS

The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.

Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances

OBJECTIVE

Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the "Analogy" criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal.

METHOD

This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General's 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, "Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults."

RESULTS

In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous.

CONCLUSIONS

Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.

A Neurobiological Model of Alcohol Marketing Effects on Underage Drinking

OBJECTIVE

Although an association between exposure to alcohol advertising and underage drinking is well documented, the underlying neurobiological contributions to this association remain largely unexplored. From an epidemiological perspective, identifying the neurobiological plausibility of this exposure-outcome association is a crucial step toward establishing marketing as a contributor to youth drinking and informing public policy interventions to decrease this influence.

METHOD

We conducted a critical review of the literature on neurobiological risk factors and adolescent brain development, social influences on drinking, and neural contributions to reward sensitization and risk taking. By drawing from these separate areas of research, we propose a unified, neurobiological model of alcohol marketing effects on underage drinking.

RESULTS

We discuss and extend the literature to suggest that responses in prefrontal-reward circuitry help establish alcohol advertisements as reward-predictive cues that may reinforce consumption upon exposure. We focus on adolescence as a sensitive window of development during which youth are particularly susceptible to social and reward cues, which are defining characteristics of many alcohol advertisements. As a result, alcohol marketing may promote positive associations early in life that motivate social drinking, and corresponding neurobiological changes may contribute to later patterns of alcohol abuse.

CONCLUSIONS

The neurobiological model proposed here, which considers neurodevelopmental risk factors, social influences, and reward sensitization to alcohol cues, suggests that exposure to alcohol marketing could plausibly influence underage drinking by sensitizing prefrontal-reward circuitry.

Anytime is the Right Time: A Content Analysis of Marijuana Ads in Freely Distributed Print Media in Western Washington State, USA

Background: Cannabis advertisement content in print media has not yet been studied, despite youth high exposure to them. This study analyzes cannabis ads content in two publications in Western Washington State, USA. Methods: Content analysis of 305 cannabis advertisements published in 2017 in two free print publications was performed with support of NVivo software. A deductive approach was utilized, leveraging alcohol advertisement studies' coding frames and adding cannabis-specific codes in an iterative process. Coding was performed using a two-step analytical procedure. Results: Ads depicted the use of cannabis as part of everyday life and coopted mainstream events such as holidays to promote sales. Ads of cannabis products emphasized lifestyles that conveyed enjoyment of time in nature; such as scenes of people sitting by waterfalls, contemplating natural landscapes, paddle boarding, and canoeing. A sizeable proportion of the cannabis ads shared with alcohol ads an emphasis on the personal and social rewards of using these products, rather than product features, such as quality and taste. Conclusions: In WA State, cannabis use ads content tend to focus on solitude and outdoor recreation rather than parties and team sports, a common theme in alcohol ads. While the themes differ from alcohol, marijuana marketing mimics strategies used by alcohol industries, such as promoting the identification of their products with lifestyles and values considered appealing to attract new consumers. Many ads presented content known to appeal to youth, with content designed to elicit responses based on emotions rather than cognition.

Aspirational Brand Choice and Underage Alcohol Use

OBJECTIVE

Marketing aims to foster brand allegiance, and alcohol is a heavily marketed commodity. We hypothesize that exposed youth who are able to identify an aspirational alcohol brand will be at higher risk for underage drinking.

METHOD

U.S. youth ages 15-20 (N = 2,012; 51% female) were surveyed twice in 2011-2013. Aspirational brand was assessed by asking, "If you could drink any brand you want, what is the name of the brand of alcohol you would choose?" Multivariable logistic regression tested associations between having an aspirational brand at baseline and onset of ever, binge (≥6 drinks/occasion), and hazardous drinking (Alcohol Use Disorders Identification Test-Consumption ≥ 4).

RESULTS

Baseline ever, binge, and hazardous drinking prevalence was 55%, 26%, and 19%, respectively; 47% reported having an aspirational brand, of whom 20% were nondrinkers. Top five reported brands were Budweiser, Smirnoff, Corona, Jack Daniels, and Bacardi, all heavily advertised brands. Older age, male gender, sensation seeking, and peer/parent drinking were associated with having an aspirational brand. After we controlled for these confounders, having an aspirational brand was independently associated cross-sectionally with greater risk of ever, binge, and hazardous drinking (adjusted odds ratio = 4.47, 95% CI [3.33, 6.00], 4.84 [3.41, 6.86], and 5.46 [3.63, 8.23], respectively) and longitudinally with initiation of binge and hazardous drinking (1.80 [1.19, 2.73] and 2.02 [1.33, 3.06], respectively).

CONCLUSIONS

Having an aspirational alcohol brand is both common and independently associated with subsequent underage alcohol use and misuse. Further studies examining how youth interact with and are affected by branded advertising are critical to guide development of effective education and policy interventions.

Adolescents' Sex-Related Alcohol Expectancies and Alcohol Advertisements in Magazines: The Role of Wishful Identification, Realism, and Beliefs about Women's Enjoyment of Sexualization

In the United States, approximately one in five sexually active teens report alcohol or drug use before their last sexual encounter. The co-occurrence of alcohol with sex increases risky behaviors, such as having unprotected sex. Magazines that target adolescents often feature alcohol advertisements with sexual innuendo and female objectification. Such advertisements may inform adolescents' expectancies that alcohol can facilitate sex. With an experimental design and path analysis, we examined 874 adolescents' (ages 15-17, M = 16.05) exposure to objectifying alcohol ads, their perceptions of the ads, and their attitudes about women's sexualization in relation to sex-related alcohol expectancies. For female adolescents we assessed their enjoyment of sexualization, and for male adolescents, we assessed their perceived enjoyment of sexualization among women. Teens' perceptions that alcohol ads promote the co-occurrence of alcohol with sex mediated the effect of ad exposure and perceived realism of the ads on sex-related alcohol expectancies. The enjoyment of sexualization construct mediated the effect of wishful identification and perceived realism on sex-related alcohol expectancies. Wishful identification also directly related to sex-related alcohol expectancies. Results challenge the alcohol industry's compliance with advertisement regulations and suggest media literacy as a strategy to promote healthy sex-related alcohol expectancies among adolescents.

Viewers' Perceptions of Objectified Images of Women in Alcohol Advertisements and Their Intentions to Intervene in Alcohol-Facilitated Sexual Assault Situations

Alcohol-facilitated sexual assault is a serious problem on college campuses, and bystander intervention has been shown to be a successful method in reducing sexual assaults. Although there are a number of factors associated with individuals' intentions to intervene in sexual assault situations, the media's cultural scripts that link alcohol consumption to sexual success may play a role. Alcohol advertisements, in particular, routinely portray women as sexual objects and often link alcohol consumption to sexual success; therefore, exposure to such content may be negatively associated with people's intentions to intervene in alcohol-facilitated sexual assault situations. Thus, the current study investigated if exposure to and perceptions of objectified images of women in alcoholic beverage advertisements were associated with college students' intentions to intervene in alcohol-facilitated sexual assault situations. Undergraduate college students (N = 1208) were randomly assigned to view three alcohol advertisements that either included highly-objectified or low-objectified women, and then they reported their perceptions of the women in each of the alcohol advertisements and their intentions to intervene in sexual assault situations. Hierarchical regression analyses indicated that individuals' perceptions of alcohol advertisements moderate the relationship between exposure to objectifying alcohol advertisements and intentions to intervene in sexual assault situations.

Prospective changes in neural alcohol cue reactivity in at-risk adolescents

Adolescence represents an ideal time for elucidating the etiology of cue reactivity profiles. This study examined the influence of three risk factors consistently associated with heavy adolescent drinking on alcohol cue reactivity. Youth were first assessed while still naïve to alcohol (12-14 years old) and followed after transitioning into alcohol use (17-21 years old). The effects of family history of substance use disorder, sex, and history of early of dating (i.e., before 14 years of age) on BOLD response contrast to alcohol picture cues were examined in a linear mixed model, controlling for age and alcohol use patterns at follow-up. Activation to alcohol picture cues differed as a function of risk factor and time. At baseline, family history positive youth showed greater activation to alcohol cues than family history negative peers in the right middle occipital and anterior cingulate gyri. Youth with a history of early-dating showed greater activation to alcohol cues, compared to non-early daters, in the left anterior cingulate/white matter region. Girls showed greater activation to alcohol than boys at baseline in left middle frontal gyrus. At follow-up, after drinking started, patterns reversed for each risk factor. These results indicate that even prior to initiating alcohol use, adolescents showed differences in activation to alcohol cues based on their family history, dating history, and sex.

Perceptions of Alcohol Advertising Vary Based on Psychological Characteristics

BACKGROUND

The alcohol industry recognizes children and pregnant women as population sub-groups vulnerable to the effects of alcohol marketing. Research indicates that heavy alcohol users are also potentially vulnerable to alcohol marketing. The purpose of the current study is to determine if sub-groups defined by psychological characteristics should be classified as potentially vulnerable as well.

METHODS

College students (n = 326) from two northeast schools were recruited to complete a survey containing questions on demographics, alcohol use, and psychological characteristics (alcohol expectancies, alcohol dependence, sensation seeking traits, and past delinquent behaviors). Additionally, after viewing each of five alcohol ads (4 television and 1 magazine), participants answered questions about their perceptions of alcohol consumption, responsible drinking, excessive drinking, and appeal of the ads. Main effects were assessed using hierarchical linear modeling, with adjustment for age, sex, race, ethnicity, and AUDIT score.

RESULTS

Alcohol expectancies (p < .001), particularly the social and physical pleasure and social expressiveness sub-scales, and sensation seeking traits (p = .002) were positively associated with alcohol ad appeal. Alcohol dependence symptoms, specifically impaired control and tolerance, were positively associated with perceptions of responsible drinking (p = .035), even though mean perceived number of drinks consumed met the definition of binge drinking.

CONCLUSIONS

Individuals with positive alcohol expectancies, sensation seeking traits, and alcohol dependence may be vulnerable to alcohol advertising and marketing. Because alcohol advertising often contains content that can serve as a cue or reinforce to drink, specific regulations may be needed to prevent alcohol-related harm from occurring in these sub-populations.

Behind Closed Doors: The Priorities of the Alcohol Industry as Communicated in a Trade Magazine

Background: Efforts to reduce alcohol-related harm face strong resistance from the alcohol industry. It is important to monitor industry actions over time to assist in developing appropriate responses to this resistance. Monitoring can enable public health to identify industry positions on alcohol policy issues, stay abreast of current and emerging marketing tactics, and inform the development of possible counter-actions. One form of monitoring is the examination of industry trade publications where the industry converses with itself. The aim of this study was to assess industry strategic approaches as communicated in articles published in a leading Australian alcohol trade magazine to provide insights for policy makers and advocacy groups. Methods: Thematic analysis of 362 articles published in a trade magazine over a one-year period. Results: Three primary themes were evident in the articles: (1) the legitimization of alcohol as an important social and economic product, (2) the portrayal of the industry as trustworthy and benign, and (3) the strategic embedding of alcohol in various facets of everyday life. Conclusions: There was a general failure to acknowledge the substantial burden of disease caused by alcohol products, and instead much effort was expended on legitimizing the product and the companies responsible for its production, distribution, and promotion. The level of denial exhibited shows that additional regulation of the industry and its tactics will need to proceed without industry acceptance. Clear resistance to increasing consumer protections also points to the futility of inviting industry members to the policy table.

Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study

AIMS

To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines.

DESIGN

Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G).

SETTING

Australia, 2016.

PARTICIPANTS

A total of 3718 drinkers aged 18-64 years (48.5% male).

MEASUREMENTS

Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption.

FINDINGS

After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar.

CONCLUSIONS

Alcohol harm television advertisements increase intentions to reduce alcohol consumption among both low- and high-risk drinkers. The addition of low-risk drinking guidelines can enhance these effects for advertisements featuring long-term harms and improve estimates of both short- and long-term harmful drinking levels.

Alcohol and violence in 2017 National Football League Super Bowl commercials

Background: The National Football League (NFL) Super Bowl is a widely-viewed sports event and the commercials are especially popular among viewers. Previous research has demonstrated risky health behaviors in advertisements aired during sporting events. The purpose of this study was to analyze the content of the advertisements aired during the 2017 NFL Super Bowl.

Methods: This cross-sectional study involved examining the content of all commercials, with an emphasis on health-compromising behaviors. The themes and highlights of the advertisements were analyzed based on whether there was a reference to alcohol or violence.

Results: A total of 103 unique commercials were analyzed. The most common themes were humor (n=43), happiness (n=25), innovation (n=25), and enjoyment or relaxation (n=25).Alcohol was referenced in 13 (12.6%, 95% CI 7.5%, 20.4%) of the commercials. Advertisements with alcohol references were more likely to contain the themes of partying (odds ratio [OR]:16.2, 95% CI 1.4-193.4, P=0.041) and enjoyment or relaxation (OR: 4.7, 95% CI 1.4-15.6,P=0.014). There were 24 commercials with references to violence and these were more likely tobe promoting a movie (OR: 5.4, 95% CI 3.5-8.2, P<0.001) or television program (OR: 8.9,95% CI 2.6-30.26, P<0.001).

Conclusion: Parents should consider whether it is appropriate for their children to watch a concentrated number of intense images containing references to alcohol and violence during this popular sporting event.

The Myriad Influences of Alcohol Advertising on Adolescent Drinking

Purpose of Review

This review investigates effects of alcohol advertising on adolescent drinking. Prior reviews focused on behavioral outcomes and long-term effects. In contrast, the present review focuses on subgroups with greater exposure to alcohol advertising, research methods to study alcohol advertising, potential mechanisms underlying relationships between adolescent exposure to alcohol advertising and increased drinking and points to prevention/intervention strategies that may reduce effects of alcohol advertising.

Recent Findings

Alcohol advertising influences current and future drinking. Further, evidence suggests adolescents may be targeted specifically. Alcohol advertisements may influence behavior by shifting alcohol expectancies, norms regarding alcohol use, and positive attitudes. Media literacy programs may be an effective intervention strategy.

Summary

Adolescents are exposed to large quantities of alcohol advertisements, which violates guidelines set by the alcohol industry. However, media literacy programs may be a promising strategy for adolescents to increase critical thinking and create more realistic expectations regarding alcohol.

Alcohol harm reduction advertisements: a content analysis of topic, objective, emotional tone, execution and target audience

BACKGROUND

Public health mass media campaigns may contribute to reducing the health and social burden attributed to alcohol consumption, but little is known about which advertising characteristics have been used, or have been effective, in alcohol harm reduction campaigns to date. As a first step towards encouraging further research to identify the impact of various advertising characteristics, this study aimed to systematically identify and examine the content of alcohol harm reduction advertisements (ads).

METHOD

Ads were identified through an exhaustive internet search of Google, YouTube, Vimeo, and relevant government and health agency websites. Eligible ads were: English language, produced between 2006 and 2014, not primarily focused on drink-driving or alcohol in pregnancy, and not alcohol industry funded. Systematic content analysis of all ads was performed; each ad was double-coded.

RESULTS

In total, 110 individual ads from 72 different alcohol harm reduction campaigns were identified, with the main source countries being Australia (40%) and the United Kingdom (26%). The dominant topic for 52% of ads was short-term harms, while 10% addressed long-term harms, 18% addressed underage drinking, 17% communicated a how-to-change message, and 3% advocated for policy change. The behavioural objective of most ads was to motivate audiences to reduce their alcohol consumption (38%) or to behave responsibly and/or not get drunk when drinking (33%). Only 10% of all ads mentioned low-risk drinking guidelines. Eighty-seven percent of ads used a dramatisation execution style and 74% had a negative emotional tone. Ninety percent of ads contained messages or content that appeared to target adults, and 36% specifically targeted young adults.

CONCLUSIONS

Some message attributes have been employed more frequently than others, suggesting several promising avenues for future audience or population-based research to compare the relative effectiveness of different characteristics of alcohol harm reduction ads. Given most alcohol-attributable harm is due to long-term disease, these findings suggest future campaigns may fill a potentially important gap if they were to focus on long-term harms. There is scope for such long-term harm campaigns to place greater emphasis on encouraging reduced personal consumption of alcohol, potentially through more frequent communication of low-risk drinking guidelines.

The party effect: prediction of future alcohol use based on exposure to specific alcohol advertising content

AIMS

To test whether exposure to party-related alcohol advertising is associated with drinking behavior in a national US sample of adolescents and young adults, independently of exposure to other alcohol advertising.

DESIGN

Longitudinal telephone- and web-based surveys conducted in 2011 and 2013.

SETTING

All regions of the United States, participants selected via mixed-mode random-digit-dial landline and cellphone frames.

PARTICIPANTS

A sample of 705 respondents who never had a whole drink of alcohol at baseline (mean age 16.9 years, 53.3% female) and a sample of 1036 who never had six or more drinks during one drinking occasion (mean age 17.4 years, 55.8% female).

MEASUREMENTS

Outcome measures were onset of alcohol use and binge drinking during the study interval. Primary predictor was exposure to television alcohol advertising, operationalized as contact frequency and brand recall for 20 randomly selected alcohol advertisements. Independent post-hoc analyses classified all advertisements as 'party' or 'non-party' advertisements. Socio-demographics, sensation-seeking, alcohol expectancies and alcohol use of friends and family were assessed as covariates.

FINDINGS

Onset rates for having the first whole drink of alcohol and for first binge drinking were 49.2% and 29.5%, respectively. On average, approximately half (median = 10.2) of the 20 alcohol advertisements in each individual survey were 'party' advertisements. If both types of exposures ('party' and 'non-party') were included in the regression model, only 'party' exposure remained a significant predictor of alcohol use onset [adjusted odds ratio (AOR) = 19.17; 95% confidence interval (CI) = 3.72-98.79] and binge drinking onset (AOR = 3.87; 95% CI = 1.07-13.99) after covariate control.

CONCLUSIONS

Adolescents and young adults in the United States appear to have higher rates of alcohol use and binge drinking onset if they have higher exposure to alcohol advertisements using a partying theme, independently of the amount of exposure to alcohol advertisements with non-party themes.

Industry self-regulation of alcohol marketing: a systematic review of content and exposure research

BACKGROUND AND AIMS

With governments relying increasingly upon the alcohol industry's self-regulated marketing codes to restrict alcohol marketing activity, there is a need to summarize the findings of research relevant to alcohol marketing controls. This paper provides a systematic review of studies investigating the content of, and exposure to, alcohol marketing in relation to self-regulated guidelines.

METHODS

Peer-reviewed papers were identified through four literature search engines: SCOPUS, Web of Science, PubMed and PsychINFO. Non-peer-reviewed reports produced by public health agencies, alcohol research centers, non-governmental organizations and government research centers were also identified. Ninety-six publications met the inclusion criteria.

RESULTS

Of the 19 studies evaluating a specific marketing code and 25 content analysis studies reviewed, all detected content that could be considered potentially harmful to children and adolescents, including themes that appeal strongly to young men. Of the 57 studies of alcohol advertising exposure, high levels of youth exposure and high awareness of alcohol advertising were found for television, radio, print, digital and outdoor advertisements. Youth exposure to alcohol advertising has increased over time, even as greater compliance with exposure thresholds has been documented.

CONCLUSIONS

Violations of the content guidelines within self-regulated alcohol marketing codes are highly prevalent in certain media. Exposure to alcohol marketing, particularly among youth, is also prevalent. Taken together, the findings suggest that the current self-regulatory systems that govern alcohol marketing practices are not meeting their intended goal of protecting vulnerable populations.