Regulation of alcohol marketing in Australia: A critical review of the Alcohol Beverages Advertising Code Scheme's new Placement Rules

Through the looking glass: An alcohol advertisement every 3 minutes

INTRODUCTION

There is growing concern over the lack of regulation of alcohol advertisements on social media platforms frequented by youths. This study aims to build upon existing literature by assessing the frequency with which young Australians (17-25) are shown advertisements promoting alcohol use and the themes utilised in these advertisements.

METHODS

A total of 125 Australian youths (mean age 18.74 years; 74.40% female) were recruited in exchange for course credit to participate in an online study. Participants scrolled through Facebook or Instagram for a period of 30 min and screenshotted any alcohol advertisements encountered. Participants then identified the advertisement qualities (or 'themes') present in the advertisements, based on pre-identified categories. Demographic, social media usage and historical personal, peer or familial substance use behaviour data was also collected.

RESULTS

Seventy-one university students were exposed to 796 alcohol advertisements across both platforms, and they encountered an advertisement every 2 min and 43 s on average. Most advertisements included call to action features on both Facebook (78.80%) and Instagram (71.17%). Advertisements relating to ease of access (promoting subscription/home delivery; 41.72% and 42.56%) and sales incentives (special offers, promotions, samples or bonuses with purchase; 43.70% and 46.84%) were most common across both platforms.

DISCUSSION AND CONCLUSIONS

Alcohol advertisements are highly prevalent online, particularly among Australian youth social media users. Future research should endeavour to identify whether temporal use of alcohol is a predictor of subsequent exposure to alcohol advertising on social media, and whether this exposure is likely to increase successive alcohol use behaviours.

Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries

CONTEXT

Public health law is an important tool in non-communicable disease (NCD) prevention. There are different approaches available for achieving policy objectives, including government, co-, quasi- and self-regulation. However, it is often unclear what legal design features drive successes or failures in particular contexts. This scoping review undertakes a descriptive analysis, exploring the design characteristics of legal instruments that have been used for NCD prevention and implemented and evaluated in OECD countries.

METHODS

A scoping review was conducted across four health and legal databases (Scopus, EMBASE, MEDLINE, HeinOnline), identifying study characteristics, legal characteristics and regulatory approaches, and reported outcomes. Included studies focused on regulation of tobacco, alcohol, unhealthy foods and beverages, and environmental pollutants.

FINDINGS

We identified 111 relevant studies evaluating 126 legal instruments. Evaluation measures most commonly assessed implementation, compliance and changes to the built and lived environment. Few studies evaluated health or economic outcomes. When examining the design and governance mechanisms of the included legal instruments, government regulation was most commonly evaluated (n = 90) and most likely to be reported effective (64%). Self-regulation (n = 27) and quasi-regulation (n = 5) were almost always reported to be ineffective (93% and 100% respectively). There were few co-regulated instruments evaluated (n = 4) with mixed effectiveness. When examining public health risks, food and beverages including alcohol were more likely to be self- or quasi-regulated and reported as ineffective more often. In comparison, tobacco and environmental pollutants were more likely to have government mandated regulation. Many evaluations lacked critical information on regulatory design. Monitoring and enforcement of regulations was inconsistently reported, making it difficult to draw linkages to outcomes and reported effectiveness.

CONCLUSIONS

Food and alcohol regulation has tended to be less successful in part due to the strong reliance on self- and quasi-regulation. More work should be done in understanding how government regulation can be extended to these areas. Public health law evaluations are important for supporting government decision-making but must provide more detail of the design and implementation features of the instruments being evaluated - critical information for policy-makers.

Falling through the cracks: How do policies for alcohol marketing apply to zero alcohol products in Australia?

ISSUES

There is a decline in youth drinking, but also a causal link between alcohol marketing and drinking among young people. Therefore, novel alcohol marketing strategies should be scrutinised, particularly where children are exposed. This includes marketing for zero-alcohol products (ZAP) (containing 0.00% to 1.15% alcohol by volume), which has expanded considerably in recent times. This review examines how the current industry-managed regulatory approach to alcohol marketing applies to ZAPs in Western Australia.

APPROACH

The marketing mix (four Ps of marketing: product, promotion, place, price) was used as a framework to examine federal and state government policies and industry managed codes. Policies were included if they applied to marketing of alcohol products, for example, product labelling, promotion and advertising across various media, the place of purchase and pricing measures (taxation).

KEY FINDINGS

ZAPs were inconsistently defined, meaning that products between 0.05% and 1.15% alcohol by volume were covered under some but not all alcohol policy measures, and application to products under 0.5% alcohol by volume was limited.

IMPLICATIONS

Government policy should more clearly define alcohol marketing and whether ZAPs and other alcohol brand extensions should be treated in the same way as alcoholic products.

CONCLUSION

In Western Australia, the ways in which alcohol policy measures apply to ZAPs are limited and close attention must be paid to how ZAPs may provide additional marketing opportunities for the alcohol industry.

Association between single-channel and cumulative exposure to alcohol advertising and drinking behaviours among Australian adolescents

INTRODUCTION

Widespread commercial promotion of alcohol products in Australia undermines the abstinence message for young people. This study aims to document the frequency of adolescents' exposure to alcohol advertising and examine associations with drinking behaviours.

METHODS

Students aged 12-17 years (n = 3618) participating in a cross-sectional survey self-reported their exposure to alcohol advertising via eight sources. Students also indicated whether they had never consumed alcohol, consumed at least a few sips of alcohol in their lifetime but none in the past month ('irregular drinkers') or consumed more than 10 drinks in their lifetime including at least one drink in the past month ('drinkers'). Multinomial logistic regression analyses examined associations between both single-channel and cumulative exposure to alcohol advertising and drinking status, controlling for sex, age and education sector.

RESULTS

Television (61%), the internet (56%) and at sporting events (50%) were the most common channels through which students reported seeing alcohol advertising. Weekly exposure via each of the eight assessed channels was associated with being a drinker (vs. a non-drinker or an irregular drinker, respectively), whereas only weekly exposure via television and sporting events was associated with being an irregular drinker (vs. a non-drinker). As students' level of cumulative exposure to alcohol advertising increased, so too did their likelihood of being a drinker.

DISCUSSION AND CONCLUSIONS

Alcohol advertising exposure is positively associated with drinking among Australian adolescents. Tighter restrictions on alcohol advertising across all media in Australia may reduce adolescent exposure and help de-normalise alcohol use.

Drinking and swimming around waterways: The role of alcohol, sensation-seeking, peer influence and risk in young people

The role of individual and sociocultural factors contributing to drowning risk for young adults is complex and poorly understood. This study examined the relationship between behaviour in and around waterways and: 1) alcohol consumption; 2) resistance to peer influence; 3) sensation-seeking; 4) perception of risk among people aged 15–24 in Western Australia. A cross-sectional online survey was conducted at three time-points with a convenience sample. Predictor variables included: Alcohol Use Disorder Identification Test Consumption (AUDIT_C); Resistance to Peer Influence; Brief Sensation Seeking scale; Benthin’s Perception of risk. Pearson chi-squared tests determined the association between demographic and predictor variables. Logistic regression explored influence of potential predictor variables on behaviour in and around water. The final sample (n = 730) participants, consisted of females (n = 537, 74.5%), metropolitan dwelling (n = 616, 84.4%), and attended university (n = 410, 56.9%). Significant associations were found for those who swum after drinking alcohol compared with those that had not by age, gender, education. For every 1-unit increase in AUDIT-C participants were 60% more likely to swim after drinking (OR 95% CI 1.60 1.44–1.78). Participants who considered an adverse event serious were 15% less likely to have swum after drinking alcohol (OR 0.85 95% CI 0.73–0.99). The complex relationship between social participation in activities in and around waterways, higher drowning rates, propensity for risk, and the meaning young adults attach to risk locations and practices present unique challenges for drowning prevention research. Findings should be used to improve the awareness and education components of future youth water safety strategies in high-income settings.

Patterns of alcohol and alcohol-flavoured non-alcoholic beverage advertisements over Japanese free-to-air television networks

Background

Alcohol use is a serious public health challenge worldwide. Japan has no government regulations or legal penalties against advertising alcoholic beverages on television (TV). Instead, advertisements depend on the Japanese alcohol industry’s self-regulation on airtime (no advertisements from 5 am to 6 pm) and the content of alcoholic beverages, which must not tempt minors. However, many adolescents (10 to 19 years old) watch TV from 6 pm to 11 pm. The aim of this study was to describe the pattern in the advertising of alcoholic beverages and alcohol-flavoured non-alcoholic beverages (AFNAB) in Japan during the popular TV viewing time for adolescents.

Methods

A secondary analysis of advertising airtime data from five free-to-air Japanese TV networks in the Greater Tokyo area that aired between 12 August and 3 November 2019, was performed.

Results

During the study period, 5215 advertisements for alcoholic beverages and AFNABs aired (1451.75 min). In total, 2303 advertisements (44.2%) were beer, low-malt beer, or beer-taste beverages, 277 (5.3%) were whisky, 2334 (44.8%) were local alcoholic beverages (shochu and seishu), and 301 (5.8%) were AFNAB. On average, more advertisements aired on weekends (67.6 advertisements) than on weekdays (59.3 advertisements) per day. Approximately 30% of advertisements for AFNABs were aired during the time restricted for alcohol advertising, although AFNABs are considered alcohol according to industry guidelines. During the popular television viewing time for young adolescents, about two to three times more advertisements were aired per hour than during the rest of the day, on both weekdays and weekends (p < 0.001).

Conclusion

The number of alcohol advertisements aired at times when adolescents often watch TV is 2 to 3.2 times higher than that at other times of the day. Furthermore, despite the industry’s self-imposed regulations, some alcoholic beverages are still advertised. Therefore, other methods to protect children and adolescents from exposure to advertisements for alcoholic beverages should be investigated and implemented.

You've got mail: Drinks are on sale! A study to assess volume and content of direct marketing received from online alcohol retailers in Australia

BACKGROUND

Customers of online alcohol retailers are exposed to marketing displayed on alcohol retailers' websites and may also receive direct marketing via email and text message once contact details are provided in an online sale. To date, this direct marketing activity from online alcohol retailers has not been studied. This study aims to document the quantity and content of marketing material received by customers of online alcohol retailers in Australia, and whether the material complies with relevant regulation.

METHODS

A cross-sectional study of direct marketing from the 100 most popular online alcohol retailers in Australia. Marketing material received via email and text message was collected for three-months from March to June 2021. Email and text messages were coded for 17 variables in four categories: primary purpose of the communication; compliance with relevant regulations; marketing themes and practices used; and offers, promotions, and discounts.

RESULTS

We received 1496 emails from 85 of the 100 retailers. Of the retailers who sent emails, the number sent varied widely (Mdn=8; IQR=2-21). Seven retailers sent a total of 18 text messages. The primary purpose of most emails (67.4%) was to advertise a special or offer a discount. Almost all emails (98.6%) complied with spam legislation to include an unsubscribe link, but around half (46.5%) of emails from retailers in jurisdictions where the inclusion of a liquor license number is mandatory, failed to include one. The most common marketing theme was to link specific times or events to drinking (18.8%). Almost half (48.5%) of emails advertised free or discounted delivery for purchasing over a specified threshold.

CONCLUSION

Most online alcohol retailers in Australia are engaging in direct marketing to their customers via email. More research is needed to understand how these emails may influence purchasing and consumption.

An evaluation of the evidence submitted to Australian alcohol advertising policy consultations

BACKGROUND

Industry self-regulation is the dominant approach to managing alcohol advertising in Australia and many other countries. There is a need to explore the barriers to government adoption of more effective regulatory approaches. This study examined relevance and quality features of evidence cited by industry and non-industry actors in their submissions to Australian alcohol advertising policy consultations.

METHODS

Submissions to two public consultations with a primary focus on alcohol advertising policy were analysed. Submissions (n = 71) were classified into their actor type (industry or non-industry) and according to their expressed support for, or opposition to, increased regulation of alcohol advertising. Details of cited evidence were extracted and coded against a framework adapted from previous research (primary codes: subject matter relevance, type of publication, time since publication, and independence from industry). Evidence was also classified as featuring indicators of higher quality if it was either published in a peer-reviewed journal or academic source, published within 10 years of the consultation, and/or had no apparent industry connection.

RESULTS

Almost two-thirds of submissions were from industry actors (n = 45 submissions from alcohol, advertising, or sporting industries). With few exceptions, industry actor submissions opposed increased regulation of alcohol advertising and non-industry actor submissions supported increased regulation. Industry actors cited substantially less evidence than non-industry actors, both per submission and in total. Only 27% of evidence cited by industry actors was highly relevant and featured at least two indicators of higher quality compared to 58% of evidence cited by non-industry actors.

CONCLUSIONS

Evaluation of the value of the evidentiary contribution of industry actors to consultations on alcohol advertising policy appears to be limited. Modifications to consultation processes, such as exclusion of industry actors, quality requirements for submitted evidence, minimum standards for referencing evidence, and requirements to declare potential conflicts, may improve the public health outcomes of policy consultations.

Exploring the potential of citizen science for public health through an alcohol advertising case study

Citizen science connects academic researchers with the public through combined efforts in scientific inquiry. The importance of involving impacted populations in health research is well established. However, how to achieve meaningful participation and the methodological impact of citizen science needs further examination. We examined the feasibility of using citizen science to understand the impact of alcohol advertising on Australian women through a breast cancer prevention project. Two hundred and eighty-two ('participants') citizen scientists completed demographic and behavioural questions via an online survey. The research participants moved into the role of citizen scientists by completing the data collection tasks of capturing and classifying images of alcohol advertising they saw online. Interrater reliability tests found high levels of agreement between citizen scientists and academic researchers with the classification of alcohol advertising brand (Kappa = 0.964, p < 0.001) and image type (Kappa = 0.936, p < 0.000). The citizen scientists were women aged 18 and over, with 62% between 35 and 55 years old. The majority were from major cities (78%), had attained a bachelor's degree or higher-level education (62%) and were recruited via email or Facebook (86%). The use of citizen science provided methodological gains through the creation of a unique dataset with higher levels of validity than the existing literature, which employed traditional investigator-driven research methodologies. Citizen science enriched the dataset and provided a powerful methodological vehicle to understand an environmental determinant of health. The study illuminates how public participation benefitted the research process, the challenges and the potential for citizen science to improve public health.

Depictions of Alcohol in Australian TV 'Bachelor In Paradise': A Content Analysis

AIMS

To quantify the depictions of alcohol in the popular Australian reality TV show-Bachelor in Paradise (season 1: 2018).

METHODS

All 16 episodes were coded in 1-min intervals for the presence of alcoholic beverage related content and non-alcoholic beverage content, and the categories of actual use, implied use and other references.

RESULTS

Alcohol was highly prevalent in all episodes. Alcohol content occurred frequently, with 70.7% of intervals having any alcohol content. Actual alcohol use occurred in 31.9% of 1-min intervals, implied alcohol use occurred in 63.4% of intervals and other alcohol references occurred in 14.0% of intervals. Alcohol content was present in the first or second 1-min interval of all 16 episodes. Alcohol content was more than twice as prevalent as non-alcoholic content (34.0%).

CONCLUSIONS

The high volume of alcohol content depicted in the show is of concern, due to the important influence it may have on the audience. Vulnerable viewers, especially minors and young adults, are being exposed to ubiquitous alcohol references. This may influence their perceptions of normal alcohol use, their attitudes toward alcohol and their own consumption of alcohol. A stronger regulatory regime is required in Australia to protect young people more effectively from depictions in television programs.

Are Australian regulatory codes adequate in scope to protect youth from alcohol advertising?

ISSUE ADDRESSED

Exposure to alcohol advertising has been found to be associated with more positive attitudes toward alcohol and heavier drinking among youth. Appropriate regulation of alcohol advertising is thus crucial for reducing use among members of this population group. To assist policy makers in their alcohol control efforts, this study explored the scope of Australian alcohol advertising codes and the extent to which they address issues relating to youth exposure.

METHODS

Two researchers assessed 628 unique alcohol advertisements against youth-related provisions of the Alcohol Advertising Review Board (AARB) Code and Alcohol Beverages Advertising Code (ABAC). A third researcher resolved discrepancies. The ads sampled were those that had been the subject of formal complaints to the AARB.

RESULTS

Most (94%) ads were assessed as violating at least one of the AARB Code provisions relating to youth, while 36% were found to violate at least one of the ABAC youth provisions. The most frequently violated AARB Code provision related to placement, with 88% of ads located in places or broadcast at times where young people were likely to be exposed. The most frequently violated ABAC provision related to appeal to minors (33%).

CONCLUSIONS

Results indicate that self-regulation is an ineffective means of protecting youth from alcohol advertising, with the ABAC failing to capture many ads featuring content that appeals to youth. SO WHAT?: Greater efforts are required to protect youth from alcohol advertising. Findings from the present study reinforce calls for mandatory, evidence-based regulation that is administered independently of the alcohol industry.

SUMMARY

An analysis of 628 unique alcohol advertisements found that the vast majority were in violation of the AARB Code's youth-related provisions whereas substantially fewer were in violation of the ABAC, supporting arguments that self-regulation is an ineffective means of protecting youth from alcohol advertising.

Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies

OBJECTIVE

This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults.

METHOD

Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion.

RESULTS

Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples' alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples.

CONCLUSIONS

Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples' alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.