Aspirational Brand Choice and Underage Alcohol Use

Eye-tracking to examine differences in alcohol product appeal by sex among young people

Background: Advertising of traditional alcopops contains elements that appeal to youth, especially females. Supersized alcopops are marketed differently than traditional alcopops and contain up to 5.5 standard alcoholic drinks. Young females are more likely to underestimate the alcohol content of supersized alcopops, putting them at higher risk of overconsumption. Similar to supersized alcopops, beer is packaged in large cans and in the same areas of store shelves.Objective: This study examined among young people whether supersized alcopops versus beer products disproportionately appealed to females.Methods: Eleven adolescents (13-17 years old) and 72 college students (21-26 years old) were recruited during 2019-2020. Participants viewed 19 photos of convenience store display cases containing both supersized alcopop and beer products. While viewing each image, participants were instructed to click on the beverage that looked the "coolest" (i.e. most appealing). Eye-tracking hardware and software measured the amount of time participants visually fixated on each product. Participants completed a survey to record demographic characteristics.Results: Compared to males (n=25), females (n=58) fixated on supersized alcopops for 6.8 seconds longer (95%CI 0.3,13.3). Females also had 3.7 times the odds of selecting a supersized alcopop as the product they found most appealing compared to males (95%CI 1.68,8.01), adjusting for amount of time visually fixating on supersized alcopops, which was also a significant predictor.Conclusions: Young females' strong preference for supersized alcopops is concerning given they disproportionately underestimate their potency, relative to males, and are more likely to obtain dangerously high BAC levels from consuming one or two supersized alcopops.

A Content Analysis of Cannabis Company Adherence to Marketing Requirements in Four States

OBJECTIVE

Marketing messages can influence adolescents' attitudes and behaviors toward alcohol and tobacco. In the era of legalized cannabis use, retail cannabis companies often use social media marketing on platforms popular among youth. The purpose of this study was to evaluate adherence to state-based regulations for restricted and required content across social media from recreational cannabis businesses.

METHOD

A retrospective content analysis was used to evaluate one year of publicly displayed posts by retail cannabis companies on Facebook and Instagram from four states in which recreational cannabis use is legal (Alaska, Colorado, Oregon, and Washington State). We evaluated restricted content including the following: (a) business practices, such as avoiding discounts/promotions or promoting branded products; (b) modeling cannabis use or overconsumption; (c) youth-focused messaging; and (d) health benefits. We evaluated required content including three types of warnings: (a) limiting cannabis use to those age 21 and over, (b) avoiding impaired driving, and (c) describing health risks.

RESULTS

A total of 2,660 posts were evaluated from 14 businesses. In the area of restricted content, discounts/promotions were present in approximately 35% of all posts. Another common category was overconsumption, found in 12% of posts. Required content regarding warnings was present in less than half of all social media posts.

CONCLUSIONS

Despite state-based advertising restrictions, recreational cannabis business pages use messages with youth appeal. Required safety message adherence is not typical on social media business pages.

A Content Analysis of Cannabis Company Adherence to Marketing Requirements in Four States

OBJECTIVE

Marketing messages can influence adolescents' attitudes and behaviors toward alcohol and tobacco. In the era of legalized cannabis use, retail cannabis companies often use social media marketing on platforms popular among youth. The purpose of this study was to evaluate adherence to state-based regulations for restricted and required content across social media from recreational cannabis businesses.

METHOD

A retrospective content analysis was used to evaluate one year of publicly displayed posts by retail cannabis companies on Facebook and Instagram from four states in which recreational cannabis use is legal (Alaska, Colorado, Oregon, and Washington State). We evaluated restricted content including the following: (a) business practices, such as avoiding discounts/promotions or promoting branded products; (b) modeling cannabis use or overconsumption; (c) youth-focused messaging; and (d) health benefits. We evaluated required content including three types of warnings: (a) limiting cannabis use to those age 21 and over, (b) avoiding impaired driving, and (c) describing health risks.

RESULTS

A total of 2,660 posts were evaluated from 14 businesses. In the area of restricted content, discounts/promotions were present in approximately 35% of all posts. Another common category was overconsumption, found in 12% of posts. Required content regarding warnings was present in less than half of all social media posts.

CONCLUSIONS

Despite state-based advertising restrictions, recreational cannabis business pages use messages with youth appeal. Required safety message adherence is not typical on social media business pages.

Supersized alcopop related calls in the National Poison Data System, 2010-2019

BACKGROUND

Supersized alcopops are single-serving high-alcohol-content beverages frequently consumed by underage drinkers. However, little data exist regarding the public health burden of supersized alcopops during the last decade. The current study examined the characteristics of calls to U.S. poison control centers involving supersized alcopops. This study also compared the proportion of calls for underage consumers between calls involving consumption of supersized alcopops and calls involving other types of alcohol (e.g., liquor, beer, wine).

METHODS

Data from the National Poison Data System (NPDS) repository of calls to U.S. poison control centers were analyzed.

RESULTS

Between 2010 and 2019, poison control centers received 1719 calls for exposures to supersized alcopops. Nearly one-half of calls involving supersized alcopop consumption (46.3 %) were made for consumers who were below the legal drinking age. In all years, the proportion of calls for supersized alcopops that were for underage exposures greatly exceeded the proportion of calls that were for underage exposures for other types of alcohol. For those 0-11 years of age, 91 % of supersized alcopop exposures were unintentional; however, for each other age group, at least 84 % of exposures were intentional. Supersized alcopop exposures involved a co-ingested product in more than 80 % of cases among patients of legal drinking age and less than 50 % of cases among patient under legal drinking age.

CONCLUSIONS

Compared to other alcohol products, calls to U.S poison control centers for supersized alcopops disproportionately involved underage drinkers. To protect youth, improved regulation of supersized alcopop products is urgently needed.

Cyber-ethnography of cannabis marketing on social media

Background

Since 2012, several states have legalized non-medical cannabis, and cannabis businesses have used social media as a primary form of marketing. There are concerns that social media cannabis exposure may reach underage viewers. Our objective was to identify how cannabis businesses cultivate an online presence and exert influence that may reach youth.

Methods

We chose a cyber-ethnographic approach to explore cannabis retailers on social media. We searched cannabis retailers with Facebook and Instagram presence from Alaska, Oregon, Colorado, and Washington, and identified 28 social media business profiles. One year of content was evaluated from each profile. In-depth, observational field notes were collected from researchers immersed in data collection on business profiles. Field notes were analyzed to uncover common themes associated with social media cannabis marketing.

Results

A total of 14 businesses were evaluated across both Facebook and Instagram, resulting in 14 sets of combined field notes. A major theme was Normalization of Cannabis, involving both Broad Appeal and Specific Targeting.

Conclusions

It is concerning that Normalization of Cannabis by cannabis businesses may increase cannabis acceptability among youth. In a digital world where the majority of youth are spending time online, it is important for policymakers to examine additional restrictions for cannabis businesses marketing through social media.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13011-021-00359-w.

Supersized Alcopop Consumption Associated With Homelessness and Gang Membership

BACKGROUND

Supersized alcopops are single-serving, ready-to-drink beverages with very high alcohol content. Research suggests that consumption of these products is especially dangerous. The current study was one of the first to examine individual-level characteristics associated with recent consumption of supersized alcopops.

METHODS

Adults on probation (n = 253; 70% male) in Baltimore City, MD, and Dallas, TX, who reported heavy drinking or any illicit drug use completed interviews. Psychosocial scales were drawn from the Criminal Justice Client Evaluation of Self and Treatment Intake. Bivariate analyses were conducted to examine characteristics associated with past 30-day consumption of supersized alcopops.

RESULTS

Past 30-day consumption of supersized alcopops was significantly associated with higher scores for hostility and risk-taking, and lower scores on the self-esteem scale compared to nonconsumers. Recent consumption of supersized alcopops was also significantly associated with past 30-day homelessness and current gang affiliation. Among those who did not experience homelessness, 11% consumed supersized alcopops, compared to 30% of those who experienced homelessness. Further, 11% of those who were not gang-affiliated reported consuming a supersized alcopop within the past 30 days, compared to 57% of those who were gang-affiliated.

DISCUSSION

This study identifies disparate consumption of dangerous supersized alcopop products by vulnerable and at-risk groups. Better regulation of supersized alcopop marketing is needed to reduce alcohol consumption among high-risk groups, including people who are homeless and gang members, and display greater hostility and risk-taking traits. Previous research suggests that reducing the alcohol by volume and increasing the retail price of supersized alcopops would reduce some of the harms associated with consumption.

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.