Brian Hoyle

May 03, 2011

May 3, 2011 (Denver, Colorado) — Alcohol marketing is effective. Although profitable for the manufacturers, the detrimental results seen in American adolescents — who are not the target audience — are increased frequencies of drinking and binge drinking, which could be a prelude to alcohol-related behavioral and health problems in later life.

The findings from a pair of studies were presented by Susanne Tanski, MD, from Dartmouth-Hitchcock Medical Center of Pediatrics, Lebanon, New Hampshire, here at the Pediatric Academic Societies and Asian Society for Pediatric Research 2011 Annual Meeting.

In any given month, approximately 40% of American high-school students drink alcohol. Of these, nearly 25% will binge drink, consuming 5 or more drinks in succession.

"The alcohol industry works hard to get our money, with $17 billion spent on ads in 2009 [in the United States]. The goal is to create brand loyalty, and alcohol ads link drinking with partying and having fun," Dr. Tanski told Medscape Medical News.

Surprisingly little is known about whether alcohol marketing is a risk factor for alcohol abuse in adolescents, Dr. Tanski noted.

In the first study, of the 328 adolescents (18 to 23 years of age; 164 males, 164 females) who participated, 58% had drunk in the previous month and 62% had binged. The anonymous Web survey was a "cue-based" recall of television ads, in which still images from 39 alcohol ads and 15 fast food ads with the identifying brand name/logo digitally obscured were viewed. A 4-point scale was used to determine whether participants had seen the ad and whether they could identify the brand.

The ad responses were linked to responses concerning drinking intensity (recall of the number of times drinking and the number of times binge drinking in the previous 30 days), glass size of a typical drink corresponding to photos of various beverage glasses, and abuse of alcohol in the previous year. The latter category included the number of episodes of vomiting (54% of respondents), passing out (23%), and memory loss (38%) after drinking.

When age, sex, ownership of alcohol-branded clothes/other merchandise, professed preference in alcohol brand, and food ad recognition/recall were controlled for in a regression analysis, increased alcohol ad recognition/recall was associated with higher drinking intensity and increased alcohol abuse.

"Something striking is going on here. Controlling for recall of fast food marketing, the results suggest that alcohol ad targeting is related to alcohol abuse in adolescents," Dr. Tanski told Medscape Medical News.

"Every day in the United States, approximately 4750 people under age 16 start drinking. Work documenting the role of alcohol marketing in young people's drinking is important because alcohol is the leading drug problem among young people, responsible for approximately 5000 deaths per year among persons under 21," David Jernigan, PhD, associate professor at Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and director of the Center on Alcohol Marketing and Youth, told Medscape Medical News.

Television networks are awash in alcohol ads, and although voluntary restrictions in the age of the target audience exist, how adolescents respond to alcohol ads targeted at an older audience has been unclear.

To specifically address this, the second study focused on the influence of television advertising of alcohol products on the brand preference and frequency of alcohol use in 2699 adolescents, aged 16 to 20 years, as part of a longitudinal study of media use by American youth. Every state in the country was represented.

About 64% of respondents had tried alcohol, and nearly 21% had binged in the preceding month. Of those who ever drank, 68.1% had a favorite brand. Of the list of 158 brands, distilled spirits were the choice of 53.2% (typically girls, whose preference was Smirnoff); beers were the choice of 42.4% (typically males, who preferred Budweiser).

Annual ad expenditures for 95 alcohol brands correlated with the selection of a brand; Spearman's correlation coefficient for this "brand signature" was 0.64 (P < .0001). Moreover, binge drinking in those who had a favorite brand ranged from 28% to 74% (by sex, 25.1% for females and 38.8% for males), compared with 11% in those with no professed brand preference.

"Our data suggest that alcohol ad campaigns influence the consumption of alcohol by adolescents at levels that are a risk to their present and future health," Dr. Tanski told Medscape Medical News.

"Other federally funded long-term studies have found that the more young people are exposed to alcohol marketing of various kinds, the more likely they are to drink or, if already drinking, to drink more. However, there has been very little published on the relationship between youth brand preference and drinking behavior. Since marketing is done by brand, this kind of work is crucial to understanding the role of marketing in youth drinking behavior," Dr. Jernigan told Medscape Medical News.

"There are no nationally representative long-term data on youth brand preference. Our center monitors youth exposure to alcohol marketing, and repeatedly identifies a small group of brands (between 5% and 8%) that are responsible for the majority of youth exposure. We (as well as the Institute of Medicine and, last week, a bipartisan group of 24 state attorneys general) have argued for stronger industry self-regulation to shield young people from the marketing. This youth brand preference data could make the case for more meaningful action stronger," Dr. Jernigan told Medscape Medical News.

Dr. Tanski and Dr. Jernigan have disclosed no relevant financial relationships.

Pediatric Academic Societies (PAS) and Asian Society for Pediatric Research 2011 Annual Meeting: Abstracts 2155.1 and 2155.2. Presented April 30, 2011.


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