Does alcohol marketing influence alcohol consumption?

Today BMC Public Health publishes an article investigating the effect alcohol advertisements have on consumption in young people. Co-author Kaidy Stautz explains more about what they found in this blog.

For governments considering how to reduce excessive alcohol consumption and its related harms, restricting or banning alcohol marketing seems a relatively good policy option – low in cost, easy to implement, and higher in public acceptability than alternatives.

In recent years, the governments of France, Russia, and Turkey have implemented restrictions, whilst Ireland’s is among those considering them. Such policies rest on the assumption that exposure to alcohol marketing influences people to drink more, and that reducing this exposure would therefore lead to people drinking less. There is disagreement as to whether this is an accurate assumption.

The position of the alcohol industry, which spends an estimated £800 million per year on marketing in the UK and over $2 billion in the USA, is that marketing does not influence consumption levels at all. Rather, marketing is designed only to encourage selection of certain brands over others. Industry representatives state that restrictions to marketing would therefore be ineffective in reducing excessive alcohol consumption.

The public health consensus is that alcohol marketing does influence alcohol consumption, particularly among young people.

The public health consensus is that alcohol marketing does influence alcohol consumption, particularly among young people. This is informed by systematic reviews of studies that have investigated marketing exposure and alcohol use over time in adolescent and young adult samples. These studies consistently show that the more young people are exposed to alcohol marketing the earlier they start to drink and the more they drink.

The UK government’s perspective is that alcohol marketing targeting young people should be restricted by the industry’s self-regulatory body, but that current evidence on alcohol marketing’s effects on consumption is not sufficient to warrant a ban. In particular, evidence of a causal impact of alcohol marketing on alcohol consumption is lacking.

To address this issue, experimental studies in which individuals are randomly assigned to view either alcohol marketing or a control stimulus before having their alcohol consumption measured would be useful.

What did we do?

Fortunately, a number of such studies have been conducted. In a systematic review of these studies, conducted at the Behaviour and Health Research Unit and published today in BMC Public Health, we combined all available data from randomized, experimental studies examining the effect of alcohol marketing communications and media portrayals of alcohol use on objectively measured alcohol consumption.

We identified seven studies that examined whether participants exposed to alcohol advertising drank more alcohol after viewing than those who viewed advertising for non-alcohol products.

We identified seven studies that examined whether participants exposed to alcohol advertising drank more alcohol after viewing than those who viewed advertising for non-alcohol products. All of these studies were conducted with undergraduate student samples, mostly in North America or in the Netherlands.

What did we find?

Combining the data from these studies, we found that those who viewed alcohol adverts drank more alcohol than those who viewed non-alcohol adverts. In terms of typical alcohol consumption by adult drinkers in the UK, this increase is equivalent to about half a pint of beer (between 0.39 and 2.67 more alcohol units) for males and half a small glass of wine (between 0.25 and 1.69 more units) for females on the heaviest drinking day of the week.

Our review did not find that viewing characters drinking alcohol in TV programmes or films increased alcohol consumption. We did not identify any eligible studies that examined marketing channels other than video advertising and media portrayals.

Given that alcohol companies now allocate a large proportion of their marketing budgets to online and social media, we would hope that high quality studies into the effects of marketing via these channels are now beginning to be conducted.

Our findings regarding the impact of alcohol advertising on consumption are broadly consistent with those of previous reviews

Our findings regarding the impact of alcohol advertising on consumption are broadly consistent with those of previous reviews, and show that the effects of alcohol marketing on consumption are not limited to those under the legal drinking age.

Whilst previous investigations focused on long-term effects, we have shown that advertising may also influence consumption after just a one-off exposure. If such effects are sustained with repeated exposures, this could have a meaningful impact on population level consumption. We suggest that short-term and long-term effects are likely to be related, with small immediate effects cumulating to influence more general alcohol use habits over time.

Future alcohol marketing research

Our results are certainly limited by the primary study samples being made up solely of students, who may not be representative of the wider population. Also, our focus on immediate effects of marketing exposure meant that we could not examine the more insidious effects of alcohol marketing, such as how it might increasingly link alcohol use with an ever broader range of emotions, experiences, and contexts for drinking, or how an environment saturated with alcohol marketing might make it difficult for heavy drinkers to reduce their consumption.

A key outstanding question is whether drinking behavior would change in response to the removal of alcohol marketing, and if so how long this would take to occur.

A key outstanding question is whether drinking behavior would change in response to the removal of alcohol marketing, and if so how long this would take to occur. Evidence on the effectiveness of alcohol advertising restrictions is not yet developed enough to answer this question, though in coming years we hope to see new information from countries that have recently enacted bans.

In the meantime, our review adds support to the case for restricting alcohol marketing to reduce population alcohol consumption, and shows that the assumption that alcohol marketing influences alcohol consumption may well be an accurate one.

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