Adolescent Drinking : The Role of Advertising

by National Institute of Health

(Page 2 of 3)

Youth are exposed to a significant amount of alcohol advertising. Alcohol ads appear in virtually all types of media. Such ads are common on television and often are presented in ways that appeal to youth and are shown at times when many youth are likely to see them. Half of televised beer ads, for example, air during Saturday or Sunday afternoon sporting events - programs that are popular among youth. Beer is the beverage of choice for many youth, and between 1998 and 2002, industry spending on televised beer ads increased 45 percent to $972 million. Over the same period, spending on liquor advertising increased 530 percent to $18 million. Youth also routinely see ads for alcoholic beverages in magazines, on billboards, and on the Internet. For example, the Center on Alcohol Marketing and Youth found that youth saw 49 percent more beer ads and 20 percent more distilled spirits ads than did adults. CAMY researchers also reported that 12- to 17-year-olds hear more alcohol ads on the radio than do adults. Radio alcohol ads were frequently placed on stations with youth formats and were aired when youth were most likely to be listening. A study of Internet use by youth found that alcohol-related Web sites contained features appealing to youth, such as video games and cartoons, but had few effective mechanisms to keep underage youth from accessing the Web sites.

Scientists are trying to determine how advertising affects youth generally and underage alcohol consumption more specifically. A simple model of the effects of alcohol advertising would posit that greater amounts of advertising lead to more exposure to advertising, which leads to more drinking. Thus, much of the research in this area has been focused on explicating part or all of this sequence by: quantifying the number of alcohol portrayals in various media (including advertising); estimating exposure to advertising in various populations; studying whether exposed populations recall and are aware of alcohol advertising; examining how awareness affects alcohol expectancies and intention to drink; studying cross-sectionally the association between advertising and alcohol outcomes; and studying prospectively the causal relationships among advertising variables and drinking outcomes, such as initiation, escalation, and levels and frequency of consumption. Among these, the longitudinal studies are of greatest interest because they have the potential to address the fundamental questions of cause and effect.

Assessing the effect of advertisements on the drinking behavior of individuals or populations is a complicated endeavor. It often is difficult to ascertain the specific effects of advertising because they must be measured against a background dense in alcohol messages and images. In addition, advertisements or alcohol-related messages will influence different individuals and different populations differently at different developmental stages and times in their lives. And furthermore, the mechanisms by which advertising may affect actual drinking behavior have not been extensively studied and are not well understood.

One line of research in this area has directly studied young people's reactions to alcohol advertisements and the correlates of those reactions. A study of third, sixth, and ninth graders showed that the third grade children who found alcohol ads desirable also were more likely to see positive benefits from drinking and to desire products with alcohol logos. Older children in the study who found the ads and logo products appealing were more likely to already be engaged in drinking behaviors. A related survey of 9th and 12th grade students examined the effect of media exposure on drinking behavior. Students reported on their television viewing habits, viewing perceptions, desire for alcohol products, and alcohol use. Findings supported a positive and indirect effect of media on adolescent drinking. The media influence beliefs about the appeal and desirability of alcohol, and the beliefs in turn influence drinking.

Another study examined brain response to viewing alcoholic beverage pictures and nonalcoholic beverage pictures in 15- to 17-year-old heavy drinkers and nondrinkers using functional magnetic resonance imaging. Heavy-drinking teens showed substantially greater brain activation while viewing the alcohol ads relative to the nonalcohol ads, and this pattern differed significantly from that of nondrinkers. Brain regions showing differential brain response suggested that heavy-drinking teens attended more closely, recalled pleasure and positive affect, and generated increased appetitive response while viewing an assortment of alcohol advertisements. On the other hand, Zogg and colleagues, in an expectancy study of perceived positive and negative outcomes of alcohol use, found no predictive effects of exposure to televised alcohol advertisements, televised sports, or firsthand observation of others drinking.

Image advertising, which focuses on the lifestyle of the product user rather than the product itself, is preferred by underage youth (seventh grade) and has been associated with intentions to drink in the future. A study involving male and female Anglo and Latino adolescents found that, both for males and females, positive responses to beer advertisements were associated with greater present and planned alcohol use. No differences were found related to ethnicity. Another study conducted focus group discussions with students ages 9 to 15 to learn what aspects of television alcohol advertisements made them attractive to young people. The students responded positively to ads with humor, talking animals, and youthful lifestyle appeal and negatively to the product focus of the ads.

Although they are informative and interesting, these studies do not address the question of causality: Do alcohol advertisements cause youth to drink, or do youth who already drink pay more attention to alcohol advertising?

Two recent cross-sectional studies found positive associations between advertising and consumption. Collins and colleagues measured advertisement awareness, drinking beliefs, and drinking behavior among eighth grade students. These researchers found that boys are more likely to be aware of and remember beer marketing and may be more likely to drink as a result of this awareness.

Another study examined whether recall of and liking of alcohol advertisements leads to greater intentions to drink in the future and higher consumption of alcohol. This study sampled students in grades 5 to 8 and grades 9 to 11 and measured their response to 16 alcohol ads and 4 soft drink ads. The study found that liking specific elements of alcohol ads (characters, humor, story line) predicted liking the advertisements, and that liking the advertising directly predicted current drinking levels and had significant indirect effects on drinking and future intentions to drink. Results of earlier studies that examined the relationship between liking alcohol advertising and current and future intentions to drink, however, were mixed.

A few prospective studies also have addressed this issue. A longitudinal study of New Zealand youth found that liking alcohol advertising at age 18 was related to higher levels of beer consumption at age 21. Two additional recent prospective studies found a positive relationship between exposure to advertising and consumption. Ellickson and colleagues found in a sample of seventh grade drinkers and nondrinkers from North Dakota that several forms of advertising predicted future adolescent drinking for both groups. And Stacy and colleagues found that exposure to advertising increased the risk of subsequent beer consumption.

Another group of potentially informative investigations are econometric studies of the relationship between alcohol advertising and consumption. Results of these studies also have been mixed. A study by Saffer found that advertising increased consumption, whereas other studies found that alcohol advertising affects brand choice but not overall consumption. Another study by Saffer and Dhaval suggests that a complete ban on alcohol advertising might reduce the prevalence of monthly drinking by 12- to 18-year-olds from about 25 percent to 21 percent and of binge drinking from 12 percent to 7 percent. Despite their potential effectiveness for reducing underage drinking, comprehensive advertising bans are not likely to receive public support, and partial bans are likely to prompt the alcohol industry to increase their ads in other media.

In general, research on the impact of alcohol advertising on actual drinking behavior has been mixed, and observed effects have been small. In addition, many of the cited studies are subject to recall bias. Furthermore, many studies have been cross-sectional, making it difficult to draw definitive conclusions about the relationship between advertising and alcohol consumption.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.