Does Industry-Driven Alcohol Marketing Influence Adolescent Drinking Behaviour? A Systematic Review

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Abstract

Aim

To systematically review evidence on the influence of specific marketing components (Price, Promotion, Product attributes and Place of sale/availability) on key drinking outcomes (initiation, continuation, frequency and intensity) in young people aged 9–17.

Methods

MEDLINE, EMBASE, SCOPUS, PsychINFO, CINAHL and ProQuest were searched from inception to July 2015, supplemented with searches of Google Scholar, hand searches of key journals and backward and forward citation searches of reference lists of identified papers.

Results

Forty-eight papers covering 35 unique studies met inclusion criteria. Authors tended to report that greater exposure to alcohol marketing impacted on drinking initiation, continuation, frequency and intensity during adolescence. Nevertheless, 23 (66%) studies reported null results or negative associations, often in combination with positive associations, resulting in mixed findings within and across studies. Heterogeneity in study design, content and outcomes prevented estimation of effect sizes or exploration of variation between countries or age subgroups. The strength of the evidence base differed according to type of marketing exposure and drinking outcome studied, with support for an association between alcohol promotion (mainly advertising) and drinking outcomes in adolescence, whilst only two studies examined the relationship between alcohol price and the drinking behaviour of those under the age of 18.

Conclusion

Despite the volume of work, evidence is inconclusive in all four areas of marketing but strongest for promotional activity. Future research with standardized measures is needed to build on this work and better inform interventions and policy responses.

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Most cited references 61

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Global burden of disease in young people aged 10-24 years: a systematic analysis.

Fiona M Gore, Paul J N Bloem, George C Patton … (2011)

Young people aged 10-24 years represent 27% of the world's population. Although important health problems and risk factors for disease in later life emerge in these years, the contribution to the global burden of disease is unknown. We describe the global burden of disease arising in young people and the contribution of risk factors to that burden. We used data from WHO's 2004 Global Burden of Disease study. Cause-specific disability-adjusted life-years (DALYs) for young people aged 10-24 years were estimated by WHO region on the basis of available data for incidence, prevalence, severity, and mortality. WHO member states were classified into low-income, middle-income, and high-income countries, and into WHO regions. We estimated DALYs attributable to specific global health risk factors using the comparative risk assessment method. DALYs were divided into years of life lost because of premature mortality (YLLs) and years lost because of disability (YLDs), and are presented for regions by sex and by 5-year age groups. The total number of incident DALYs in those aged 10-24 years was about 236 million, representing 15·5% of total DALYs for all age groups. Africa had the highest rate of DALYs for this age group, which was 2·5 times greater than in high-income countries (208 vs 82 DALYs per 1000 population). Across regions, DALY rates were 12% higher in girls than in boys between 15 and 19 years (137 vs 153). Worldwide, the three main causes of YLDs for 10-24-year-olds were neuropsychiatric disorders (45%), unintentional injuries (12%), and infectious and parasitic diseases (10%). The main risk factors for incident DALYs in 10-24-year-olds were alcohol (7% of DALYs), unsafe sex (4%), iron deficiency (3%), lack of contraception (2%), and illicit drug use (2%). The health of young people has been largely neglected in global public health because this age group is perceived as healthy. However, opportunities for prevention of disease and injury in this age group are not fully exploited. The findings from this study suggest that adolescent health would benefit from increased public health attention. None. Copyright © 2011 Elsevier Ltd. All rights reserved.

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Relationship between body image disturbance and incidence of depression: the SUN prospective cohort

Adriano Pimenta, Almudena Sánchez-Villegas, Maira Bes-Rastrollo … (2009)

Background Body image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, body dysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression. Methods This study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates, who were followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models. Results The cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI. Conclusion We found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain.

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Health lifestyle theory and the convergence of agency and structure.

William Cockerham (2005)

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.

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Author and article information

Journal

Journal ID (nlm-ta): Alcohol Alcohol

Journal ID (iso-abbrev): Alcohol Alcohol

Journal ID (publisher-id): alcalc

Journal ID (hwp): alcalc

Title: Alcohol and Alcoholism (Oxford, Oxfordshire)

Publisher: Oxford University Press

ISSN (Print): 0735-0414

ISSN (Electronic): 1464-3502

Publication date (Print): January 2017

Publication date (Electronic): 20 December 2016

Publication date PMC-release: 20 December 2016

Volume: 52

Issue: 1

Pages: 84-94

Affiliations

[1 ]Institute of Health & Society, Baddiley-Clark Building, Newcastle University , Richardson Road, Newcastle upon Tyne NE2 4AX, UK

[2 ]Health and Social Care Institute, Parkside West Offices, Teesside University , Middlesbrough, Tees ValleyTS1 3BA, UK

[3 ]Centre for Early Child Development, NSPCC, Number One, Bickerstaffe Square, Blackpool FY1 3AH, UK

Author notes

[*Corresponding author ]: Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne NE2 4AX, UK. Tel.: +44 (0)191 208 7734; Fax: +44 (0)191 208 6043; E-mail: steph.scott@ 123456ncl.ac.uk

Article

Publisher ID: agw085

DOI: 10.1093/alcalc/agw085

PMC ID: 5169036

PubMed ID: 27864186

SO-VID: 00cb8764-dda3-4b6a-8178-a3fec5f528de

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 18 May 2016

Date revision received : 19 October 2016

Date accepted : 26 October 2016

Funding

Funded by: Economic and Social Research Council (ESRC);

Award ID: UKCRC, Res 590-25-0004

Funded by: National Institute for Health Research (NIHR)’s School for Public Health Research (SPHR);

Does Industry-Driven Alcohol Marketing Influence Adolescent Drinking Behaviour? A Systematic Review

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Most cited references 61

Global burden of disease in young people aged 10-24 years: a systematic analysis.

Relationship between body image disturbance and incidence of depression: the SUN prospective cohort

Health lifestyle theory and the convergence of agency and structure.

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