Alcohol marketing and underage drinking: Which subgroups are most susceptible to alcohol advertisements? (2019)

OBJECTIVES: The aim of this study was as follows: (a) to study the relation between alcohol advertisement exposure and the initiation of (binge) alcohol drinking among secondary school students, and (b) to identify subgroups of students that may be more vulnerable for the influence of alcohol marketing than others.
METHODS: A longitudinal survey was conducted with three waves (12- and 24-month interval). Eight secondary schools of various school levels in the Netherlands participated. Participants included 942 second grade students, average age 13.2 years, 46.0% boys. Exposure to alcohol and non-alcohol advertisements was measured at baseline with images of 16 commercial advertisements with all brand information removed. Students were asked to indicate contact frequency and recall brand names. Outcome measure was initiation of (binge) alcohol drinking between baseline and 12- and 24-month follow-up.
RESULTS: The results showed small but statistically significant associations between alcohol advertisement exposure and both drinking and binge drinking initiation over a 12-month interval. Over a 24-month interval, a statistically significant association was only found for initiation of binge drinking. The association was stronger for students from the lowest school level.
CONCLUSION: The study confirms previous longitudinal studies demonstrating an association between exposure to alcohol marketing and initiation of (binge) drinking among adolescents. This association is moderated by school level. Students from the lower school levels may therefore be the most appropriate target group for selective prevention efforts and should be taken particularly into account when formulating policies to reduce and prevent underage drinking.