THE MARKETING OF ALCOHOL David H Jernigan Ph

THE MARKETING OF ALCOHOL David H. Jernigan Ph. D Associate Professor Johns Hopkins Bloomberg School of Public Health and Director, Center on Alcohol Marketing and Youth

Acknowledgments • Michele Simon, J. D. , Research and Policy Director, The Marin Institute • Amanda Stewart, B. S. , M. P. H. student, Johns Hopkins Bloomberg School of Public Health

Alcohol marketing and NCDs • What is the connection? – Patterns of light to moderate drinking without heavy drinking occasions may be protective – Heavy drinking patterns (>50 g. /day for women, >60 g. /day for men) increase risk of a wide range of adverse health effects – Drinking patterns established early in life – Alcohol marketing most influential on young people

Youthful drinking and heavy drinking • Young people who begin drinking before age 15 are four times more likely to become alcohol dependent than those who wait until 21 (Grant and Dawson 1997) • Incidence of the onset of alcohol dependence peaks at age 18 – risk of dependence very low after age 25. (Li et al. 2004)

Adverse consequences of early onset • In the US, compared with persons who wait until age 21 to start drinking, young people who start drinking before age 15 are: – Four times more likely to develop alcohol dependence (Grant and Dawson 1997) – Six times more likely to be in a physical fight after drinking; – Greater than six times more likely to be in a motor vehicle crash because of drinking; – Almost five times more likely to suffer from other unintentional injuries after drinking (Hingson et al. 2009).

The public health interest • Strong public health interest in delaying onset of drinking as well as any binge occasions. • In the US, more than 90% of alcohol consumed by young people is drunk on binge occasions. • Exposure to alcohol marketing increases likelihood of early onset of drinking and, if already drinking, of heavier consumption. (Anderson et al. 2009)

Longitudinal studies connecting youth exposure to drinking • Television advertisements (Collins et al. 2007, Snyder et al. 2006, Stacy et al. 2004, Morganstern et al. 2011) • Alcohol ads in magazines (Collins et al. 2007, Snyder et al. 2006) • Alcohol ads on billboards (Snyder et al. 2006, Pasch et al. 2007) • In-store beer displays (Collins et al. 2007) • Beer concessions at sporting events (Collins et al. 2007) • Per capita spending on alcohol advertising in their media market (Snyder et al. 2006) • Alcohol use in movies (Sargent et al. 2006) • Ownership of alcohol promotional items (Mc. Clure et al. 2006, Henriksen et al. 2008)

Alcohol industry self-regulation Beer advertising and marketing materials should not…claim or represent that individuals cannot obtain social, professional, educational, athletic, or financial success or status without beer consumption.

Alcohol industry self-regulation • Beverage alcohol advertising and marketing materials should not be associated with anti-social or dangerous behavior.

What the Center on Alcohol Marketing and Youth (CAMY) does • Answers the question: how much alcohol advertising do kids see? • Tracks alcohol advertising on TV and radio and in magazines • Uses standard industry sources – Neilsen, Arbitron, etc. – to measure the audiences for that advertising. • Shows that over and over again, kids are exposed to more alcohol advertising person than adults.

Youth exposure to alcohol advertising: magazines In 2008, compared to adults 21 and over, youth ages 12 -20 saw per capita… • • • 10% more beer ads 16% more ads for alcopops 73% fewer wine ads The overwhelming majority of youth exposure – 78% came from ads placed in magazines with disproportionate youth audiences.

Youth Exposure to Alcohol Ads on U. S. Television • In 2009, 315, 581 alcohol product commercials appeared on U. S. television. • Underage youth ages 12 -20 were more likely than legalage adults on a per capita basis to have seen 67, 656 of them, or about 21%. • These ads accounted for more than 44% of youth exposure to alcohol advertising on television. • From 2001 to 2009 – the number of television alcohol ads seen by the average 12 to 20 year-old increased by 69%, from 217 per year to 366 per year.

Marketing alcohol to women • Girls much more overexposed than boys – Magazines, 2002: • Girls saw 68% more beer advertising, 95% more alcopops advertising per capita than women – Radio, 2009 • In five of 11 markets measured – Washington, Philadelphia, Houston, San Francisco, and Detroit – underage girls were more exposed to alcohol advertising than adult women, age 21 and above.

“Targeting” youth? • Cable television study: – Census of 608, 591 advertisements on cable television, 2001 to 2006 – each one-point increase in the percentage of the audience that was adolescent was associated with more beer (+7%), spirits (+15%), and alcopop (+22%) ads per viewerhour, but fewer wine (-8%) ads (P<. 001 for all). (Chung et al. , American Journal of Public Health, 2009)

Trends in alcohol marketing • New products • Digital marketing • Alcohol as a health food • Stakeholder marketing

“Alcopops” In Nova Scotia:

How popular are alcopops among kids? • Most popular with the youngest drinkers. • 78% of current 8 th grade drinkers (past 30 days) drank alcopops in the past 30 days. • 71% of current 10 th grade drinkers (past 30 days) drank alcopops in the past 30 days. • 65% of current 12 th grade drinkers (past 30 days) drank alcopops in the past 30 days. • 42% of current drinkers, age 19 to 30, drank alcopops in the past 30 days. Source: MTF 2004

Most popular with females in every age group • Teenage girls (33%) were more likely to prefer alcopops compared to teenage boys (27%) • Girls saw 95% more magazine advertising for alcopops than legal-age women (Arch Pediatr Adolesc Med 2004) • Exposure to girls of advertising for alcopops increased 216% from 2001 -2002

Alcoholic energy drinks Research findings on effects of alcoholic energy drinks on the drinker: • Subjective perceptions of intoxication decreased (i. e. headache, weakness, dry mouth, perception of impaired motor coordination) compared to effects of drinking alcoholic non-energy drink • However, according to objective tests, motor coordination and visual reaction time were still just as impaired. (ACER 30: 598 -605, 2006) • AED drinkers more likely to engage in dangerous activities

Alcoholic energy drinks • Caffeinated alcoholic beverages declared adulterated product by FDA in November 2010 – banned from the market by mid. December • Still available in Canada:

The Latest in Alcopops: High Alcohol Flavored Malt Beverages • “Binge in a can” – Same packaging as alcoholic energy drinks – Same huge serving size – 23. 5 ounces of 12% alcohol – Similar dangers to youth • Equivalent of 5 drinks, sold as single serving • Category grossed $959 million in 2010 (WSJ)

New products: Nova Scotia • Alcoholic chocolate milk…

New products: alcoholic whipped cream • “Whipahol”, “Whipped Lightning”, “Get Whipped” • One can has alcohol content of 3 beers (18. 5% alcohol) • Flavors like white chocolate raspberry and strawberry colada