The marketing of alcoholic beverages is one cause of underage drinking, according to new research in the Journal of Studies on Alcohol and Drugs. Because of this, countries should abandon what are often piecemeal and voluntary codes to restrict alcohol marketing and construct laws designed to limit marketing exposure and message appeal to youth, according to public health experts.

These conclusions stem from a series of eight review articles published as a supplement to JSAD, which synthesised the results of 163 studies on alcohol advertising and youth consumption.

“There is persuasive evidence that exposure to alcohol marketing is one cause of drinking onset during adolescence and also one cause of binge drinking,” writes James D Sargent, MD, of the C Everett Koop Institute at Dartmouth, and Thomas F Babor, PhD, MPH, of the University of Connecticut, in a conclusion to the supplement.

Each of the eight review articles in the supplement evaluated a different aspect of alcohol marketing and drinking among young people. The reviews looked at hundreds of studies that used different research designs and measurement techniques, and the data came from a variety of countries and scientific disciplines.

The authors of the reviews used the Bradford Hill criteria – a well-known framework for determining causal links between environmental exposures and disease – to determine whether marketing is a cause of youth alcohol use. The criteria involve determining such aspects as the strength of the association, the consistency of the link, the timing of the exposure with the outcome, and biological and psychological plausibility.

Each of the criteria were met within the eight reviews, supporting a modest but meaningful association between advertising and youth drinking.

Although such a relationship had been previously known, this is the first time any public health expert has explicitly concluded that advertising causes drinking amongst adolescents. As a result, the authors recommend the following:

  • Government agencies – independent from the alcohol industry – should restrict alcohol marketing exposures in the adolescent population.
  • The Centers for Disease Control and Prevention or the Office of the Surgeon General should sponsor a series of reports on alcohol and health, similar to the ones that have been published on tobacco.
  • The US National Institute on Alcohol Abuse and Alcoholism should resurrect its programme to fund research on alcohol marketing and vulnerable populations.
  • A larger international panel of public health experts should be convened in order to reach a broader consensus, particularly in relation to digital marketing.

Sargent and Babor expressed the hope that the findings will promote “thoughtful discourse amongst researchers, effective prevention measures amongst policymakers, and an effort to reach consensus on this issue amongst a larger and more representative body of scientists.”

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