Aims: To assess the impact of alcohol advertising and media exposure on future adolescent alcohol use. Methods: We searched MEDLINE, the Cochrane Library, Sociological Abstracts, and PsycLIT, from 1990 to September 2008, supplemented with searches of Google scholar, hand searches of key journals and reference lists of identified papers and key publications for more recent publications. We selected longitudinal studies that assessed individuals' exposure to commercial communications and media and alcohol drinking behaviour at baseline, and assessed alcohol drinking behaviour at follow-up. Participants were adolescents aged 18 years or younger or below the legal drinking age of the country of origin of the study, whichever was the higher. Results: Thirteen longitudinal studies that followed up a total of over 38,000 young people met inclusion criteria. The studies measured exposure to advertising and promotion in a variety of ways, including estimates of the volume of media and advertising exposure, ownership of branded merchandise, recall and receptivity, and one study on expenditure on advertisements. Follow-up ranged from 8 to 96 months. One study reported outcomes at multiple time-points, 3, 5, and 8 years. Seven studies provided data on initiation of alcohol use amongst non-drinkers, three studies on maintenance and frequency of drinking amongst baseline drinkers, and seven studies on alcohol use of the total sample of non-drinkers and drinkers at baseline. Twelve of the thirteen studies concluded an impact of exposure on subsequent alcohol use, including initiation of drinking and heavier drinking amongst existing drinkers, with a dose response relationship in all studies that reported such exposure and analysis. There was variation in the strength of association, and the degree to which potential confounders were controlled for. The thirteenth study, which tested the impact of outdoor advertising placed near schools failed to detect an impact on alcohol use, but found an impact on intentions to use. Conclusions: Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.

Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies

The effect of alcohol portrayals and advertising on the drinking behaviour of young people is a matter of much debate. We evaluated the relationship between exposure to alcohol advertising, marketing and portrayal on subsequent drinking behaviour in young people by systematic review of cohort (longitudinal) studies. studies were identified in October 2006 by searches of electronic databases, with no date restriction, supplemented with hand searches of reference lists of retrieved articles. Cohort studies that evaluated exposure to advertising or marketing or alcohol portrayals and drinking at baseline and assessed drinking behaviour at follow-up in young people were selected and reviewed. seven cohort studies that followed up more than 13,000 young people aged 10 to 26 years old were reviewed. The studies evaluated a range of different alcohol advertisement and marketing exposures including print and broadcast media. Two studies measured the hours of TV and music video viewing. All measured drinking behaviour using a variety of outcome measures. Two studies evaluated drinkers and non-drinkers separately. Baseline non-drinkers were significantly more likely to have become a drinker at follow-up with greater exposure to alcohol advertisements. There was little difference in drinking frequency at follow-up in baseline drinkers. In studies that included drinkers and non-drinkers, increased exposure at baseline led to significant increased risk of drinking at follow-up. The strength of the relationship varied between studies but effect sizes were generally modest. All studies controlled for age and gender, however potential confounding factors adjusted for in analyses varied from study to study. Important risk factors such as peer drinking and parental attitudes and behaviour were not adequately accounted for in some studies. data from prospective cohort studies suggest there is an association between exposure to alcohol advertising or promotional activity and subsequent alcohol consumption in young people. Inferences about the modest effect sizes found are limited by the potential influence of residual or unmeasured confounding.

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The effect of alcohol advertising, marketing and portrayal on drinking behaviour in young people: systematic review of prospective cohort studies.

Physical punishment/maltreatment during childhood and adjustment in young adulthood

The factors associated with adolescent resiliency to childhood adversity were examined in a birth cohort of 940 New Zealand adolescents studied to the age of 16 years. Resilient teenagers were defined by: (a) high exposure to family adversity during childhood and (b) an absence of a wide range of externalising problems during adolescence including substance abuse, juvenile offending and school problems. Resilient teenagers were characterised by significantly higher IQ (p < .001), lower novelty seeking (p < .01) and lower affiliations with delinquent peers (p < .005) with these factors acting accumulatively to influence the probability of resilience to externalising problems.

Adolescent Resiliency to Family Adversity

Background: Cue reactivity studies in alcoholdependent adults have shown atypical physiological, cognitive, and neural responses to alcohol-related stimuli that differ from the responses of light drinkers. Cue reactivity and its neural substrates are unclear in youth. We hypothesized that teens with alcohol use disorder would show greater brain response than nonabusing teens to alcohol images relative to neutral beverage images in limbic and frontal brain regions. Methods: We tested the hypotheses in a crosssectional functional magnetic resonance imaging study. Adolescents aged 14 to 17 were recruited from local high schools. Teens with alcohol use disorders (n=15) and demographically similar infrequent drinkers (n=15) met strict exclusion criteria (no left-handedness or neurological, other psychiatric, or other substance use disorders). Diagnoses were determined by means of structured and semistructured clinical interviews. Subjects were shown pictures of alcoholic and nonalcoholic beverage advertisements during blood oxygen level– dependent functional magnetic resonance imaging. Selfreports of craving were obtained before and after cue exposure. Results: Teens with alcohol use disorders showed substantially greater brain activation to alcoholic beverage pictures than control youths, predominantly in the left anterior, limbic, and visual system areas (P.05; cluster threshold, 515 µL). The degree of brain response to the alcohol pictures was highest in youths who consumed more drinks per month and reported greater desires to drink. Conclusions: These results confirm previous studies by demonstrating an association between the urge to drink alcohol and blood oxygen use in areas of the brain previously linked to reward, desire, positive affect, and episodic recall. This study extends this relationship to adolescents with relatively brief drinking histories using visual alcohol stimuli, and suggests a neural basis for response to alcohol advertisements in youths with drinking problems.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/207629/yoa20745.pdf

Neural response to alcohol stimuli in adolescents with alcohol use disorder.

Data from a longitudinal study carried out in Dunedin, New Zealand, were used to investigate associations between alcohol consumption at age 18 years and alcohol-related mass media communications recalled at ages 13 and 15 years. The respondents' recall of alcohol-related mass media material were categorized as: commercial alcohol advertising, alcohol moderation messages or the portrayal of alcohol in entertainment. An additional media variable was the number of hours spent watching television. Non-media variables, such as peer approval of drinking, living situation and occupation (all at age 18 years) were also included in the analyses. The period between the interviews at ages 13 and 15 years saw an increase in the broadcast of commercial alcohol advertisements on television in New Zealand and this was reflected in an increase in the proportion of the mass media material recalled which was categorized as commercial advertising. At age 15 years television advertising, mostly for beer companies, was the predominant material recalled. No relationships were found between the commercial advertising and wine and spirits consumption, among either men or women, but young women who had watched more hours of television drank more wine/spirits. Among women there were two unexpected negative relationships between recall of alcohol in the media at age 13 years and beer consumption. However, among men there was a consistent positive relationship such that those who had recalled more alcohol advertisements at age 15 years drank larger quantities of beer at age 18 years.

Alcohol in the mass media and drinking by adolescents: a longitudinal study.

A longitudinal study assessed the use of alcohol and related measures among New Zealand children aged 9, 11, 13 and 15 years. The proportion of children who were abstainers was at a similar level to the adult population by age 15 years. Those remaining abstainers were more likely to have infrequently drinking parents and to have been warned of the bad effects of alcohol by their parents. In terms of amount consumed and frequency of drinking, there was an increase with age and a marked increase between the ages of 13 and 15 years. Frequency of drinking was positively associated with the frequency of drinking by the mother and father. Girls drank less than boys until the age of 15 years, when they drank slightly more and a difference in terms of socio-economic status (SES) emerged at age 15 years with lower SES groups drinking more. Language: en

A longitudinal study of New Zealand children's experience with alcohol.

This study investigated the influence of the situational characteristics of the drinking setting and a number of parental, personal and demographic variables on adolescents' alcohol use. The sample were 15-year-old participants in a multidisciplinary longitudinal study carried out in New Zealand. Measures of alcohol consumption were self reported amount of alcohol consumed on the most recent drinking occasion and amount usually consumed. All of the situational variables investigated had an effect on the amount of alcohol consumed on the most recent occasion. Greater amounts of alcohol were consumed if the alcohol was obtained from peers or by the 15-year-olds themselves, if the drink was consumed away from their own home, in the presence of peers only, and during the evening. More money to spend each week and lower SES were also associated with reports of greater alcohol consumption on the most recent drinking occasion. Adolescents with female friends who approved of drinking reported greater amounts of alcohol, the effect of female friends was most marked in the lower amounts reported by males who had female friends that disapproved of drinking. For amount of alcohol usually consumed, reports of larger amounts of alcohol were associated with more money available to spend each week and with lower SES. Furthermore, both males and females reported greater usual amounts if their male friends approved of drinking; female friends' approval was associated with greater amounts of alcohol usually being consumed, this effect was strongest for males. Sixty-eight per cent of the 15-year-olds indicated that they thought they definitely or probably would get drunk in the future.

Drinking context and other influences on the drinking of 15-year-old New Zealanders.

Associations between parents' alcohol problems when children were aged 9 and children's behaviour at ages 9 and 13 as reported by parents and teachers were investigated. The sample consisted of participants in a multidisciplinary longitudinal study, data were collected by face-to-face interview. When compared to children with no or mild parental alcohol problems, children classified as having severe parental alcohol problems were more likely to display high levels of problem behaviour at age 9 as reported by teachers and at age 13 as reported by parents. Poorer family relationships, lower verbal and reading proficiency and being male were also associated with high levels of behaviour problems.

The effect of parents' alcohol problems on children's behaviour as reported by parents and by teachers.

http://psycnet.apa.org/journals/xlm/15/6/1175.pdf

Gary M. Connolly

Papers

Alcohol in the mass media and drinking by adolescents: a longitudinal study.

A longitudinal study of New Zealand children's experience with alcohol.

Drinking context and other influences on the drinking of 15-year-old New Zealanders.

The effect of parents' alcohol problems on children's behaviour as reported by parents and by teachers.

Memory scanning: are fixed and varied sets scanned concurrently or successively?