Orratai Waleewong

1
The Impact of Alcohol AdvertisingYoung People
Commercial Communications
E L S A project report on the evidence
to strengthen
regulation to protect young people
Peter Anderson on behalf of the National
Foundation for Alcohol Prevention, the
Netherlands and the ELSA project 2005-2007

• Orratai Waleewong
• (IHPP)
• International Health Policy Program
• Ministry of Public Health, Thailand

7-Nov-09
2

• The ELSA Project
• (Enforcement of National Laws and Self-regulation
  in Advertising Marketing of Alcohol)
• Period 2005 2007, Participants 23 Member
  States and Norway
• Funded by EU (the European Commission)
  Partnership of STAP with Actis and Alkokutt
  (Norway)
• Assess and report on the enforcement of national
  laws and self-regulations on the advertising and
  marketing of alcoholic beverages in EU member
  states, the applicant countries and Norway.

3
Deliverables of ELSA 1.Training Manual
Description method used in ELSA, use for
follow-up studies 2. Report on Regulations
Overview existing national regulations on alcohol
marketing in Europe, level of integrating EU,
recommendations in national regulations, overview
existing procedures in European countries 3.
Report on Adherence Collecting existing
documents written between 2000-2005 on the
adherence efficiency to national
regulations. 4. Report on Impact Overview of
findings in scientific studies on the effects of
alcohol advertising and marketing. 5. Appealing
Alcohol Beverages and Marketing Practices in
Europe Overview of most appealing alcoholic
beverages alcohol advertisements among minors
in Europe 6. Report with Conclusions Summary of
main findings of other deliverables, Policy
recommendations
4
Commercial communication

• This vulnerability is exacerbated by the enormous
  exposure to commercial communications
• All type of media are used for commercial
  communication
• Television
• Music music videos
• Films
• Paid placements in films, TV shows, books
  videogame
• The internet gtgtincreasing difficult to regulate
• Grass roots word of mouths (viral marketing
  technique)
• Sports sponsorship
• In USA, mostly targeted to young people.

5

• In USA, mostly commercial communications targeted
  to young people.

Advertisement rate ratio
6
Young people are vulnerable to alcohol advertising
View of the neuroscience, psychology and
marketing.

• The adolescent brain undergoes major development
  gtgtmakes adolescents more vulnerable to
  impulsivity with greater sensitivity to pleasure
  and reward.

• - Adolescents are more impulsive and
  self-conscious than adults.
• The adolescent brain's plasticity makes it more
  vulnerable to harm. Thus, there is emerging
  justification for restricting adolescents'
  exposure to advertising and promotions for
  high-risk, addictive products, especially if
  impulsive behaviors or image benefits are
  depicted.

- Adolescents, because of how the human brain
develops, may be particularly attracted to
branded products such as alcohol that are
associated with risky behavior and that provide,
in their view, immediate gratification, thrills
and/or social status.
7

• Adolescents have 3 distinctive vulnerabilities
  (Pechmann et al.2005)
• Impulsivity, linked to a temporal gap between
  the onset of hormonal and environmental stimuli
  into the amygdala and the more gradual
  development of inhibitory control through
• the executive planning and decision-making
  functions of the pre-frontal cortex
• Self-consciousness Self-doubt, attributable at
  least in part to the emergence of abstract
  thinking, but evident in the greater frequency
  and intensity of negative mood states during
  adolescence
• Elevated risk from product use, including
  impulsive behaviour such as drinking and driving,
  but also greater susceptibility
• to toxins because of the plasticity of the
  developing brain as well as greater sensitivity
  to the brains stamping functions identifying
  pleasure and reward

8
Neural response to alcohol stimuli in
adolescents with alcohol use disorder.
( Tapert et al.2003)

• BACKGROUND
• Cue reactivity studies in alcohol-dependent
  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.
• Hypothesis
• 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.

9
Neural response to alcohol stimuli in
adolescents with alcohol use disorder.
( Tapert et al.2003)

• METHODS
• Cross-sectional functional magnetic resonance
  imaging study.
• Adolescents aged 14 -17, local high schools.
• Teens with alcohol use disorders (n 15)
  demographically similar infrequent drinkers (
  control group n 15)
• Strict exclusion criteria (no left-handedness
  or neurological, other psychiatric, or other
  substance use disorders).
• Diagnosed 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.
• Self-reports of craving were obtained before and
  after cue exposure.

10
Cross-sectional functional magnetic resonance
imaging
Teens with alcohol use disorders showed
substantially greater brain activation to
alcoholic beverage pictures than control youths,
predominantly in the brain areas linked to
reward, desire , positive affect and episodic
recall.(left anterior, limbic, and visual system
areas)
11
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.
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.
12
Young people are vulnerable to alcohol advertising

• Alcohol advertising manipulates adolescents
  vulnerability by shaping their attitudes,
  perceptions and particularly expectancies about
  alcohol use, which then influence youth decision
  to drink.
• (Grube and Waiters 2005)

13
Young people are vulnerable to alcohol advertising

• There seems to be a cognitive progression from
  liking of alcohol advertisements
• (an affective response associated with the
  desirability of portrayals in the advertisements
  and a resulting identification with characters in
  the advertisements)
• to positive expectancies about alcohol use,
  to intentions to drink or
  actual drinking among young people.
• (Austin and Knaus 2000 Austin et al. 2000)

14
Alcohol advertising are related to young
peoples expectancies about alcohol and their
desire to consume alcohol.

• Enormous wealth of evidence that
• Alcohol ad
• gtgtrelated to positive attitudes belief about
  alcohol among young people.
• The content of advertisements
• gtgtrelated to expectancies about use of alcohol
  among young people and the role of alcohol in
  their lives.

15
Alcohol advertisements (volume and exposure)
increase the likelihood of young people starting
to drink, the amount they drink, and the amount
they drink on any one occasion.

• Similar to the impact of advertising on smoking
  and eating behavior.

Although causal effects are uncertain,
we can see that the joint effect of exposure from
different types of marketing practices is
strongly associated with drinking behaviour and
intentions to drink. (exposure beer ads on tv,
alcohol advertising in magazines, radio
listening, exposure to beer concessions, exposure
to in-store beer displays, promotional
items) (Collins et al. 2007 US)
16
8 Results of (good quality) longitudinal studies
on impact of media and advertising exposure on
alcohol use youth drinking behaviour

• Robinson et al (1998) follow up 18 months
• Each 1-hour increase in television viewing
  gtgtassociated with a 9 increased risk for
  initiating drinking.
• Each 1-hour increase in watching music videos
  associated with a 31 increased risk for
  initiating drinking.

• Wingood et al (2003) follow up 12 months
• High exposure to rap music leads to 1.5 times
  greater likelihood to use alcohol compared with
  low exposure.

17
8 Results of (good quality) longitudinal studies
on impact of media and advertising exposure on
alcohol use youth drinking behaviour

• Stacy et al. (2004) follow up 12 months
• Those who watched 60 more alcohol
  advertisements on TV
• one year later,
• - 44 more likely to have used beer,
• - 34 more likely to have ever used
  wine/liquor,
• - 26 more likely to have had 3 or more drinks
  on one occasion.

• Van Den Bluck Beullens (2005) follow up 12
  months
• Quantity of alcohol consumed while going out
  related to overall TV viewing and their music
  video exposure.

18
8 Results of (good quality) longitudinal studies
on impact of media and advertising exposure on
alcohol use youth drinking behaviour

• Ellickson et al. (2005) follow up 36 months
• Exposure to in-store beer displays, advertising
  in magazines and beer concession stands at
  sports/music events predicted drinking onset for
  non-drinkers after 2 years.
• Note!! effects of sponsorship

• Snyder et al. (2006) follow up 26 months
• For every 4 more alcohol advertisements seen on
  TV, radio, billboards and in magazines drank 1
  more drinks per month,
• (at base line saw 23 advertisements/month, 38.5
  drinks/month)
• For every 15 more exposure in their media
  market on alcohol advertising, drank 3 more
  drinks per month.

19
8 Results of (good quality) longitudinal studies
on impact of media and advertising exposure on
alcohol use youth drinking behaviour

• Sargent et al (2006) follow up 12-24 months
• Significant linear and quadratic relationship
  between movie alcohol exposure and initiation of
  drinking
• ,with the effect strongest at lower levels of
  exposure .

This strengthened the case for an independent
effect of exposure to alcohol use in films on
early-onset drinking, as opposed to the observed
relationship being simply an artefact of the
frequent movie-watching of poorly supervised or
academically disengaged young people.

• McClure et al. (2006) Same study as Sargent et
  al (2006)
• Owners of alcohol branded merchandise had higher
  rates of alcohol initiation (25) compared with
  non-owners (13.1).

Alcohol producers distribute branded clothing,
toys, game equipment and so on as part of
embedding their brands in daily life.
20
How mass media advertising links in with wider
marketing communications (including consumer
stakeholder marketing) to impact not just
individual consumers but overall social norms
about alcohol.
21
Integrated marketing communications mix
22
The main conclusions of ELSA study 1 Alcohol
advertisements are related to positive attitudes
and beliefs about alcohol amongst young people,
and increase the likelihood of young people
starting to drink, the amount they drink, and the
amount they drink on any one occasion. 2 There
is no available scientific evidence which shows
that the non-statutory regulation of commercial
communications impacts on the content or volume
of advertisements 3 There is great variety in
regulations related to the advertisement of
alcoholic products in the European Member
States 4 There is very little documentation on
adherence to the existing regulations 5 The most
appealing alcoholic beverages and alcohol
advertisements to young people use elements
associated with youth culture 6 There is no
informative body which systematically monitors
the impact of regulations on alcohol marketing
and its adherence
23
Thank You