THOMAS BABOR, DAVID JERNIGAN, CHRIS BROOKES. Alcohol marketing: the simple truth

According to the World Health Organization, there are 3.3 million deaths attributable to alcohol use worldwide each year. Alcohol marketing, promotion and sponsorship are widespread in most of the world today and marketers are moving increasingly to digital and social media, where efforts at regulation have fallen far behind industry innovations in producing audience engagement and brand ambassadorship.  

Many governments have attempted to protect young people from inappropriate exposure to alcohol marketing through regulations. These have ranged from total marketing bans to voluntary self-regulation using industry codes of practice.

Alcohol is a psychoactive substance with numerous negative consequences to the health and wellbeing of consumers as well as others affected by drinkers’ behaviour. With the advent of recent restrictions on tobacco marketing, because of the Framework Convention on Tobacco Control (a global agreement), no other legal product with such potential for harm is as promoted and advertised in the world as alcohol.

The behaviour and activity of the alcohol industry has attracted the attention academic researchers. In a supplement to the scientific journal Addiction, a collection of 13 papers and one editorial comment published on 10 January 2017, examines in detail the current state alcohol marketing regulation.

This collection of papers represents the highest level of scholarly attention devoted to this issue that has been brought together in the pages of one scientific journal.

Three compelling themes emerge from this collection.

Alcohol marketing causes harm to vulnerable populations

Moral philosopher Chapman describes the legal and moral case of exposing children and young people to alcohol marketing, tracing the evolution of international law and other measures designed to protect vulnerable populations from the marketing of potentially harmful products. In a related paper, Babor et al. consider the public health implications of an expanded definition of vulnerability as it relates to not only alcohol marketing reaching children and adolescents, but also pregnant women and people with alcohol dependence.

Jernigan and colleagues reviewed the recent literature on the association between alcohol marketing and youth drinking. The systematic review identified 12 new studies reporting findings from nine unique cohorts including more than 35,000 people across several countries. All studies found a significant association between youth exposure to alcohol marketing and subsequent drinking behaviour.

The findings of the review of digital marketing studies by Lobstein and colleagues concludes that marketing through digital media uses approaches that are attractive to young people and will likely effect their drinking behaviour.

Industry self-regulation is ineffective in protecting vulnerable populations

A systematic review of the literature by Jonathan Noel and colleagues evaluates the legal history and current research, and demonstrates that the industry codes are largely ineffective in reducing youth exposure to potentially harmful sales promotions.

Of the 19 studies evaluating a specific marketing code and 25 content analysis studies reviewed, all detected content that is potentially harmful to children and adolescents, including themes that appeal strongly to young men. Of the 57 studies of alcohol advertising exposure, high levels of youth exposure and high awareness of alcohol advertising were found for television, radio, print, digital and outdoor advertisements. In a literature comprising more than 100 studies, the current self-regulatory systems that govern alcohol marketing practices in many countries were found to be ineffective in meeting their intended goal of protecting vulnerable populations.

Another review showed that the industry’s complaint processes fail to address the need to remove marketing materials that have been identified as non-compliant with industry codes.

Alternatives are available to address the problem

An evaluation of the French Loi Évin described by Galopel and colleagues provides insight into marketing controls to be more effective than industry self-regulation. But it shows that while laws strictly limiting the promotion of alcohol products may have been successful in preventing certain kinds of potentially harmful marketing, legislative inaction and industry weakening of the 1991 legislation has reduced its effectiveness.

Legally binding global health treaties and non-binding codes are used to restrict the marketing of tobacco, breast milk substitutes and unhealthy foods, based on evidence of a public health crisis. Landon and colleagues discuss the implications of international codes and agreements for the control of alcohol marketing.

Having commercial operators account for their marketing practices is a critical element in the continued development and strengthening of public health policies that may ultimately require a global agreement on alcohol marketing. Finally, the implications of international trade and investment agreements on alcohol policy are explored for their possible effects on the control of alcohol marketing.

CONCLUSION

Harmful use of alcohol is increasing among young people and women in some regions of the world, especially in the Americas region.

Given the causal role of harmful use of alcohol in negative health outcomes to drinkers and others (regardless of their drinking status), the promotion of alcohol consumption by means of marketing needs to be controlled by governments as part of their duty to protect the health of their populations, particularly among the most vulnerable groups.

Over the years, governments have relied heavily on the alcohol industry’s self-regulatory measures on alcohol advertising; but we can no longer say that they protect our young people – they don’t.

These papers offer guidance for developing effective alcohol marketing controls.

The most effective response to alcohol marketing is likely to be a comprehensive ban on alcohol advertising, promotion and sponsorship, in accordance with each country’s constitution or constitutional principles.

Regulations should be statutory, and enforced by an appropriate public health agency of the local or national government, not by the alcohol industry.

Regulations should be independent of the alcohol industry, whose primary interest lies in growing its markets and maximising profits.

A global agreement on the marketing of alcoholic beverages would support country efforts to move towards a comprehensive ban on alcohol advertising, promotion and sponsorship.

The protection of young persons from alcohol marketing should be coordinated with other population-level efforts to restrict marketing of other potentially harmful products, such as ultra-processed food, sugary beverages, and tobacco.

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Acknowledgement

This article describes a series of papers published in a supplement to Addiction entitled: ‘The regulation of alcohol marketing: from research to public health policy’. The journal supplement is funded by Alcohol Research UK and the Institute of Alcohol Studies, with the authors and editors of the supplement giving their time to produce these papers pro bono.

Thomas F Babor
Thomas F Babor is a Professor and Chairman in the Department of Community Medicine and Health Care, University of Connecticut School of Medicine. He has worked with the World Health Organization on alcohol screening tools, serves on the Board of the Global Alcohol Policy Alliance, and is author or co-author of Drug Policy and the Public Good and Alcohol: no ordinary commodity – Research and public policy.

David Jernigan
Dr David Jernigan is the Director of the Center on Alcohol Marketing and Youth (CAMY) and an associate professor at the Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. He has worked as an advisor to the World Health Organization (WHO) and the World Bank on alcohol issues. He has also authored numerous peer-reviewed articles and has trained thousands of public health advocates in media advocacy and alcohol-problems prevention.

Chris Brookes
Chris Brookes is Director of Global Business Development for the UK Health Forum. Chris has worked in the public health field for 16 years, with a particular focus on actions to address health inequalities internationally.

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