AN EXAMINATION OF THE ROLE OF ADVERTISING CONTENT IN THE RELATIONSHIP BETWEEN ALCOHOL ADVERTISING EXPOSURE AND UNDERAGE DRINKING
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Background Young people’s exposure to alcohol marketing is a major public health issue, given its potential impact on drinking behaviors. Young people are spending significant amounts of time watching television, and alcohol marketing and promotion on TV is increasing. Little information exists on the presence of youth-appealing content in U.S. televised alcohol advertisements, and whether this is associated with youth drinking behaviors. Objectives The objectives of this research are to (1) determine the extent to which youth-appealing content is found in televised alcohol advertising, (2) test the influence of content on youth consumption, and (3) test the joint influence of exposure and content on youth consumption. Methods Descriptive and univariate data from a content analysis of 96 televised alcohol ads selected from among both popular and unpopular alcohol brands among youth were analyzed for the presence of primarily youthful content appeal (PYCA). Mean brand PYCA scores’ association with youth consumption and adult consumption of each brand, as well as PYCA scores’ association with youth consumption relative to adult consumption were tested through bivariate and multivariate linear regression. Associations of content and youth consumption by subgroup (popular versus unpopular brands) were also tested. A measure of brand exposure calculated using adstock was added as a predictor and the multiplicative influence of exposure and content on youth consumption was tested through bivariate and multivariate linear regression by brand subgroup. Results Primarily youthful content appeal was present in many of the televised ads and popular brands had a higher mean PYCA score (M=2.7, SD=10.16) than unpopular brands (M=-2.72, SD=9.93), t(94) = -2.61, p<.05. There was a positive association between brand PYCA score and brand consumption among youth (β=.15, p < .001) controlling for adult consumption, alcohol type and popularity, and a negative association between brand PYCA score and adult consumption (β=-.15, p < .001) controlling for youth consumption, alcohol type and popularity. Separating by brand popularity, the association between brand PYCA score and youth consumption was present only among the popular brands (β=.33, p < .001), and the association between brand PYCA score and relative youth-to-adult consumption was only present among the popular brands (β=.68, p < .001). Among popular brands, brand exposure score was negatively associated with youth consumption (β=-.14, p < .001), and there was no interaction effect of brand PYCA score on the association. There was a main effect of brand PYCA score on youth consumption (β=.33, p < .001) controlling for brand exposure and adult consumption. Among unpopular brands, in the bivariate model brand exposure was positively associated with youth consumption (β=.39, p < .01), and there was a significant interaction effect of brand PYCA score such that higher mean PYCA score strengthened the positive effect of brand exposure. Conclusions Reducing the influence of alcohol advertising on underage drinking requires that researchers, public health practitioners and policy makers augment their focus on exposure with a serious consideration of advertising content. Youth are not passive viewers of advertising, and an effective approach to regulation of alcohol advertising requires stronger provisions regarding content.