Objective: To test whether alcohol advertising expenditures and the degree of exposure to alcohol advertisements affect alcohol consumption by youth.
Design: Longitudinal panel using telephone surveys.
Setting: Households in 24 US media markets, April 1999 to February 2001.
Participants: Individuals aged 15 to 26 years were randomly sampled within households and households within media markets. Markets were systematically selected from the top 75 media markets, representing 79% of the US population. The baseline refusal rate was 24%. Sample sizes per wave were 1872, 1173, 787, and 588. Data on alcohol advertising expenditures on television, radio, billboards, and newspapers were collected.
Main exposures: Market alcohol advertising expenditures per capita and self-reported alcohol advertising exposure in the prior month.
Main outcome measure: Self-reported number of alcoholic drinks consumed in the prior month.
Results: Youth who saw more alcohol advertisements on average drank more (each additional advertisement seen increased the number of drinks consumed by 1% [event rate ratio, 1.01; 95% confidence interval, 1.01-1.02]). Youth in markets with greater alcohol advertising expenditures drank more (each additional dollar spent per capita raised the number of drinks consumed by 3% [event rate ratio, 1.03; 95% confidence interval, 1.01-1.05]). Examining only youth younger than the legal drinking age of 21 years, alcohol advertisement exposure and expenditures still related to drinking. Youth in markets with more alcohol advertisements showed increases in drinking levels into their late 20s, but drinking plateaued in the early 20s for youth in markets with fewer advertisements. Control variables included age, gender, ethnicity, high school or college enrollment, and alcohol sales.
Conclusion: Alcohol advertising contributes to increased drinking among youth.