Association between stricter alcohol advertising regulations and lower hazardous drinking across European countries

Addiction. 2014 Oct;109(10):1634-43. doi: 10.1111/add.12562. Epub 2014 May 4.


Aims: To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50-64 years in 16 European countries, taking into account both individual and contextual-level factors (alcohol taxation, availability, etc.).

Design: Cross-sectional study based on SHARE project surveys.

Setting and participants: A total of 27 773 subjects, aged 50-64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project.

Measurements: We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi-level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained.

Findings: The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI = 29.3-31.8) in countries with no restrictions, 20.3% (95% CI = 19.3-21.2) in countries with some restrictions and 14.4% (95% CI = 11.9-16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI = 0.90-2.06) for countries with some restrictions and 1.95 (95% CI = 1.31-2.91) for those with no advertising restrictions.

Conclusions: The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50-64 years.

Keywords: AUDIT-C; Alcohol; Europe; alcohol marketing; alcohol policy; hazardous drinking.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Advertising / legislation & jurisprudence*
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / legislation & jurisprudence
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Risk-Taking*