Should parents worry about children seeing the Pac-Man ad? If you want my professional opinion -- yes! -- parents should approach ads for alcoholic beverages with great caution. In a new study
published in JAMA Pediatrics, my colleagues at Dartmouth and I showed that youths' involvement with alcohol marketing influenced their drinking behaviors.
We asked about alcohol use in more than 2,000 U.S. teens, ages 15-20. For the survey, we collected more than 300 alcohol advertisements that aired on American television during the prior year. From each of these ads, a still photo was captured. These stills went into a pool of images from which 20 were randomly drawn for each survey. We wanted to know whether children, when presented these images, would say they had seen them or liked them. We also airbrushed any indication of brand, and asked them if they could tell which brand of alcohol was being advertised.
Based on the responses, we created a score that measured how familiar they were with alcohol advertising. We wanted to know if that score would predict whether or not they transitioned from never drinking to trying alcohol, or from trying alcohol to trying binge drinking. Binge drinking was defined as consuming six or more alcoholic drinks at any one time.
To make sure that any effect seen was due to the content of the alcohol ads, we also captured fast-food ads, created stills from these ads and put together a score for familiarity with fast-food television advertising. We also asked how many of their friends drink alcohol, how much their parents drink alcohol, and how much the kids like to take risks.
We then resurveyed the children one to two years later. A lot of them made drinking transitions: For example, about a third who, at the beginning of the study, had never tried binge drinking had begun to binge drink by the follow-up survey. We wanted to know which characteristics at the first survey predicted starting to binge drink at the second. The key risk factors were drinking by friends, risk taking and familiarity with television alcohol advertising. All else being equal, kids who scored highest on familiarity with alcohol ads were more than four times more likely to take up binge drinking compared with low scoring ones.
In contrast, familiarity with fast-food TV advertising did not predict binge drinking, nor did parent drinking. In a previous paper involving these youths, we showed that familiarity with fast-food marketing (but not alcohol marketing) was linked to more eating at fast-food restaurants and higher risk for obesity.
Unfortunately, U.S. youth in this age range commonly start binge drinking and often report problems because of their drinking. The problems range from fighting and sexual encounters they regret, to injuries and deaths youths sustain when they drive drunk. Pediatricians see these problems in our clinics and emergency rooms; that's why we want to find out whether there are risk factors for binge drinking that could be modified to reduce the problem. Alcohol marketing seems to be a key modifiable risk factor.
This study raises serious questions about whether alcohol companies should be able to advertise on television at all, much less on a program that reaches as many children as the Super Bowl. In 1970, the U.S Congress passed the Public Health Cigarette Smoking Act, which banned cigarette companies from advertising on television. Perhaps it's time for us to ask why alcohol companies are still allowed to place their ads there when studies show they may affect underage drinking.
For Sunday, the Super Bowl offers parents a chance to explain that alcohol advertising aims to associate the brand with humor, friendship, romance and partying, with the goal of getting you to want to buy that brand and drink it. The hope is that by promoting a discussion, parents will teach healthy skepticism about the intent of companies and reduce the influence of their ads.