David H. Jernigan

The global alcohol industry: an overview

AIMS To describe the globalized sector of the alcoholic beverage industry, including its size, principal actors and activities. METHODS Market research firms and business journalism are the primary sources for information about the global alcohol industry, and are used to profile the size and membership of the three main industry sectors of beer, distilled spirits and wine. FINDINGS Branded alcoholic beverages are approximately 38% of recorded alcohol consumption world-wide. Producers of these beverages tend to be large multi-national corporations reliant on marketing for their survival. Marketing activities include traditional advertising as well as numerous other activities, such as new product development, product placement and the creation and promotion of social responsibility programs, messages and organizations. CONCLUSIONS The global alcohol industry is highly concentrated and innovative. There is relatively little public health research evaluating the impact of its many marketing activities.

Global Alcohol Producers, Science, and Policy: The Case of the International Center for Alcohol Policies

In this article, I document strategies used by alcohol producers to influence national and global science and policy. Their strategies include producing scholarly publications with incomplete, distorted views of the science underlying alcohol policies; pressuring national and international governmental institutions; and encouraging collaboration of public health researchers with alcohol industry-funded organizations and researchers. I conclude with a call for an enhanced research agenda drawing on sources seldom used by public health research, more focused resourcing of global public health bodies such as the World Health Organization to counterbalance industry initiatives, development of technical assistance and other materials to assist countries with effective alcohol-control strategies, and further development of an ethical stance regarding collaboration with industries that profit from unhealthy consumption of their products.

Media Advocacy: Lessons from Community Experiences

Media advocacy is the strategic use of mass media and community organizing as a resource for advancing a social or public policy initiative. Across the United States, communities are using media advocacy to promote healthier public policies and environments. The U.S. Center for Substance Abuse Prevention commissioned numerous case studies of media advocacy on alcohol and tobacco issues in a diverse array of communities, including efforts in African-American and Latino communities or using computer-based electronic communication systems. The paper describes these efforts briefly, and summarizes lessons learned, including: media advocacy can lead to larger victories when used as a complement to community organizing in the context of a larger strategic vision for policy change; like policy advocacy, media advocacy is best done in the context of clear long-term goals; conscious framing, guiding the choice of spokespeople, visuals, and messages, can alter media coverage and public debate of health policies; advocates need to respect the media but also remember that they have power in relation to the media; and media advocacy is often controversial and not suited to every situation. The case studies show that media advocacy is a potent tool for public health workers, making an important contribution to campaigns to promote healthier public policies.

Brand‐Specific Consumption of Alcohol Among Underage Youth in the United States

BACKGROUND Little is known about brand-specific alcohol consumption among underage youth, as existing information is collected at the level of alcoholic beverage type. This study identifies the alcohol brands consumed by a nationally representative sample of underage youth in the United States. METHODS We obtained a national sample of 1,032 underage youth, aged 13 to 20, using a pre-recruited Internet panel maintained by Knowledge Networks. Youth aged 18 to 20 were recruited directly from the panel via email invitation. Teens aged 13 to 17 were identified by asking adult panelists to identify a member of their household. The survey assessed the past 30-day consumption of 898 brands of alcohol among 16 alcoholic beverage types, including the frequency and amount of each brand consumed in the past 30 days. Market share for a given brand was calculated by dividing the total number of drinks for that brand in the past 30 days across the entire sample by the total number of drinks for all identified brands. RESULTS The alcohol brands with highest prevalence of past 30-day consumption were Bud Light (27.9%, 95% confidence interval [CI] 23.3 to 32.4%), Smirnoff malt beverages (17.0%, 95% CI 12.9 to 21.1%), and Budweiser (14.6%, 95% CI 11.0 to 18.3%). Brand market share was concentrated in a relatively small number of brands, with the top 25 brands accounting for nearly half of all market shares. CONCLUSIONS Underage youth alcohol consumption, although spread out over several alcoholic beverage types, is concentrated among a relatively small number of alcohol brands. This finding has important implications for alcohol research, practice, and policy.

Measuring youth exposure to alcohol marketing on social networking sites: Challenges and prospects

Youth exposure to alcohol marketing has been linked to increased alcohol consumption and problems. On relatively new and highly interactive social networking sites (SNS) that are popular with youth, tools for measuring youth exposure to alcohol marketing in traditional media are inadequate. We critically review the existing policies of Facebook, Twitter, and YouTube designed to keep branded alcohol content away from underage youth. Looking at brand and user activity on Facebook for the 15 alcohol brands most popular among US youth, we found activity has grown dramatically in the past 3 years, and underage users may be accounting for some of this activity. Surveys of youth and adult participation in alcohol marketing on SNS will be needed to inform debate over these marketing practices.

Association Between Adolescent Viewership and Alcohol Advertising on Cable Television

OBJECTIVES We examined whether alcohol advertising on cable television is associated with adolescent viewership. METHODS Using Nielsen data for every national cable alcohol advertisement from 2001 to 2006 (608 591 ads), we examined whether ad incidence in a given advertising time slot was associated with adolescent viewership (i.e., the percentage of the audience that was aged 12-20 years) after we controlled for other demographic variables. RESULTS Almost all alcohol ads appeared in time slots with audiences made up of 30% or fewer underage viewers. In these time slots (standardized by duration and number of viewers), each 1-percentage-point increase in adolescent viewership was associated with more beer (7%), spirits (15%), and alcopop (or low-alcohol refresher; 22%) ads, but fewer wine (-8%) ads (P < .001 for all). For spirits and alcopops, associations were stronger among adolescent girls than among adolescent boys (P < .001 for each). CONCLUSIONS Ad placements for beer, spirits, and alcopops increased as adolescent viewership rose from 0% to 30%, especially for female viewers. Alcohol advertising practices should be modified to limit exposure of underage viewers.

The use of caffeinated alcoholic beverages among underage drinkers: Results of a national survey

OBJECTIVE The mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users. METHODS We used an existing Internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30 days among a national sample of 1031 youth drinkers age 13-20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use). RESULTS The overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%-57.4%). CAB prevalence was 48.4% among 13-15 year-old drinkers, 45.3% among 16-18 year-old drinkers, and 58.4% among 19-20 year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR]=6.3), fighting (OR=4.4), and alcohol-related injuries (OR=5.6). CONCLUSIONS The problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.

Breakfast cereal industry pledges to self-regulate advertising to youth: will they improve the marketing landscape?

In 2007, the Council of Better Business Bureaus created the Childrens Food and Beverage Advertising Initiative to improve the nutritional profile of products marketed to children in the United States. We provide quantitative baseline data describing (a) the amount of child-directed breakfast cereal advertising in 2007; (b) an assessment of the nutritional value for all cereals advertised on television; and (c) the relationship between nutrition quality and child exposure to television advertising for major cereal brands. In 2007, the average American child viewed 757 cereal ads, and 98 per cent of these ads promoted unhealthy cereals that would be prohibited from advertising to children in the United Kingdom. Healthy cereals were advertised in 2007 in the United States, but adults, not children, were predominantly exposed to these ads. These quantitative methods can be used in the future to evaluate the impact of industry self-regulation efforts to improve the marketing landscape.

The concentration of the global alcohol industry and its penetration in the African region

AIMS To describe the penetration and expansion of the global alcohol industry into the African region, as a context for exploring the implications for public health. METHODS Source materials for this study came primarily from market research and the business press. This was supplemented by industry sources (from websites, company annual reports), World Health Organization reports and the scientific literature. RESULTS Drinking in Africa is characterized by high rates of abstention and a high prevalence of heavy episodic consumption among those who drink. Much of the region is currently experiencing a rapid rise in consumption. Rising populations and income and the rapid pace of urbanization make Africa very attractive to the global alcohol industry, and industry leaders have identified Africa as a key area for growth. The shift from collaboration to competition in Africa among the global alcohol companies has prompted increasing alcohol production, promotion, new product development, pricing schemes and stakeholder lobbying. CONCLUSIONS Beer consumption has increased across most of the continent, and global brewers view themselves as legitimate players at the alcohol policy table. Weak alcohol policy environments may be compromised further in terms of public health protections by alcohol industry opposition to effective measures such as marketing regulations, availability controls and taxation.

The commercial use of digital media to market alcohol products: A narrative review

BACKGROUND AND AIMS The rising use of digital media in the last decade, including social networking media and downloadable applications, has created new opportunities for marketing a wide range of goods and services, including alcohol products. This paper aims to review the evidence in order to answer a series of policy-relevant questions: does alcohol marketing through digital media influence drinking behaviour or increases consumption; what methods of promotional marketing are used, and to what extent; and what is the evidence of marketing code violations and especially of marketing to children? METHOD AND FINDINGS A search of scientific, medical and social journals and authoritative grey literature identified 47 relevant papers (including 14 grey literature documents). The evidence indicated (i) that exposure to marketing through digital media was associated with higher levels of drinking behaviour; (ii) that the marketing activities make use of materials and approaches that are attractive to young people and encourage interactive engagement with branded messaging; and (iii) there is evidence that current alcohol marketing codes are being undermined by alcohol producers using digital media. CONCLUSIONS There is evidence to support public health interventions to restrict the commercial promotion of alcohol in digital media, especially measures to protect children and youth.