Abstract
AimTo systematically review evidence on the influence of specific marketing components (Price, Promotion, Product attributes and Place of sale/availability) on key drinking outcomes (initiation, continuation, frequency and intensity) in young people aged 9–17.MethodsMEDLINE, EMBASE, SCOPUS, PsychINFO, CINAHL and ProQuest were searched from inception to July 2015, supplemented with searches of Google Scholar, hand searches of key journals and backward and forward citation searches of reference lists of identified papers.ResultsForty-eight papers covering 35 unique studies met inclusion criteria. Authors tended to report that greater exposure to alcohol marketing impacted on drinking initiation, continuation, frequency and intensity during adolescence. Nevertheless, 23 (66%) studies reported null results or negative associations, often in combination with positive associations, resulting in mixed findings within and across studies. Heterogeneity in study design, content and outcomes prevented estimation of effect sizes or exploration of variation between countries or age subgroups. The strength of the evidence base differed according to type of marketing exposure and drinking outcome studied, with support for an association between alcohol promotion (mainly advertising) and drinking outcomes in adolescence, whilst only two studies examined the relationship between alcohol price and the drinking behaviour of those under the age of 18.ConclusionDespite the volume of work, evidence is inconclusive in all four areas of marketing but strongest for promotional activity. Future research with standardized measures is needed to build on this work and better inform interventions and policy responses.
Highlights
Heavy drinking or high intensity alcohol use is the leading risk to health and well-being in young people, accounting for 7% of disability adjusted life years in 10–24-year olds globally (Gore et al, 2011)
Categorization of studies according to marketing focus was guided by criteria from the UK’s National Institute for Health and Care Excellence (NICE) (2010) and the WHO (World Health Organisation, 2010)
We were interested in studies which reported effects on young people’s alcohol consumption, and found very little which focused upon other aspects of placement or distribution, reflecting methodological gaps and limitations previously identified by Holmes et al (2014a)
Summary
Heavy drinking or high intensity alcohol use is the leading risk to health and well-being in young people, accounting for 7% of disability adjusted life years in 10–24-year olds globally (Gore et al, 2011). The longer and heavier an individual drinks, the greater the risk of developing chronic health problems such as liver disease or cancers later in life (Secretan et al, 2009; Holmes et al, 2014b; Williams et al, 2014; Bagnardi et al, 2015)
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