Exposure to alcohol advertising and teen drinking

Objective. Assessing the association between alcohol ad exposure and alcohol use in German adolescents, controlling for general ad exposure. Method. Cross-sectional survey of 3415 sixth to eighth graders (mean 12.5 years) from 29 schools in three German states (June 2008). Exposure to 9 alcohol and 8 non-alcohol advertisements was measured with masked ad images; students indicated contact frequency and brand recall. Main outcomes were ever drinking, current drinking, binge drinking, alcohol use intentions and outcome expectancies. Results. There was a bivariate association between both exposures (alcohol and non-alcohol ads) and all alcohol use measures. After adjustment for confounding, only alcohol ad exposure retained a significant association with outcomes. Multi-level logistic regressions revealed that compared with quartile one alcohol ad exposure, the adjusted odds ratios for quartile four were 2.4 (95% confidence interval 1.7-3.4) for trying drinking, 2.7 (1.8-3.9) for current drinking and 2.3 (1.6-3.5) for ever binge drinking. There was also an independent association between alcohol ad exposure and alcohol-related attitudes among never drinkers. Conclusion. This study demonstrates a positive association between exposure to alcohol advertising and multiple youth drinking outcomes, showing that the association is content-specific, not just a function of general ad exposure. (C) 2010 Elsevier Inc. All rights reserved.