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Research Letters |

Alcohol Brand Preference and Binge Drinking Among Adolescents FREE

Susanne E. Tanski, MD, MPH; Auden C. McClure, MD, MPH; David H. Jernigan, PhD; James D. Sargent, MD
[+] Author Affiliations

Author Affiliations: Department of Pediatrics, Dartmouth Medical School, Hanover (Drs Tanski, McClure, and Sargent), and Norris Cotton Cancer Center, Lebanon (Drs Tanski, McClure, and Sargent), New Hampshire; and Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Jernigan).


Arch Pediatr Adolesc Med. 2011;165(7):675-676. doi:10.1001/archpediatrics.2011.113.
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Adolescents commonly misuse alcohol, with 24.2% reporting current binge drinking in surveys of US high school students.1 Early-onset drinking raises risks for drinking-related morbidity2 and alcohol dependence. The alcohol industry spent $1.7 billion in media advertising in 2009 (The Nielsen Co, unpublished data, 2009. Ratings and other data contained herein are the copyrighted property of The Nielsen Co. Unauthorized use of this copyrighted material is expressly prohibited. Violators may be subject to criminal and civil penalties under Federal Law [17 USC 101 et seq.]. All rights reserved.), operating only under voluntary limits regarding youth. Moreover, in 1996, the Distilled Spirits Council of the United States ended its ban on television advertising. If such advertising is reaching adolescents, brands with larger ad expenditures may be chosen as favorites, and adolescents might choose a distilled spirit as their favorite brand to drink. We report favorite brand and its association with ad expenditures and binge drinking in a population survey of underage adolescents.

As part of a longitudinal telephone survey of US adolescents and media use,3 we surveyed 2699 youth aged 16 to 20 years about their alcohol use and report on favorite brand to drink among the underage drinkers (n = 1734). Adolescents from all regions of the United States were represented, parental consent was obtained for those younger than 18 years, and the study was approved by the Committee for the Protection of Human Subjects at Dartmouth.

Of the ever drinkers, 21% (26% males, 16% females) had drunk 5 or more drinks in a row in the past 30 days (current binge drinking) and 68% (71% males, 65% females) endorsed a favorite brand to drink, naming 158 brands in all. A distilled spirit brand was named by 53%; a beer brand, by 42%; and wine/cider, by 3.3% (unable to determine brand in 1.1%). Favorite brands are shown in the Table, with brands identified by fewer than 15 respondents collapsed into “other” categories. The most commonly chosen favorites among underage females and males were Smirnoff (Diageo, London, England) and Budweiser (Anheuser-Busch Companies, St Louis, Missouri), respectively. The eFigure illustrates the proportion of current binge drinkers by sex and favorite brand to drink (see the eTable for numeric data). Whereas the current binge drinking rate among underage drinkers with no favorite brand (“none” category) was 0.11 (95% confidence interval, 0.08-0.14), rates among those identifying a favorite brand were higher, ranging from 0.28 to 0.71. Beer brand favorites seemed as likely to be associated with binge drinking as distilled spirits brands, but choice of wine/cider was not. Annual advertising expenditures for alcohol brands in all media were obtained from The Nielsen Company for 95 of the named alcohol brands (The Nielsen Co, unpublished data, 2009). The Spearman correlation between annual ad expenditures and the proportion of adolescent drinkers overall who chose each brand was 0.64 (P < .001).

Table Graphic Jump LocationTable. Percentage of US Underage Drinkers Reporting Favorite Brand of Alcohol to Drink by Favorite Brand and Sex

Within this national sample of underage drinkers, two-thirds reported a favorite brand of alcohol. Distilled spirit brands were cited as often as beer, consistent with a regional survey4 and suggesting that concentrated forms of alcohol are among the alcohol brands underage drinkers currently aspire to consume. The correlation between underage drinkers' brand preference and marketing expenditures suggests a marketing influence on choice of beverage. Moreover, higher rates of binge drinking among adolescents who named a favorite brand suggest that alcohol advertising campaigns may influence the likelihood that alcohol will be consumed at levels that pose a risk to health.

This cross-sectional study cannot answer questions on temporality and did not distinguish among products within brand. Specifically what youths drink when they report Smirnoff as their favorite (eg, Smirnoff Ice) is an important topic for further research. This sample, while national, may not be representative of responses for subjects with higher attrition (in this case, poorer families and minorities). Finally, as with any observational study, there may be a third variable besides exposure to alcohol advertising that represents the true cause of the development of an alcohol preference and its associated binge drinking.

Despite the limitations, youths chose distilled spirit brands in large numbers, brands preferred by youth have tended to have high advertising expenditures, and choosing a favorite brand was associated with binge drinking. Youth exposure to alcohol advertising on television has increased significantly since 2001.5 These findings support the premise that alcohol advertising plays a role in youth consumption patterns and that more effective means are needed to reduce youth exposure to alcohol advertising.

Correspondence: Dr Tanski, Department of Pediatrics, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Hinman Box 7925, Lebanon, NH 03756 (susanne.e.tanski@dartmouth.edu).

Author Contributions:Study concept and design: Tanski, McClure, Jernigan, and Sargent. Acquisition of data: Tanski, McClure, Jernigan, and Sargent. Analysis and interpretation of data: Tanski, McClure, Jernigan, and Sargent. Drafting of the manuscript: Tanski, McClure, and Sargent. Critical revision of the manuscript for important intellectual content: Tanski, McClure, Jernigan, and Sargent. Statistical analysis: Tanski and Sargent. Obtained funding: Tanski, Jernigan, and Sargent. Study supervision: Jernigan and Sargent.

Financial Disclosure: None reported.

Funding/Support: This work was supported by grant AA015591 from the National Institute on Alcohol Abuse and Alcoholism and in part by Cooperative Agreement 5U58DP002072-02 from the Centers for Disease Control and Prevention (Dr Jernigan).

Disclaimer: The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention (CDC).  Vital signs: binge drinking among high school students and adults: United States, 2009.  MMWR Morb Mortal Wkly Rep. 2010;59(39):1274-1279
PubMed
Hingson RW, Edwards EM, Heeren T, Rosenbloom D. Age of drinking onset and injuries, motor vehicle crashes, and physical fights after drinking and when not drinking.  Alcohol Clin Exp Res. 2009;33(5):783-790
PubMed   |  Link to Article
Dal Cin S, Worth KA, Gerrard M,  et al.  Watching and drinking: expectancies, prototypes, and friends' alcohol use mediate the effect of exposure to alcohol use in movies on adolescent drinking.  Health Psychol. 2009;28(4):473-483
PubMed   |  Link to Article
Centers for Disease Control and Prevention (CDC).  Types of alcoholic beverages usually consumed by students in 9th-12th grades: four states, 2005.  MMWR Morb Mortal Wkly Rep. 2007;56(29):737-740
PubMed
Center on Alcohol Marketing and Youth.  Youth Exposure to Alcohol Advertising on Television, 2001 to 2007. Washington, DC: Center on Alcohol Marketing and Youth; 2008

Figures

Tables

Table Graphic Jump LocationTable. Percentage of US Underage Drinkers Reporting Favorite Brand of Alcohol to Drink by Favorite Brand and Sex

References

Centers for Disease Control and Prevention (CDC).  Vital signs: binge drinking among high school students and adults: United States, 2009.  MMWR Morb Mortal Wkly Rep. 2010;59(39):1274-1279
PubMed
Hingson RW, Edwards EM, Heeren T, Rosenbloom D. Age of drinking onset and injuries, motor vehicle crashes, and physical fights after drinking and when not drinking.  Alcohol Clin Exp Res. 2009;33(5):783-790
PubMed   |  Link to Article
Dal Cin S, Worth KA, Gerrard M,  et al.  Watching and drinking: expectancies, prototypes, and friends' alcohol use mediate the effect of exposure to alcohol use in movies on adolescent drinking.  Health Psychol. 2009;28(4):473-483
PubMed   |  Link to Article
Centers for Disease Control and Prevention (CDC).  Types of alcoholic beverages usually consumed by students in 9th-12th grades: four states, 2005.  MMWR Morb Mortal Wkly Rep. 2007;56(29):737-740
PubMed
Center on Alcohol Marketing and Youth.  Youth Exposure to Alcohol Advertising on Television, 2001 to 2007. Washington, DC: Center on Alcohol Marketing and Youth; 2008

Correspondence

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Re: Alcohol Brand Preference and Binge Drinking Among Adolescents
Posted on August 9, 2011
Raymond Scalettar, M.D., D.Sc.
George Washington University Medical Center
Conflict of Interest: None Declared
August 8, 2011 Re: Alcohol Brand Preference and Binge Drinking Among Adolescents
The conclusion of the Tanski et al study1 that marketing expenditures drive underage “brand preferences” is not supportable. As outlined below, the authors’ own survey data and marketplace realities belie their conclusion.
• The most commonly chosen answer among both males and females who were surveyed on their “favorite brand to drink” was “none.” This response was cited twice as many times as any brand cited in the survey, yet this key finding was not addressed by the study’s authors.
• Scientific literature shows the majority of underage individuals who drink obtain their alcohol from parents and other adults and that most get their alcohol for free. For example, a 2011 government survey by the Substance Abuse and Mental Health Services Administration found 93.4 percent of those youth surveyed obtained their alcohol for free.2 Therefore, if anything, this survey reflects the brand choices of adults of legal purchase age.
• The authors claim that youth chose spirits brands in large numbers. This assertion regarding distilled spirits cannot be made. The authors themselves acknowledged that the survey questionnaire did not differentiate among products that could have been a distilled spirit or a beer.
• The authors’ assertion that alcohol advertising plays a role in underage consumption based on the “correlation of annual ad expenditures and the proportion of adolescent drinkers overall who chose each brand” is unfounded. It is not known whether these particular adolescents ever saw an advertisement for the brands cited.
• It also is important to note that, in direct contradiction to the hypothesis, none of the distilled spirits brands cited in this survey are among the top 10 most advertised beverage alcohol brands.3
• And finally, the authors’ claim that an increase in alcohol advertising is causing teens to drink is disproved by Federal government statistics, which show that alcohol consumption and binge drinking rates among 8th, 10th and 12th graders have continued their long-term decline, reaching historically low levels.4
The serious limitations in this study’s methodology make the results meaningless. One cannot conclude from this study that alcohol advertising has any impact on underage drinking decisions.
Raymond Scalettar, M.D., D.Sc.
Clinical Professor of Medicine, George Washington University Medical Center
Past Chair of the Board of Trustees, American Medical Association
Medical Advisor, Distilled Spirits Council of the United States
rscalettar@msn.com
References:
1. Tanski SE, McClure AC, Jernigan DH, Sargent JD. Alcohol brand preference and Binge Drinking Among Adolescents. Arch Pediatr Adolesc Med. 2011; 165(7):675-676.
2. The National Survey on Drug Use and Health. Data Spotlight: “Young Alcohol Users Often Get Alcohol from Family or Home.” Substance Abuse and Mental Health Services Administration; Center for Behavioral Health Statistics and Quality; February 17, 2011. www.oas.samhsa.gov/spotlight/Spotlight022YouthAlcohol.pdf.
3. Beverage Information Group Handbooks 2010. Kantar Media Intelligence 2009 data; 2010.
4. Monitoring the Future: National Results on Adolescent Drug Use. Overview of Key Findings, 2010. U.S. Department of Health & Human Services; National Institute on Drug Abuse; The University of Michigan Institute for Social Research; 2010. http://monitoringthefuture.org/pubs/monographs/mtf-overview2010.pdf.

Conflict of Interest: Medical Advisor, Distilled Spirits Council of the United States
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