title: Alcohol consumption in movies and adolescent binge drinking in 6 European countries.
abstract: OBJECTIVE
  The goal of this study was to investigate whether the association between exposure to images of alcohol use in movies and binge drinking among adolescents is independent of cultural context.
  
  
  METHODS
  A cross-sectional survey study in 6 European countries (Germany, Iceland, Italy, Netherlands, Poland, and Scotland) was conducted. A total of 16 551 pupils from 114 public schools with a mean (± SD) age of 13.4 (± 1.18) years participated. By using previously validated methods, exposure to alcohol use in movies was estimated from the 250 top-grossing movies of each country (years 2004-2009). Lifetime binge drinking was the main outcome measure.
  
  
  RESULTS
  Overall, 27% of the sample had consumed >5 drinks on at least 1 occasion in their life. After controlling for age, gender, family affluence, school performance, television screen time, sensation seeking and rebelliousness, and frequency of drinking of peers, parents, and siblings, the adjusted β-coefficient for lifetime binge drinking in the entire sample was 0.12 (95% confidence interval: 0.10-0.14; P < .001). The crude relationship between movie alcohol use exposure and lifetime binge drinking was significant in all countries; after covariate adjustment, the relationship was still significant in 5 of 6 countries. A sensitivity analysis revealed that the association is content specific, as there was no significant association between lifetime binge drinking and exposure to smoking in movies.
  
  
  CONCLUSIONS
  The link between alcohol use in movies and adolescent binge drinking was robust and seems relatively unaffected by cultural contexts.
authors.affiliation: Institute for Therapy and Health Research, Kiel, Germany. hanewinkel@ift-nord.de
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.forename: Evelien A P
authors.initials: EA
authors.lastname: Poelen
authors.forename: Ron
authors.initials: R
authors.lastname: Scholte
authors.forename: Ewa
authors.initials: E
authors.lastname: Florek
authors.forename: Helen
authors.initials: H
authors.lastname: Sweeting
authors.forename: Kate
authors.initials: K
authors.lastname: Hunt
authors.forename: Solveig
authors.initials: S
authors.lastname: Karlsdottir
authors.forename: Stefan Hrafn
authors.initials: SH
authors.lastname: Jonsson
authors.forename: Federica
authors.initials: F
authors.lastname: Mathis
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Faggiano
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007100:Imitative Behavior; D008297:Male; D009040:Motion Pictures; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult