title: Portrayal of alcohol consumption in movies and drinking initiation in low-risk adolescents.
abstract: OBJECTIVE
  To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol.
  
  
  METHODS
  Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up.
  
  
  RESULTS
  Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02-1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06-1.20; P < .001).
  
  
  CONCLUSIONS
  Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure.
authors.affiliation: Institute for Therapy and Health Research (IFT-Nord), Kiel, Germany;Institute for Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel, Germany; hanewinkel@ift-nord.de.
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
authors.affiliation: Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire;
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.affiliation: MRC/CSI Social & Public Health Sciences Unit, University of Glasgow, Scotland;
authors.forename: Kate
authors.initials: K
authors.lastname: Hunt
authors.affiliation: MRC/CSI Social & Public Health Sciences Unit, University of Glasgow, Scotland;
authors.forename: Helen
authors.initials: H
authors.lastname: Sweeting
authors.affiliation: Behavioural Science Institute, Radboud University, Nijmegen, Netherlands;
authors.forename: Rutger C M E
authors.initials: RC
authors.lastname: Engels
authors.affiliation: Behavioural Science Institute, Radboud University, Nijmegen, Netherlands;
authors.forename: Ron H J
authors.initials: RH
authors.lastname: Scholte
authors.affiliation: Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Italy; and.
authors.forename: Federica
authors.initials: F
authors.lastname: Mathis
authors.affiliation: Laboratory of Environmental Research, Department of Toxicology, University of Medical Sciences, Poznan, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Florek
authors.affiliation: Institute for Therapy and Health Research (IFT-Nord), Kiel, Germany;Institute for Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel, Germany;
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D063425:Binge Drinking / Q000453:epidemiology / Q000523:psychology; D015984:Causality; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006306:Health Surveys; D006801:Humans; D007100:Imitative Behavior; D008137:Longitudinal Studies; D008297:Male; D009040:Motion Pictures; D012306:Risk; D012928:Social Desirability
keywords: Europe; alcohol imagery; binge drinking; movies; young people