title: Cued recall of alcohol advertising on television and underage drinking behavior.
abstract: OBJECTIVE
  Alcohol is the most common drug among youth and a major contributor to morbidity and mortality worldwide. Billions of dollars are spent annually marketing alcohol.
  
  
  OBJECTIVE
  To examine the reach of television alcohol advertising and its effect on drinking among underage youth.
  
  
  METHODS
  Longitudinal telephone- and web-based surveys conducted in 2011 and 2013 involving 2541 US adolescents 15 to 23 years of age at baseline, with 1596 of these adolescents completing the follow-up survey. Cued recall of television advertising images for top beer and distilled spirits brands that aired nationally in 2010-2011 (n = 351). Images were digitally edited to remove branding, and the respondents were queried about 20 randomly selected images. An alcohol advertising receptivity score was derived (1 point each for having seen the ad and for liking it, and 2 points for correct brand identification). Fast-food ads that aired nationally in 2010-2011 (n = 535) were similarly queried to evaluate message specificity.
  
  
  METHODS
  Among the underage youth at baseline, we determined (1) the onset of drinking among those who never drank, (2) the onset of binge drinking among those who were never binge drinkers, and (3) the onset of hazardous drinking among those with an Alcohol Use Disorders Identification Test consumption subscore of less than 4. Multivariate regressions were used to predict each outcome, controlling for covariates (demographics, drinking among friends and parents, and sensation seeking), weighting to the US population, and using multiple imputation to address loss to follow-up.
  
  
  RESULTS
  Underage participants were only slightly less likely than participants of legal drinking age to have seen alcohol ads (the mean percentage of ads seen were 23.4%, 22.7%, and 25.6%, respectively, for youth 15-17, 18-20, and 21-23 years of age; P < .005). The transition to binge and hazardous drinking occurred for 29% and 18% of youth 15 to 17 years of age and for 29% and 19% of youth 18 to 20 years years of age, respectively. Among underage participants, the alcohol advertising receptivity score independently predicted the onset of drinking (adjusted odds ratio [AOR], 1.69 [95% CI, 1.17-2.44]), the onset of binge drinking (AOR, 1.38 [95% CI, 1.08-1.77]), and the onset of hazardous drinking (AOR, 1.49 [95% CI, 1.19-1.86]). Fast-food advertising receptivity was not associated with any drinking outcome.
  
  
  CONCLUSIONS
  Receptivity to television alcohol advertising predicted the transition to multiple drinking outcomes. The findings are consistent with the idea that marketing self-regulation has failed to keep television alcohol advertising from reaching large numbers of underage persons and affecting their drinking patterns.
authors.affiliation: Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire2Norris Cotton Cancer Center, Lebanon, New Hampshire.
authors.forename: Susanne E
authors.initials: SE
authors.lastname: Tanski
authors.affiliation: Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire2Norris Cotton Cancer Center, Lebanon, New Hampshire3The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire.
authors.forename: Auden C
authors.initials: AC
authors.lastname: McClure
authors.affiliation: Norris Cotton Cancer Center, Lebanon, New Hampshire4Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.
authors.forename: Kristina
authors.initials: K
authors.lastname: Jackson
authors.affiliation: Norris Cotton Cancer Center, Lebanon, New Hampshire6Institute for Therapy and Health Research, Kiel, Germany.
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
authors.affiliation: Norris Cotton Cancer Center, Lebanon, New Hampshire.
authors.forename: Zhongze
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire2Norris Cotton Cancer Center, Lebanon, New Hampshire3The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire4Section of Biostatistics a.
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000329:Advertising / Q000706:statistics & numerical data*; D000367:Age Factors; D000428:Alcohol Drinking / Q000523:psychology*; D003463:Cues; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D013690:Television / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult