Ownership of Alcohol-Branded Merchandise and Initiation of Teen Drinking

Background

The alcohol industry spends over $5 billion a year on marketing, much of which is accessible to children. The distribution of branded articles of clothing and other personal items is one aspect of alcohol marketing that has not been adequately studied. In this study, the prevalence of ownership of alcohol-branded merchandise (ABM) was determined in a sample of rural northern New England adolescents, and the relationship between ownership of such items and initiation of alcohol use was examined.

Design/Methods

Northern New England middle school students who had not yet initiated alcohol use were captured at baseline in a 1999 school-based survey, and ownership of an ABM item and initiation of alcohol use were determined 1 to 2 years later by telephone. The analysis controlled for demographics (gender, grade in school); characteristics of the child (school performance, sensation seeking, rebelliousness); parenting style; and peer alcohol use.

Results

Of 2406 baseline never-drinkers, 15% had initiated alcohol use and 14% owned an ABM item by follow-up. ABM items consisted primarily of articles of clothing such as t-shirts and hats. ABM ownership was associated with higher grade in school, male gender, exposure to peer drinking, having tried smoking, poorer academic performance, higher levels of sensation seeking and rebelliousness, and less-responsive and restrictive parenting styles. Owners of ABM items at follow-up had higher rates of alcohol initiation compared with non-owners (25.5% vs 13.1%, respectively, p<0.001). After adjusting for the above confounders, students who owned an ABM item were significantly more likely to have initiated alcohol use compared with students who did not own one (adjusted odds ratio 1.5, 95% confidence interval, 1.1–2.0).

Conclusions

In this northern New England adolescent sample, ownership of alcohol-branded merchandise was prevalent and exhibited an independent cross-sectional association with onset of adolescent drinking. Further studies are necessary to determine whether the relationship is causal, and whether teen use of ABM items influences peer drinking norms and behavior.

Introduction

Alcohol use among young people is an area of ongoing national concern.1, 2 The use of alcohol by teens is associated with poor school performance, impaired relationships with family and friends, and the adoption of other risk-taking behaviors, such as driving while intoxicated, alcohol-related aggression, and unsafe sexual activity.3, 4, 5, 6, 7 Teen alcohol use is also associated with a higher risk of future alcohol abuse and dependence.8, 9, 10, 11

The alcohol industry is not required to report its marketing expenditures, but they have been estimated to exceed several billion dollars per year.¹² The impact of alcohol advertising on youth has been studied for a number of media channels, including television, magazine, and billboard advertising. There is a growing body of evidence that these advertising venues are reaching both children and adolescents,13, 14, 15, 16, 17 and that exposure to alcohol advertising is related to the development of positive attitudes toward alcohol use14, 16, 17 and the adoption of its use.18, 19, 20, 21 Marketing expenditures are not limited to advertising; in 1999, the Federal Trade Commission reported that the “industry’s total expenditures to promote alcohol may be three or more times its expenditures for measured media advertising.” Such promotions include the “distribution of brand-logoed items such as t-shirts, hats, watches, and glassware.”²² In this article, those items are referred to as alcohol-branded merchandise (ABM). Our clinical experience suggests that ABM may be finding its way into the hands of adolescents just as cigarette-branded merchandise did a decade ago. This observation is supported by one cross-sectional study showing that 31.7% of middle school students owned ABM, and that 51.1% reported seeing such items at school.²³

High visibility in the public school setting also characterized the multi–billion dollar cigarette-branded merchandise campaigns of the 1990s. By 1990, promotional-item distribution represented one of the largest categories of tobacco marketing, which at $1.2 billion per year composed 30% of all cigarette advertising and promotional expenditures.²⁴ Subsequent research established a strong basis for a causal relationship between cigarette-branded merchandise and the initiation of smoking among youth; the findings were instrumental in the incorporation of a ban on the distribution of any cigarette-branded merchandise into the Master Settlement Agreement with the state attorneys general in 1999.²⁴

In this study, the prevalence of ownership of ABM items among northern New England adolescents was determined. Given previous research linking cigarette-branded merchandise ownership to smoking initiation, it was hypothesized that ABM ownership would be associated with the initiation of alcohol use. As a first step in testing this hypothesis, a cross-sectional study among middle school adolescents was conducted to examine the prevalence of ownership of such items and its relationship with alcohol use.

The analysis adjusted for a number of covariates that, based on previous longitudinal research, might be associated with ownership of ABM and the initiation of alcohol use. Hawkins et al.25, 26 have linked the adolescent use of alcohol with poor school bonding, friend drinking, parent drinking, and proactive parenting. Jessor²⁷ has shown that rebelliousness and having relative tolerance for deviance are associated with engaging in multiple risk behaviors during adolescence, including smoking and drinking. Several studies have linked personality factors to adolescent alcohol use; those who engaged in substance use and other problem behaviors were typically found to have higher scores on sensation seeking²⁸ and the related characteristic of novelty seeking.²⁹ Therefore, a number of these potential covariates were examined in the current study, as described below.