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Alcohol Marketing and Youth Evidence of a Problem

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									Alcohol Marketing and Youth:
   Evidence of a Problem


                David H. Jernigan Ph.D.
                 Associate Professor
     Department of Health, Behavior and Society
 And Director, Center on Alcohol Marketing and Youth
  Johns Hopkins Bloomberg School of Public Health
    Dedication: Dan Beauchamp,
   “Public health as Social Justice”
• Principles:
   1) controlling the hazards of this world
   2) to prevent death and disability
   3) through organized collective action (government or other)
   4) shared equally by all except where unequal burdens result in
      increased protection of everyone’s health and especially
      potential victims of death and disability

• Public health should work for a right to health (not just
  right to health care), defined as:
                    The right to full and equal
                 protection of all persons against
                 preventable death and disability
    Relationship between alcohol
  consumption and alcohol problems
• Alcohol problems arise from:
   – Intoxication occasions
   – Repeated episodes of intoxication
   – Steady heavy drinking
• Protective effect from consistent light drinking
   – This pattern rare in developed countries, even less common
     in developing societies
   – This pattern virtually unknown among U.S. young people; no
     evidence of health protection below age 40 anyway
• Bottom line: level of alcohol problems in a society
  will tend to rise with level of alcohol consumption
         Public health interventions
            vis a vis alcohol use
• Reduce overall alcohol consumption
   – Increase taxes
   – Reduce physical availability
• Reduce heavy drinking
   – Increase taxes
   – Reduce physical availability
   – Provide brief interventions or treatment
• Prevent/delay onset of use
   – Increase taxes
   – Reduce physical availability
   – Regulate advertising and promotion
• Reduce negative consequences of use
   – Drinking-driving countermeasures
           Factors that Affect Health
                                                    Examples
Smallest                                         Eat healthy, be
 Impact                                         physically active
                      Counseling
                      & Education
                                                 Rx for high blood
                       Clinical                   pressure, high
                                               cholesterol, diabetes
                    Interventions
                                               Immunizations, brief
                    Long-lasting             intervention, cessation
                                             treatment, colonoscop
               Protective Interventions
                                             Fluoridation, 0g trans
              Changing the Context           fat, iodization, smoke-
              to make individuals’ default   free laws, tobacco tax
Largest           decisions healthy
Impact                                         Poverty, education,
              Socioeconomic Factors            housing, inequality
                           Youth (age 12-20) Binge Drinking in the U.S.:
Much better than it would have been without community efforts, but not making
                      the progress we should be making


                                   25
     Percent drinking 5+ in past




                                   20
              30 days




                                   15

                                   10

                                   5

                                   0



                                                       Year


                                                  Males       Females


                                             Source: NSDUH 2009
                                               (SAMHSA 2010)
Binged (5+ on single occasion) in the
          past two weeks
                                         35
 Percent drinking 5+ in past two weeks




                                         30

                                         25

                                         20

                                         15

                                         10

                                          5

                                          0




                                                              Year



                                               8th Grade       10th Grade     12th Grade




                                              Source: Monitoring the Future 2010
                                                        (NIDA, 2010)
Beverage preference of 12th grade
     female binge drinkers




           Source: Monitoring the Future 2009
                     (NIDA, 2009)
           Drinking Among 15-16 year-olds:
                U.S. and Europe, 2007
                                             Percent Drank in Past 30 Days
90

80   80                            80
                              76                       75
                                                                                               73
                                                            71                                                                                                  70
70        70                                                                                        69
               66                                                                                                                                     67
                    64                            64                                 65   65                                           65
                         62                                                     63                                                63
                                        60                                                                         60                                      61
60                                                               59                                           57
                                                                           56                                                               57
                                                                                                                        52   52
50                                           48
                                                                                                                                                 44
                                                                                                         42
40
                                                                                                                                                                     33
                                                                      31
30

20

10

0
      Youth drinking in the U.S.
• Alcohol use is the number one drug problem
  among young people.
• In 2009, 10.4 million U.S. young people ages
  12-20 reported drinking in the past month,
  and 6.9 million reported binge drinking. (NSDUH)
• Every day, 4,750 kids under age 16 start
  drinking. (NSDUH)
• The earlier young people begin drinking, the
  worse the consequences are likely to be.
       Consequences of youth drinking
• Young people who begin drinking before age 15 are five times more
  likely to develop alcohol problems later in life than those who wait to
  drink until they are 21. (OSG, 2007)
• They are:
    – four times more likely to develop alcohol dependence (Grant and Dawson 1997);
    – seven times more likely to be in a motor vehicle crash because of
      drinking (Hingson et al. 2001);
    – eleven times more likely to be in a physical fight after drinking (Hingson et al.
       2000);

    – twelve times more likely to suffer from other unintentional injuries after
      drinking (Hingson et al. 2001).
• Alcohol is responsible for 5,000 deaths per year among people under
  21. (OSG, 2007)
         Death and Disability Attributable to Alcohol
            Use Among Youth Ages 15-29, 2000
                           Males 15-29                                                          Females 15-29
REGION Deaths (000s)   % total Deaths    DALYs (000s)   % total DALYs   Deaths (000s)   % total Deaths   DALYs (000s)   % total DALYs
Afr D        10            5.90%             560           5.30%             2              1.10%            129           1.00%
Afr E        28            7.90%            1,469          8.00%             5              0.90%            257           1.00%
Amr A         9           23.00%            1,388          28.40%            1              9.50%            401           9.80%
Amr B        52           35.50%            3,995          30.80%            4              7.90%            637           7.80%
Amr D         5           17.20%             369           16.80%            1              3.30%             69           3.70%
Emr B         2            4.80%              69           2.40%             0              1.20%             10           0.40%
Emr D         1            1.20%             123           1.60%             0              0.20%             16           0.20%
Eur A         9           25.60%            1,098          24.40%            1             10.20%            237           6.10%
Eur B         9           24.30%             662           16.90%            1              7.20%            103           3.10%
Eur C        42           41.00%            2,293          35.00%            5             19.90%            391           11.20%
Sear B       14           11.70%             839           11.30%            2              2.40%            116           1.80%
Sear D       26            5.70%            1,699          5.30%             6              1.30%            328           0.90%
Wpr A         2           18.40%             214           15.60%            0              7.00%            110           8.70%
Wpr B        39           13.70%            3,665          14.60%            7              4.90%            630           3.10%
WORLD        249          12.90%            18,444         13.10%            36             2.20%           3,434          2.50%



                                                        Source: Rehm et al. 2003
         Death and Disability Attributable to Alcohol
            Use Among Youth Ages 15-29, 2000

                           Males 15-29                                                          Females 15-29
REGION Deaths (000s)   % total Deaths    DALYs (000s)   % total DALYs   Deaths (000s)   % total Deaths   DALYs (000s)   % total DALYs
Afr D        10            5.90%             560           5.30%             2              1.10%            129           1.00%
Afr E        28            7.90%            1,469          8.00%             5              0.90%            257           1.00%
Amr A         9           23.00%            1,388          28.40%            1              9.50%            401           9.80%
Amr B        52           35.50%            3,995          30.80%            4              7.90%            637           7.80%
Amr D         5           17.20%             369           16.80%            1              3.30%             69           3.70%
Emr B         2            4.80%              69           2.40%             0              1.20%             10           0.40%
Emr D         1            1.20%             123           1.60%             0              0.20%             16           0.20%
Eur A         9           25.60%            1,098          24.40%            1             10.20%            237           6.10%
Eur B         9           24.30%             662           16.90%            1              7.20%            103           3.10%
Eur C        42           41.00%            2,293          35.00%            5             19.90%            391           11.20%
Sear B       14           11.70%             839           11.30%            2              2.40%            116           1.80%
Sear D       26            5.70%            1,699          5.30%             6              1.30%            328           0.90%
Wpr A         2           18.40%             214           15.60%            0              7.00%            110           8.70%
Wpr B        39           13.70%            3,665          14.60%            7              4.90%            630           3.10%
WORLD        249          12.90%            18,444         13.10%            36             2.20%           3,434          2.50%



                                                        Source: Rehm et al. 2003
         Death and Disability Attributable to Alcohol
            Use Among Youth Ages 15-29, 2000

                           Males 15-29                                                          Females 15-29
REGION Deaths (000s)   % total Deaths    DALYs (000s)   % total DALYs   Deaths (000s)   % total Deaths   DALYs (000s)   % total DALYs
Afr D        10            5.90%             560           5.30%             2              1.10%            129           1.00%
Afr E        28            7.90%            1,469          8.00%             5              0.90%            257           1.00%
Amr A         9           23.00%            1,388          28.40%            1              9.50%            401           9.80%
Amr B        52           35.50%            3,995          30.80%            4              7.90%            637           7.80%
Amr D         5           17.20%             369           16.80%            1              3.30%             69           3.70%
Emr B         2            4.80%              69           2.40%             0              1.20%             10           0.40%
Emr D         1            1.20%             123           1.60%             0              0.20%             16           0.20%
Eur A         9           25.60%            1,098          24.40%            1             10.20%            237           6.10%
Eur B         9           24.30%             662           16.90%            1              7.20%            103           3.10%
Eur C        42           41.00%            2,293          35.00%            5             19.90%            391           11.20%
Sear B       14           11.70%             839           11.30%            2              2.40%            116           1.80%
Sear D       26            5.70%            1,699          5.30%             6              1.30%            328           0.90%
Wpr A         2           18.40%             214           15.60%            0              7.00%            110           8.70%
Wpr B        39           13.70%            3,665          14.60%            7              4.90%            630           3.10%
WORLD        249          12.90%            18,444         13.10%            36             2.20%           3,434          2.50%



                                                        Source: Rehm et al. 2003
Brain activity in 15 year-olds during a
             memory task




Heavy use of alcohol during adolescence can impair brain
 development, causing loss of memory and other skills.
     Alcohol advertising and youth:
       adolescent brain research
• Brain imaging research has found that teens
  with alcohol use disorders show greater
  activity in areas of the brain previously linked
  to reward, desire, positive affect and episodic
  recall in response to alcoholic beverage
  advertisements.
• The highest degree of brain response was in
  youths who consume more drinks per month
  and report greater desires to drink. (Tapert et al.,
  2003)
     Alcohol advertising as a risk factor
• Recently published longitudinal studies have all found that the more
  youth are exposed to alcohol advertising and marketing the more
  they are likely to initiate drinking, even after controlling for other
  variables.
• Forms of alcohol advertising and marketing that predict drinking
  onset among youth:
    – Television beer advertisements (Collins et al. 2007, Snyder et al. 2006, Stacy et al.
       2004)
    – Alcohol ads in magazines (Collins et al. 2007, Snyder et al. 2006)
    – Alcohol ads on billboards (Snyder et al.    2006, Pasch et al. 2007)
    – In-store beer displays (Collins et al. 2007)
    – Beer concessions at sporting events (Collins et al. 2007)
    – Per capita spending on alcohol advertising in their media market (Snyder
       et al. 2006)
    – Alcohol use in movies (Sargent et al. 2006)
    – Ownership of alcohol promotional items (McClure et al. 2006, Henriksen et al.
       2008)
             Effects of Alcohol Advertising
           on Drinking Beliefs and Behaviors
                                          (5th – 11th Graders)

                  Exposure                           Positive      .28
                                                   Expectancies                       Intend to
                                                                    .18              Drink Beer
                     .25                                                                Adult
        Music
                               .13                                             .21    (R2=.41)
        People           .16
                                     Overall         Negative
                     .49             Liking        Expectancies
         Story
                                                                                      Intend to
                               .22                                       .13
                                                                                     Drink Beer
        Humor            .22 .37                                         .61
                                                                                     Next Year
                   .24
                                                                                      (R2=.60)
                                                        Peer
                   Attention
                                                      Drinking

Scaled 2 (795) = 899.36, p < .01                                                    Current
NFI = .85, Robust CFI = .96                                                          Drinking
                                                                  .15
RMSEA = .036                                           Peer
                                                     Approval                         (R2=.73)
                                                                           Source: Grube et al., 2005
 Alcohol advertising:
music, character, story…
   The U.S. youth alcohol market

The underage youth market is substantial, and
  dominated by heavy drinking:
• Underage drinking accounts for between 11 and 20
  percent of the U.S. alcohol market.
• Young people drink less frequently than adults, but
  drink more per occasion than adults.
• More than 90% of the alcohol consumed by 12-20
  year-olds is drunk when the drinker is having five or
  more drinks at a sitting (usually defined as within two
  hours)
            Self-regulation in
        the U.S. alcohol industry
• Alcohol industry self-regulation is the principal means
  for regulating alcohol advertising in the U.S.
• Beer and distilled spirits companies are most active
  marketers at this time.
   – Measured media expenditures 2006:
       • Total alcohol spending: $2.0 billion
       • Beer and ale alone: $1.28 billion
       • Distilled spirits alone: $492 million

• Examine codes from two industry associations:
   – Beer Institute
   – Distilled Spirits Council of the United States (DISCUS)
 U.S. Alcohol industry self-regulation
Beer Institute code:
• Beer advertising and
  marketing materials
  should not…claim or
  represent that
  individuals cannot
  obtain social,
  professional,
  educational, athletic, or
  financial success or
  status without beer
  consumption.
   Alcohol industry self-regulation

• “Beer advertising
  and marketing
  materials should not
  portray or imply
  illegal activity of any
  kind...”
• All 32 NFL stadiums
  have policies
  limiting beer sales to
  2 per customer
  Alcohol industry self-regulation

DISCUS code:
• Beverage alcohol
  advertising and
  marketing
  materials should
  not be associated
  with anti-social or
  dangerous
  behavior.
   Alcohol industry self-regulation
• DISCUS code:
  – Advertising and
    marketing
    materials should
    not contain or
    depict overt
    sexual activity or
    sexually lewd or
    indecent images
    or language.
  Ad recently played on Hulu, in conjunction with Crazy in
       Alabama, a PG-13 film with no age restrictions
  Alcohol industry self-regulation

DISCUS Code
• Beverage alcohol
  advertising and
  marketing materials
  may depict affection or
  other amorous gestures
  or other attributes
  associated with
  sociability and
  friendship.
  Previous national efforts on alcohol
        advertising in the U.S.
• 1980s – SMART campaign
   – Stop Marketing Alcohol on Radio and Television
   – Two million signatures delivered to Congress
   – No action taken
• 1990s – SAFE bill
   – “Sensible Advertising and Family Education” Act
   – Mandated warnings on alcohol advertisements – print and
     broadcast
   – Bill never even brought up for a vote in Congress
• 2000s – effort to get a national media campaign
   – $140 million in illegal drugs media campaign
   – $850,000 for alcohol campaign
Center on Alcohol Marketing & Youth
Founded in 2002, our philosophy was that
   reducing underage drinking requires a two-
   pronged public health approach:
1) Reduce young people’s access to alcohol.
2) Reduce the appeal of alcohol to young
   people, by:
     -   Providing public health messages about alcohol and
         underage drinking
     -   Limiting impact of alcohol advertising on youth by
         reducing youth exposure to it
              What CAMY does

• Answers the question: how much alcohol advertising
  do kids see?
• Tracks alcohol advertising on TV and radio and in
  magazines
• Uses standard industry sources – Neilsen, Arbitron,
  etc. – to measure the audiences for that advertising.
• Shows that over and over again, kids are exposed to
  more alcohol advertising per person than adults.
Create alcohol advertising database

   occurrence data               brands          audience data
   ad placement details          category +       youth + adult
brand and occurrence level       parent info    GRPs, impressions



   media       alcohol category database
   tools     who was exposed to what advertising


brand comparisons                              audience delivery


     category overview                   media comparisons


           local market detail      youth vs. adult exposure
      CAMY Magazine Database
• 29,616 magazine ad occurrences 2001-2008
  merged with audience data from MRI
   – Brand and audience detail
   – Audit perspective

• Data set includes virtually all spending in
  magazines monitored by Nielsen and MRI
   – database excludes demographic/regional editions,
     unmeasured magazines, corporate and responsibility ads
             Youth exposure to alcohol
              advertising: magazines

In 2008, compared to adults 21
   and over, youth ages 12-20
   saw per capita…
•   10% more beer ads
•   16% more ads for alcopops
•   73% fewer wine ads

The overwhelming majority of
   youth exposure – 78% - came
   from ads placed in
   magazines with
   disproportionate youth
   audiences.
Magazines 2002: Archives article

• Girls much more overexposed than boys
  – Girls saw 68% more beer advertising, 95% more
    alcopops advertising per capita than women
  – Girls saw more alcopops and beer advertising per
    capita than young adult women (21-34)
  – Boys saw more than adult men but not more than
    young adult men, rates of overexposure lower
  (Arch Pediatr Adolesc Med 2004)
          CAMY TV Database
• Industry standard sources (TNS and Nielsen)
• 2.1 million ad occurrences 2001-2009
• Network, program, brand, category
• Audience information
• Product, Responsibility, Corporate
• 9000+ commercials viewed and classified
        Youth Exposure to Alcohol Ads on
                 U.S. Television
• In 2009, 315,581 alcohol product commercials appeared on U.S. television.
• Underage youth ages 12-20 were more likely than legal-age adults on a per
  capita basis to have seen 67,656 of them, or about 21%.
• These ads accounted for more than 44% of youth exposure to alcohol
  advertising on television.
• From 2001 to 2009 – the number of television alcohol ads seen by the
  average 12 to 20 year-old increased by 69%, from 217 per year to 366 per
  year.
• Much of this increase was in distilled spirits ads, especially on cable TV.
• By 2004, the alcohol industry had adopted tighter ad placement standards to
  shield youth from exposure to their advertising. Nonetheless:
    –   Between 2004 and 2009, youth exposure to alcohol advertising on television actually grew at a
        faster than that of adults ages 21 and above, as well as that of young adults ages 21 to 34.
    –   This finding shows the ineffectiveness of the industry’s self-regulatory guidelines.
                    Radio 2006
• Analysis of census of all alcohol advertising in 28 of
  the largest U.S. markets in 2006:
   – More than a third – 120,299 or 35.6% – of advertising
     placements for alcohol were on programming that youth
     ages 12 to 20 were more likely per capita to hear than
     adults.
   – These ads accounted for more than half (58%) of youth
     exposure to alcohol advertising on the radio.
   – Approximately one in twelve – 27,862 or 8% – alcohol
     advertisements were on programming with youth audience
     compositions greater than the alcohol industry’s voluntary
     maximum of 30%.
   – 18 out of 143 brands placed 20% or more of their
     advertisements on programming with youth audiences above
     30%.
         Minority Youth Exposure
CAMY has issued two reports on Hispanic and two on
  African-American youth exposure to alcohol advertising.
In 2004, compared to the average for youth,
 Hispanic youth age 12 to 20 were exposed to:
    20% more alcohol advertising in English-language magazines
    More radio advertising for alcohol in 7 of the top 20 markets by
     Hispanic population in summer 2004
 African-American youth age 12 to 20 were exposed to:
    34% more alcohol advertising in national magazines
    More radio advertising for alcohol in 6 of the top 10 markets by
     population in summer 2004
        Importance of Monitoring
             at Brand Level
• Magazines, 2008:
  – 16 brands (5% of brands advertising alcohol in
    national magazines in 2008) accounted for half of
    youth exposure to alcohol advertising.

• Television, 2009:
  – 12 brands (8% of brands advertising on TV in 2007)
    accounted for half of youth overexposure.
  – 13 brands (9%) were responsible for 60% of the
    advertisements placed above the industry's
    voluntary standard of a 30% maximum for youth in
    its audiences.
 Does the industry “target” youth?
• Magazine study:
    – The ratio of the probability of a youth alcoholic beverage type
      advertising in a magazine to that of an adult type advertising in a
      magazine increased from 1.5 to 4.6 as youth readership increased
      from 0% to 40%.
    – Thus in magazines with highest youth readerships, youth alcoholic
      beverage types were more than four times more likely to advertise
      than adult alcoholic beverage types (King et al., Journal of Adolescent Health 2009)
• Cable television study:
    – Census of 608,591 advertisements on cable television, 2001 to
      2006
    – each one-point increase in the percentage of the audience that was
      adolescent was associated with more beer (+7%), spirits (+15%),
      and alcopop (+22%) ads per viewer-hour, but fewer wine (-8%) ads
       (P<.001 for all). (Chung et al., American Journal of Public Health, 2009)
Alcohol industry “responsibility advertising”
• “…no one can match the alcohol industry’s long-term
  commitment to public-service advertising that discourages
  underage drinking…”
         – Jeff Perlman, American Advertising Federation
        Alcohol industry
   “responsibility advertising”

•A “mixed message.”
•From 2001 to 2009, youth 12-20
 were 22 times more likely to see a
 product ad for alcohol on television
 than an alcohol industry
 “responsibility” ad.
                    Bottom line

• Whether intentional or not, current beer and distilled
  spirits industry practices pervasively over-expose youth to
  alcohol advertising
• This overexposure is responsible for a substantial
  proportion of youth exposure to alcohol advertising:
   – 78% of magazine exposure
   – 58% of radio exposure
   – 44% of TV exposure
• Presentation only covers measured media – one small
  subset of marketing. Other key areas: product placement,
  sponsorships, Spring Break, campus marketing, sports
  marketing, point of purchase, etc.
                  “Alcopops”

• Industry spokespersons have described
  alcopops as designed for “entry-level
  drinkers” and those who do not like the taste
  of beer.
• Even though most of them have distilled
  spirits in them, the industry claimed they were
  made from beer, so that they could be:
  – Taxed lower
  – Sold in convenience stores
  – Advertised on TV
       How popular are alcopops
            among kids?
• Most popular with the youngest drinkers.
• 78% of current 8th grade drinkers (past 30
  days) drank alcopops in the past 30 days.
• 71% of current 10th grade drinkers (past 30
  days) drank alcopops in the past 30 days.
• 65% of current 12th grade drinkers (past 30
  days) drank alcopops in the past 30 days.
• 42% of current drinkers, age 19 to 30, drank
  alcopops in the past 30 days.

                                    Source: MTF 2004
                                     Alcopops most popular with females
                                             in every age group
                              100%
Percent of current drinkers




                              90%
                              80%
                              70%
                              60%                                                                                                            Male
                              50%                                                                                                            Female
                              40%
                              30%
                              20%
                              10%
                               0%
                                     2004      2005       2006   2004      2005        2006   2004      2005        2006   2004     2005

                                            8th graders                 10th graders                 12th graders          19-30 year-olds
           New products…
• Shotpaks – 17% alcohol - .99 each…
• Featured on the Today show in July
               New products
Research findings on effects of alcoholic energy
drinks on the drinker:
   • Subjective perceptions of intoxication
   decreased (i.e. headache, weakness, dry
   mouth, perception of impaired motor
   coordination) compared to effects of
   drinking alcoholic non-energy drink
   •However, according to objective tests,
   motor coordination and visual reaction time
   were still just as impaired. (ACER 30:598-605, 2006)
   •AED drinkers more likely to engage in
   dangerous activities
New products: Nova Scotia
   New products: “Binge in a can”

• Caffeinated alcoholic beverages
  declared adulterated product by
  FDA in November 2010 – banned
  from the market by mid-December
• Companies’ response: “binge in a
  can”
  – Same packaging
  – Same huge serving size
  – Similar dangers to youth
            New products:
       alcoholic whipped cream
• “Whipahol”, “Whipped
  Lightning”, “Get Whipped”
• One can has alcohol
  content of 3 beers (18.5%
  alcohol)
• Flavors like white
  chocolate raspberry and
  strawberry colada
                Product Placement

                                                  • Many examples:
                                                       – Kahlua in
                                                         Catwoman
                                                       – Coors in Scary
                                                         Movie 3
                                                       – Carlsberg in
                                                         Spiderman
                                                       – Heineken ($10
                                                         million) in Matrix
                                                         Reloaded


Anheuser-Busch: Wedding Crashers, Batman Begins, Seabiscuit, Spider Man, Oceans
 Eleven, Terminator 3, Dodgeball, Collateral, Good Will Hunting, As Good As It Gets,
    Jerry Maguire, Children of a Lesser God, Mission Impossible, Ace Ventura: Pet
 Detective, Forrest Gump, The Silence of the Lambs, Platoon, Dirty Dancing, Working
  Girl, Top Gun, Rain Man, Erin Brockovich and Close Encounters of the Third Kind.
  Viral Marketing on the Internet


• Smirnoff Ice
  “Tea Partay”
  – Never broadcast
  – More than 4
    million hits on
    Youtube to date
  – Sequel has more
    than 3 million
    hits
                Alcohol Web Sites
• Fifty-five alcohol Web sites
  tracked by comScore Media
  Metrix during the last six months
  of 2003 had almost 700,000 in-
  depth visits from underage youth.
• Almost 60% of bacardi.com’s and
  almost half of skyy.com’s in-depth
  visits were from underage youth.
• With the help of parent volunteers
  in seven states and the District of
  Columbia, CAMY tested eight
  leading parental control software
  packages and found that 76% of
  alcohol brands eluded parental
  controls half the time or more.
Site Demographics (August 2010)




• Limitations:
     – Overall site demographics – not for specific pages or
       channels
     – Metrics largely undeveloped for this kind of marketing
•   Data source: The Nielsen Company
                                   Fans on Facebook
Brand           Page              Fans      Posts in Last   Likes   Comments   Posts in Last   Likes    Comments
                                            2 Weeks                            2 Months

Bacardi         Bacardi           119,009   1               470     54         13              3,036    477

Bacardi         Bacardi Mojito    75,250    0               0       0          7               891      129

Bacardi         Bacardi Torched   16,476    0               0       0          7               233      102
                Cherry

Bacardi         Bacardi Dragon    12,766    1               67      18         1               67       18
                Berry
Heineken        Heineken          465,456   5               4,561   869        28              16,440   3,040

Heineken        Heineken Light    34,160    4               319     132        15              1,575    377

Absolut Vodka   Absolut Vodka     530,266   1               66      12         6               680      204

Coors Light     Coors Light       352,712   2               596     245        6               3,199    924

Coors Light     Coors Light       74,033    6               296     42         31              2,523    639
                Brewing Company
Smirnoff        Smirnoff Ice      554,773   2               605     58         6               1,326    184

Smirnoff        Smirnoff US       96,670    8               2489    1647       38              11,918   6,699
              Estimated Impressions on Twitter


Brand               Followers                    Tweets            Estimated Impressions*

Bacardi             18,829                       553               5,206,218

Heineken            2,851                        55                78,402

Absolut Vodka       622                          160               49,760

Coors Light         1,883                        126               118,629

Smirnoff            11,702                       1,119             6,547,269




                                *Assuming Linear Follower Growth
                Impressions via Top Brand-Related
                        YouTube Videos*
Brand           Video URL                                    Video Title                       Views (Impressions)

Bacardi         http://www.youtube.com/watch?v=5RFxGn6C6a    Bacardi Mojito Ad                 2,411,243
                k
Heineken        http://www.youtube.com/watch?v=S1ZZreXEqSY   NEW Heineken Commercial – verry   8,572,796
                                                             funny


Absolut Vodka   http://www.youtube.com/watch?v=5p0QtJMKt1s   A Vodka Movie by Zach             1,923,074
                                                             Galifanakis, Tim and Eric


Coors Light     http://www.youtube.com/watch?v=jdUr5hF0yGc   Coors Light Jim Mora Press        1,059,570
                                                             Conference Ad


Smirnoff        http://www.youtube.com/watch?v=PTU2He2BIc0   Tea Partay                        5,582,600




                                             *Not on brand channel
Contextual Advertising – Pandora
Bud Light Lime on Pandora




                  Link to Facebook
Bud Light Lime Facebook Page
Brand-Uploaded Photo
Fan Photo on Bud Light Lime Facebook Page
Fan Photo on Bud Light Lime Facebook Page
Brand-Uploaded Photo
Brand-Uploaded Photo
Brand-Uploaded Photo
Brand-Uploaded Photos
Brand-Uploaded Photos
Fan Photo on Bacardi Silver Facebook Page
Fan Photo on Jim Beam Facebook Page
Fan Photo on Jim Beam Facebook Page
                   Coors Light 1st and Cold iPhone app




Age Verification            Content               Exposure
Age disclaimer (>17)        Interactivity/Games   254 ratings
A national debate: 2500 news
stories from 2001 to 2008
Alcohol advertising reform: national
          • Institute of Medicine recommendations:
             – There should be a national media campaign
               on underage drinking, with adults as the
               target
             – The federal government should monitor
               underage exposure to alcohol advertising on
               a continuing basis and fold these findings
               into an annual report to Congress on
               underage drinking
             – Industry self-regulation needs to get better –
               companies should move towards a 15%
               maximum youth audience composition for
               their advertising
                                       Why 15%?
              80
              70
              60
              50
    Percent

              40
              30
              20
              10
               0
                   12   13   14   15   16   17   18   19    20    21   22      23   24   25
                                                  Age

                                   Any alcohol use         Binge alcohol use

                                                                  NSDUH, 2003

• According to the National Household Survey, there is
very little current use of alcohol among those below 12.
• Thus, 12-20 is the population at highest risk.
    Young people in the population
• Youth 12-20 are 15.0% of total population 12 and
  above. (Population Estimates Program, Population Division, U.S. Census Bureau,
   5/17/2007)

     – Magazines, radio only measure 12+ population.
• Youth 12-20 are 13.0% of the total population 2 and
  above. (Population Estimates Program, Population Division, U.S. Census Bureau,
   5/17/2007)

     – Television measures 2+ population.
• A 30% youth audience threshold means youth are
  twice as likely to be in the viewing/reading/listening
  audience.
               CAMY and Public Policy
 Year   CAMY Reports on Youth Overexposure                    Policy Developments

2002    Magazines, television
2003    Radio, television, African-American     • FTC presses beer and spirits to move from 50%
        and Hispanic youth                      to 30%
                                                • NRC/IOM recommends 25%, with eventual
                                                movement to 15%
2004    Radio, internet, magazines, TV
2005    Magazines, TV, Hispanic youth
2006    Radio, television, magazines, African   • State attorneys general get industry to remove
        American youth                          ads from magazines going to schools and
                                                libraries
                                                •20 state attorneys general ask FTC to explore
                                                with industry move to 15%
2007    Magazines, radio, television            Beam Global Spirits moves to 25%, 15% annual
                                                aggregate average by brand
2008    Television                              One sitting FTC Commissioner dissents, calls for
                                                industry to move to 25%
2010    Magazines, television                   FTC staff asks industry to drop to 25%, industry
                                                refuses
 Progress in reducing youth exposure
• Magazines (2001-2008):
   – Youth exposure down by 53%
   – Adult exposure down by 37%
   – Drop in how much more advertising youth 12 to 20 saw than adults
     21+
       • Beer and ale: 58% to 24%
       • Distilled spirits: 52% to 16%
• Radio:
   – Samples of radio advertising, summer of 2003 and 2004
   – Number of markets where youth heard more alcohol advertising
     than adults fell from 92 of 104 in 2003 to 55 of 104 in 2004
• Television:
   – spending has increased, youth exposure rising
Industry practices change over time
              Attorneys-General
• Chief law enforcement officer in each state
• AGs role in tobacco key
• Bringing attention to the issue
• Playing a role in negotiations with alcohol companies
   – Movement towards less then 30% threshold
      • Beam Global, Sazerac principles
   – Other measures to reduce exposure including:
      • Selective binding to reach 21+ audiences
      • Removal of ads from issues going to schools/libraries
      • Successfully pressured to remove two leading alcoholic energy
        drink brands from the marketplace
      • Led to FDA ban of caffeinated alcoholic beverages
    CAMY modeling of impact of
        various scenarios
• Beam Global standard:
   – If adopted by the rest of the alcohol industry, would reduce
     youth exposure on television by nearly 14% and in magazines
     by more than 10%

• NRC/IOM 15% standard (modeled for last 10 months
  of 2004):
   – Youth exposure to alcohol advertising would have fallen by
     20%
   – Alcohol industry spending on television advertising would
     have fallen by 8%
   – There would have been virtually no effect on the industry’s
     ability to reach either 21 to 34 year-olds or 21 to 24 year-
     olds. (Jernigan et al. 2005)
                                                                            Percent Change in Exposure to Alcohol Advertising
                                                                        with Youth Composition Thresholds Varying from 1% - 30%
                                                                                      Target Audience Ages 21-34
                                                  50.0%
                                                                 Ages 12-20
                                                  40.0%          Ages 21-34
                                                                 Ages 35+
                                                  30.0%          Ages 21-49
     Percent Change vs. Actual 2004 Ad Schedule




                                                  20.0%


                                                  10.0%


                                                   0.0%


                                                  -10.0%


                                                  -20.0%


                                                  -30.0%


                                                  -40.0%


                                                  -50.0%


                                                  -60.0%
                                                           30%         25%               20%                15%                 10%             5%
                                                                              Youth Composition Threshold (ages 12-20 with a base of ages 2+)


•   Alcohol advertisers can reach young adult audience (21-34) without any impact, up to a 15%
    threshold
•   Youth exposure to alcohol advertising steadily declines as the youth composition threshold is
    lowered
•   Other adult (21-49, 35+) exposure increases as a consequence of targeting 21-34
    State Level Policy Options

• CAMY report:
  – Review of existing laws regarding alcohol
    advertising in the 50 states
  – Identification of best practices from among
    those laws
    •Content
    •Placement
    •Other measures
Alcohol advertising reform: state and local
• Take on the marketing “balloon”
• FTC reporting periodically on spending in 22 categories,
  including:
• Direct Mail Advertising           • Other Point-of-Sale Advertising
                                      and Promotions
• Newspaper Advertising
                                    • Spring Break Promotions
• Internet – on alcohol company-
  sponsored and other sites         • Product Placements
• Other Digital Advertising         • Retail Value-Added Expenditures
• Specialty Item Distribution       • Telemarketing
• Public Entertainment Events:      • Promotional Allowances
  Not Sports-Related
                                    • Social Responsibility Programs
• Sponsorship of Sporting Events,     and Messages
  Sports Teams, or Individual
  Athletes
Measured media: content regulation

• Prohibit false and misleading alcohol advertising
   – Best practices:
       • Idaho, Illinois, Massachusetts

• Prohibit alcohol advertising that targets minors
   – Best practices (11 states):
       • Alabama, Delaware, Maine, New Hampshire, New Jersey, North
         Carolina, Oregon, Utah, Vermont, Virginia, West Virginia

• Prohibit images of children in alcohol advertisements
   – Best practices (8 states plus D.C.):
       • Connecticut, Illinois, Michigan, Minnesota, Nebraska, New
         Hampshire, Ohio, Washington, District of Columbia
Measured media: content regulation
• Prohibit images or statements associating alcohol with athletic
  achievement
    – Best practices (6 states plus D.C.):
        • Connecticut, New Jersey, North Carolina, Utah, Virginia, Washington,
          District of Columbia
• Prohibit images or statements that portray or encourage
  intoxication
    – Best practices (9 states):
        • Delaware, North Carolina, Ohio, Oregon, Utah, Vermont, Virginia,
          Washington, West Virginia
• Establish explicit jurisdiction over in-state electronic media
    – Best practices (13 states explicitly giving alcohol control agency
      jurisdiction over television and radio advertising)
        • Illinois, Kentucky, Maryland, Mississippi, Missouri, New Hampshire,
          North Carolina, Ohio, Oregon, Pennsylvania, Tennessee, Utah, Virginia
    Measured media: placement
• Restrict outdoor alcohol advertising in locations
  where children are likely to be present
• Prohibit outdoor alcohol advertising near schools,
  public playgrounds and churches
• Restrict alcohol advertising on alcohol retail outlet
  windows and outside areas
• Restrict alcohol advertising on alcohol retail outlet
  windows and outside areas
• Prohibit alcohol advertising on college campuses
 Unmeasured media: promotions
• Restrict sponsorship of civic events
• Limit giveaways (contests, raffles, etc.)
     Measured media: placement
• Restrict outdoor alcohol advertising in locations where children
  are likely to be present
    – Can be done through general restriction of outdoor advertising,
      without reference to alcohol
    – Needs to be tailored so that youth viewing is restricted but adult
      viewing is still possible, e.g. by using “youth presence” criteria
    – Bans on outdoor advertising in public-owned venues (e.g. beaches,
      parks, buses, public buildings, stadiums, etc.) raise no
      constitutional issues
    – Best practices:
        • Ban or severely restrict outdoor advertising generally: 4 states
             – Alaska, Hawaii, Maine, Vermont
        • New Mexico – has ban on alcohol ads only on school buses
        • Other states – New York, Pennsylvania, Massachusetts – considering
          bans on alcohol ads on all publicly-funded transportation
   Measured media: placement
• Prohibit outdoor alcohol advertising near
  schools, public playgrounds and churches
  – One way of specifying “youth presence”
  – Best practice statute would:
     • Have distance threshold of 500 feet
     • Include all types of alcoholic beverage advertising
     • Specify schools, public playgrounds and churches as
       youth venues
  – No best practice states – 5 were “incomplete”:
     • Ohio, Indiana, Kentucky, Pennsylvania, Washington
   Measured media: placement
• Restrict alcohol advertising on alcohol retail
  outlet windows and outside areas
   – Should significantly limit amount of advertising on
     outside and in immediate vicinity of the retail
     establishment
   – Should significantly limit amount of advertising
     placed on both inside and outside of windows
   – Should not pre-empt stronger local actions
   – One state has best practice (Virginia); six states
     rated “incomplete”
      • California, Kansas, Mississippi, South Carolina, Texas,
        Utah
   Measured media: placement
• Prohibit alcohol advertising on college
  campuses
  – Should prohibit advertising in college newspapers
    and other publications
  – Should prohibit advertising on campus, including
    handbills, posters, etc.
  – Should include all campuses within the state.
  – Best practices (3 states)
     • New Hampshire, Pennsylvania, Utah
 Unmeasured media: promotions
• Restrict sponsorship of civic events
  – Should ban alcohol industry sponsorship of
    college/school events
  – Should ban sponsorships of events in public
    venues (e.g. parks, street fairs, government
    buildings)
  – Should significantly limit sponsorship in private
    venues other than alcohol retail outlets
  – Best practices
     • Five states “incomplete”: Florida, Michigan, Minnesota,
       Utah, Virginia
 Unmeasured media: promotions
• Limit giveaways (contests, raffles, etc.)
   – Should prohibit any giveaways as reward for purchasing the
     producer’s or distributor’s products
   – Should prohibit distribution of promotional materials at
     commercial or civic events at least to those under the legal
     drinking age
   – Best practices
       • 8 states have first provision above and so rated “incomplete”:
           – California, Connecticut, Mississippi, North Carolina, Ohio,
             Pennsylvania, Utah, Virginia
       • No state had second provision
       • New Mexico: limits advertising of “happy hour” specials etc but
         still permits a variety of giveaways, including
           – Non-alcoholic beverage promotional items
           – Free drink coupons as “gesture of good will or friendship”
  State-level progress: examples

• Taking on the rest of the marketing “balloon”:
  – Connecticut
     • Ban on all alcohol signage except at point of purchase at
       Renschler Field
  – Philadelphia
     • Ban on alcohol advertising on bus shelters
  – Ohio
     • 500 foot limit on billboard placements made enforceable
       through adoption into state administrative rules
  – California, Utah
     • CAMY data and presentations support work on alcopops
            Successes: Oregon
• Pressured national department store chains to stop
  selling t-shirts and games promoting binge drinking in
  youth departments
• Convinced Nordstrom’s department store to stop
  selling flip-flops that encouraged hiding alcohol in a
  polyurethane flask in the heel,
• Convinced Macy’s to withdraw alcohol-promoting t-
  shirts from its back-to-school advertising nationwide
• Pressured another alcoholic energy producer to
  withdraw its product, Rockstar 21, from the Oregon
  market.
                Successes: Texas
• Editorials or opinion pieces in seven major newspapers across
  the state,
• Got state Parent-Teachers Association to pass a resolution,
  testify at the state capital on alcohol advertising and youth, and
  feature the issue in their national magazine
• Convinced at least four city councils passed resolutions
  endorsing the National Research Council and Institute of
  Medicine’s recommendations on alcohol advertising
• Got state legislature to establish and study committee and hold
  hearings on alcohol advertising and youth
• Local coalitions throughout the state working to eliminate
  alcohol industry sponsorship of and reduce youth access to
  alcohol at celebrations and cultural festivals and held on public
  property.
• Organization now led by CAMY organizer; budget has tripled
                Successes: Maine
• Resolutions on alcohol marketing and youth passed by numerous
  town councils and delivered to state and federal representatives
  and policy makers.
• The youth group spearheaded the creation and dissemination of
  an Alcohol Retailer’s Local Marketing Code of Conduct.
• Local police departments surveyed alcohol type usage of minors
  arrested for alcohol possession – finds alcopops over-
  represented
• Youth group also developed a statewide survey of young people’s
  attitudes about alcohol marketing.
• All this leads to success in correcting classification of flavored
  alcoholic beverages by placing them in Maine’s higher-tax, lower
  availability low-alcohol distilled beverages category.
  Evidence Base for Effects of Reducing
  Youth Exposure to Alcohol Advertising
• An econometric study published in Health Economics in 2006
  predicted that 28% decrease in alcohol advertising would lead to a 4%
  to 16% drop in monthly youth drinking, and an 8 to 33% drop in youth
  binge drinking. (Saffer and Dave 2006)
• A demography-based test of likely effects of several alcohol policies on
  youth drinking behavior in the U.S. concluded that a complete ban on
  alcohol advertising would be the most effective for reducing premature
  mortality.
    – Complete ban: 7,609 fewer deaths from harmful drinking and a 16.4%
      drop in alcohol-related life-years lost.
    – Partial ban: 4% drop in alcohol-related life years lost. (Journal of Studies
      on Alcohol 2006)
• An analysis of the impact of evidence-based interventions on disability-
  adjusted life-years (DALYs) in 12 regions of the world found that in
  regions where heavy drinking is less prevalent, targeted strategies
  such as brief physician advice, roadside breath testing, and advertising
  bans would be most effective. (Journal of Studies on Alcohol 2004)
       Lessons learned: pace
• Requirement/ability to act in “real time”
• Understanding that there is goal in
  sight, and refusal to treat this a long
  and noble struggle
• Urgency – have to get candidate elected
• Time-limited nature of effort (“we will go
  away”)
     Lessons learned: organizing

• Many lessons in how to advocate
   – whom to reach out to and how
   – reaching decision-makers, editorial boards, etc.
   – resolutions as vehicles
   – how to walk around an op-ed, etc.
• Results, not process, are key:
   – Best results from people who understand how to reach grass
     tops, and who can put aside sub-agendas of community
     development, youth education, etc.
                       Focus
• Clear, achievable goal (reduce underage youth exposure
  to alcohol advertising)
• No diverging into other alcohol policy issues, no matter
  how tempting
• Clear, moderate policy objective (15%) – enables us to
  take high ground of reasonableness
• No industry smearing, rhetorical flights etc. – maintain
  high ground that data affords us
• Short-term
• The power of pictures
               What’s Next?
• CAMY
  – Funded by CDC through 2013 to continue
    monitoring, subject to appropriations
  – About to release report on youth exposure to
    alcohol advertising on TV 2001-2009
  – In coming months will release reports on radio,
    internet, and an update of African American youth
    exposure report
  – Have initiated a fellows program at JHSPH
    teaching students how to do the CAMY work
             WHO’s Global Strategy
• (a) leadership, awareness and commitment
• (b) health services’ response
• (c) community action
• (d) drink–driving policies and countermeasures
• (e) availability of alcohol
• (f) marketing of alcoholic beverages
• (g) pricing policies
• (h) reducing the negative consequences of drinking and alcohol
  intoxication
• (i) reducing the public health impact of illicit alcohol and informally
  produced alcohol1
• (j) monitoring and surveillance.
             WHO’s Global Strategy
• (a) setting up regulatory or co-regulatory frameworks, preferably with a
  legislative basis, and supported when appropriate by self-regulatory
  measures, for alcohol marketing by:
    – (i) regulating the content and the volume of marketing;
    – (ii) regulating direct or indirect marketing in certain or all media;
    – (iii) regulating sponsorship activities that promote alcoholic beverages;
    – (iv) restricting or banning promotions in connection with activities targeting
      young people;
    – (v) regulating new forms of alcohol marketing techniques, for instance social
      media;

• (b) development by public agencies or independent bodies of effective
  systems of surveillance of marketing of alcohol products;
• (c) setting up effective administrative and deterrence systems for
  infringements on marketing restrictions.
Alcohol advertising reform: global
• France has one of the strongest anti-alcohol advertising laws in
  the world
    – No advertising is allowed on television or in cinemas;
    – No sponsorship of cultural or sport events is permitted;
    – The law has been upheld by the European Court of Justice
• Thailand passed a new Alcoholic Beverage Control Act in 2008:
    – Prohibits sales of alcoholic beverages to anyone under 20
    – Bans consumption or sale of alcohol on government
      premises, schools, hospitals, petrol stations, parks
    – Bans alcohol advertising that in any way includes pictures of
      a product or encourages drinking – leaves only “corporate”
      advertisement and advertising originating outside of Thailand
YOU can make a difference!
 www.camy.org

								
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