Teens who sport clothes decorated with alcohol brand names are more likely to start drinking at younger ages and to engage in binge drinking, according to a telephone survey of over 6500 US youngsters age 10 to 14 years reported in the March issue of the Archives of Pediatric and Adolescent Medicine. Public-health experts are calling for stiffer regulation of alcohol-branded merchandise.
According to lead author Auden C. McClure, MD, from Dartmouth Medical School, in Hanover, New Hampshire, adolescents who own alcohol-branded items are 1.66 times more likely to begin alcohol use over the next 8 months than teens lacking such items. They were also more likely to begin binge drinking.
Conversely, teens without booze-branded clothes when they began drinking were 1.41 times more likely to own such merchandise within the next 8 months than those who did not begin drinking.
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Dr. McClure told Medscape Psychiatry that seeing alcohol-branded merchandise on an adolescent should trigger a prompt response from both clinicians and parents.
“Use this as an opening to talk to the teen and to the family about the implications of the item, and explain that it is a marker for possible progression to alcohol abuse,” Dr. McClure said.
Dr. McClure’s telephone survey first gathered information in 2003 about drinking behaviors and drinking attitudes. The main outcomes were the transition from never-drinker to trying alcohol without parents’ knowledge and from never-binge drinker (5 or more drinks in a row) to binge drinker.
In 3 follow-up surveys conducted at 8-month intervals, participants answered questions about changes in drinking habits and about ownership of alcohol-branded merchandise. The authors estimate that 3 million US teens own such merchandise. In this sample, the most common items were clothing (64%) and headwear (24%). Most items (75%) displayed beer labels, 45% of which were Budweiser.
Study Confirms, Extends Previous Work on Kids and Alcohol Ads
Behavioral scientist Rebecca L. Collins, PhD, the director of health promotion and disease prevention at RAND, in Santa Monica, California, who headed a RAND study on early adolescent exposure to alcohol advertising and its relationship to underage drinking, commented that McClure et al have produced a “very convincing” study.
“The researchers conducted the strongest test possible of the relationship between owning these items and subsequent drinking, short of giving a random group of teens these kinds of items and following up later to see how many of them started drinking or binge drinking.
“It confirms and extends the findings of other recent work, and this replicability makes it particularly compelling evidence that these items are problematic. Prior work was suggestive, but the links shown before might have meant merely that alcohol-branded merchandise was a flag for risk. This new study opened an empirical window, allowing us to view the hypothesized process behind a causal relationship,” Dr. Collins said.
Dr. Collins also pointed out that the study showed that 71% of the time, the kids got their alcohol-branded gear from “friends and/or family.”
“The finding that so many youth obtain these items from friends and family is nearly as important as the overall finding linking these items to drinking. It suggests there might be a triple-whammy effect of these items exposure to the brand names makes youth familiar with the brands and promotes liking, and actually wearing the items allows teens to identify themselves as part of the ‘club.’ Getting the items from family and friends indicates to teens it’s a club they should want to belong to,” Dr. Collins said.
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“Importantly, the results very clearly demonstrate that [alcohol-branded merchandise] ownership is more than a simple marker of an adolescent with favorable attitudes toward alcohol use, strengthening the case for [alcohol-branded merchandise] ownership as a causal factor in initiation of alcohol use and binge drinking,” the authors write.
Senior author James D. Sargent, MD, also from Dartmouth Medical School, told Medscape Psychiatry that parents need to be vigilant at not letting these items fall into the hands of their adolescents and need to realize that ownership of such an item might be a sign of teen drinking.
“I think clinicians should lobby Congress for stricter regulation of alcohol marketing, like the regulations that cover tobacco marketing. Maybe the [Food and Drug Administration] FDA should regulate alcohol. The distribution of alcohol-branded merchandise should be banned because of its effects on children,” Dr. Sargent said.
David H. Jernigan, PhD, from Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland, made a similar call for regulatory action in an editorial that accompanies this study