Alcohol consumption among adolescents is high. According to the Centers for Disease Control and Prevention, 39 percent of U.S. adolescents are current drinkers, and roughly 22 percent are current binge drinkers. The average U.S. adolescent is also exposed to about 2.5 hours of popular music per day, and eight mentions of alcohol brands every day. A new study of linkages between adolescents' involvement with music containing alcohol-brand mentions and their alcohol-related behaviors has found strong and independent associations between the two.
Results will be published in the June 2014 online-only issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Average exposure is about eight alcohol brand name mentions per day," explained Brian A. Primack, associate professor of medicine and pediatrics at the University of Pittsburgh and corresponding author for the study. "This is based on average exposure of 2.5 hours of music per day, with 3-4 brand mentions each hour. However, this is just an average. For some kids, it will be more, and for others it will be less."
"Alcohol brand names are quite prevalent in popular music," added Lisa Henriksen, senior research scientist at the Stanford Prevention Research Center. "For example, hip-hop/rap lyrics favor luxury brands, such as Cristal and Hennessy, and brand references in rap music have increased four-fold over time, from eight percent in 1979 to 44 percent in 1997. It would be foolish to think that the alcohol industry is unaware of and uninvolved with alcohol-brand mentions in music. The strategy of associating products with hip culture and celebrities who are attractive to youth comes straight from a playbook written by the tobacco industry."
"We believe that this is the first study of its kind for three primary reasons," said Primack. "First, it is large and nationally representative; second, it measured alcohol brand exposure in some relatively rigorous and innovative ways; and third, it was able to control for a number of important covariates."
For this study, Primack was part of a team of researchers led by James D. Sargent, a professor of pediatrics at the Geisel School of Medicine at Dartmouth. During 2010-2011, the team conducted a random-digit-dial survey using national U.S. landline and cell phone numbers. Through screening interviews, 6,466 eligible households with subjects between 15 to 23 years of age were identified, of whom 3,422 (52%) completed the telephone survey. Of these, 2,541 (1,296 males, 1,245 females) agreed to participate in a subsequent web-based component. Independent variables included owning and liking popular songs with alcohol-brand mentions, and correct recall of alcohol brands in songs. Outcome measures included ever having consumed a complete drink, ever bingeing, bingeing at least monthly, and having experienced problems from alcohol use.
"Based upon this data, which included a large, nationally representative sample of U.S. adolescents and young adults, we found independent associations between being receptive to and knowledgeable about alcohol brand mentions in music and important alcohol outcomes," said Primack.
"Even drinking and binge drinking were more common among young people who liked or owned popular songs with alcohol brand names," added Henriksen.
"We created a scale that placed youth into three categories – low, medium, or high – based on how much they liked and owned music containing alcohol brand mentions," explained Primack. "Compared with people who were 'low' on this scale, people who were 'high' had more than three times the odds of ever having a complete drink of alcohol, which is an important outcome in this age group. Also compared with people who were 'low' on this scale, people who were 'high' had about twice the odds of ever bingeing on alcohol. This outcome is especially problematic, because binges are particularly clinically relevant—it is on a binge that youth often get injuries or other serious problems.
"The association of receptivity to alcohol brand names in music with binge drinking is worrisome," added Henriksen. "It will be important to learn whether receptivity predicts high-risk drinking among youth who were not drinkers to start."
Both Primack and Henriksen commented on the tendency for people to believe they are immune from advertising.
"Youth tend to think that they are not influenced by media messages," said Primack. "Interestingly, they will tend to say that other people their age are influenced, but they themselves are not. So, much of this influence may be subconscious."
"People often underestimate the impact of advertising on health behaviors, such as drinking, smoking, and eating energy-dense foods," concured Henriksen. "The idea that people mistakenly assume that others' behaviors are more influenced by advertising than their own behaviors is known as the third-person effect."
"In terms of policy," said Primack, "it is worth considering whether or not payment to music stars by alcohol companies is in violation of current guidelines. For example, the Distilled Industries Council of the U.S., or DISCUS, states that 'Alcohol advertising and marketing materials should portray alcohol products and drinkers in a responsible manner.' This text is vague and challenging to interpret. However, if you watch a few music videos by stars who are spokespeople for alcohol companies, you would likely come away questioning whether these messages portray 'alcohol products and drinkers in a responsible manner.' Thus, it may not be a question of enacting new legislation, but rather one of simply enforcing current legislation."
Primack also spoke of the potential value of "media literacy," defined as the ability of a person to analyze and evaluate media messages, as part of education efforts. "Some traditional heavy-handed educational programs can actually backfire, especially for sensation seeking youth who are more likely to abuse alcohol in the first place," he said. "Media literacy, on the other hand, helps youth to analyze and evaluate what they see in the media and then make their own choices. It may be a more developmentally appropriate and effective approach, because it encourages critical thinking and supports youth autonomy."