Owning alcohol-branded merchandise common, associated with drinking behaviors among teens

Between 11 percent and 20 percent of U.S. teens are estimated to own T-shirts or other merchandise featuring an alcohol brand, and those who do appear more likely to transition through the stages of drinking from susceptibility to beginning drinking to binge drinking, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Alcohol-branded merchandise includes T-shirts, hats or other items that feature a particular brand of beverage, according to background information in the article. Increasing evidence suggests that this specialized type of marketing effectively reaches teenagers and is associated with alcohol use.

Auden C. McClure, M.D., M.P.H., of Dartmouth Hitchcock Medical Center, Hanover, N.H., and colleagues conducted a telephone survey of a representative sample of 6,522 U.S. adolescents age 10 to 14 years in 2003. The teens reported information about their drinking behaviors and drinking susceptibility, measured by items assessing responses to peer offers, intentions to drink and positive expectancies about drinking. At three follow-up surveys conducted every eight months, participants answered questions about changes in drinking habits and ownership of alcohol-branded merchandise.

The percentage of teens owning alcohol-branded merchandise ranged from 11 percent at the eight-month survey to 20 percent at the 24-month survey. The most commonly owned products were clothing (64 percent) and headwear (24 percent), with the remaining items a wide array that included jewelry, key chains, shot glasses, posters and pens. Most (75 percent) of the brands were beer, including 45 percent that featured the Budweiser label.

Among teens who had never drank alcohol, owning alcohol-branded merchandise and susceptibility to drinking were reciprocally related, with each predicting the other during an eight-month period. In addition, owning alcohol-branded merchandise and having a susceptible attitude toward drinking predicted both the initiation of alcohol use and binge drinking, even after controlling for other risk factors.

"Alcohol-branded merchandise is widely distributed among U.S. adolescents, who obtain the items one-quarter of the time through direct purchase at retail outlets," the authors write. "The results also demonstrate a prospective relationship between alcohol-branded merchandise ownership and initiation of both alcohol use and binge drinking. This is the first study to link alcohol-branded merchandise ownership to more problematic youth alcohol outcomes that predict morbidity [illness] and mortality [death]. Notably, the relationship is independent of a number of known social, personality and environmental risk factors for alcohol use."

Together with the literature to date, the study "provides strong evidence that alcohol-branded merchandise distribution among adolescents plays a role in their drinking behavior and provides a basis for policies to restrict the scope of such alcohol-marketing practices," they conclude.

(Arch Pediatr Adolesc Med. 2009;163[3]:211-217. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study is funded by a grant from the National Institute on Alcohol Abuse and Alcoholism. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

"The evidence is strong that youth exposure to alcohol marketing increases the likelihood of early initiation, which in turn puts young people at greater risk of alcohol-related harm," writes David H. Jernigan, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, in an accompanying editorial.

"Voluntary approaches have been ineffective in reducing the risk. Political will is needed both to improve data collection and reporting and to move toward restrictions that will give young people a chance to grow up alcohol-free. McClure et al provide important new evidence that points to an urgent need for action."

(Arch Pediatr Adolesc Med. 2009;163[3]:278-279. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.