Drinking culture Essay

Alcohol marketing is a global phenomenon, in which an increasingly small number of companies spend considerable sums to establish and embed their brands in the lives and lifestyles of populations. Market research data offers insight into the size and extent of the global alcohol trade, and the magnitude of alcohol advertising expenditures. Recent examples of alcohol marketing in a variety of national contexts illustrate the techniques used by the global companies. The effects of this marketing on young people are described in reviews of recent research studies on youth exposure to alcohol marketing and the effects of that exposure, interpretive models to explain the effects of alcohol marketing on young people, whether alcohol advertising targets young people, and assessments of the effectiveness of regulatory restrictions on marketing and other countermeasures. Despite the failure of public health research to keep pace with newly developing marketing technologies, there is a growing body of evidence that alcohol marketing influences young people’s drinking behavior. Measures to reduce that impact should be considered by national governments seeking to limit the public health burden caused by harmful use of alcohol. KEY WORDS: alcohol, advertising, youth, globalization, marketing. AUTHOR ’ S NOTE : Support for development of an earlier version of this paper was provided by the World Health Organization.  © 2010 by Federal Legal Publications, Inc. 58 GLOBAL ALCOHOL MARKETING From a public health perspective, alcohol marketing matters. While there is tremendous diversity in the kinds of alcohol available throughout the world, from communally-produced traditional beverages to globalized mass consumer products, the globalized beverages play a particular role. They are, of their essence, marketed products, and as such are often the most visible manifestation of alcoholic beverages in a society. In this sense they lead the market for alcoholic beverages, providing an affordable badge of participation in western culture. As socioeconomic status rises in a developing nation, the likelihood of using these products tends to increase, along with western cultural orientation (Eide, Acuda, & Roysamb, 1998). Globalized alcoholic beverages are branded products, and benefit from the latest developments in marketing technology designed to embed the brand in the lives and minds of the target consumers (Aaker, 1996). Branding and marketing knowledge are critical to their globalization because, according to one researcher working from the standpoint of the survival of global firms, â€Å"in non-science-based industries such as alcoholic beverages .. . brands and marketing knowledge rather than technological innovation are central in explaining the growth and survival of multinational firms† (Lopes, 2003). Using this marketing knowledge, the global brands gain ubiquity through traditional media, sponsorships, and on-premise promotions, as well as â€Å"new media† such as mobile phones, podcasting, and the Internet. Both research on the health effects of this marketing activity and public health responses to mitigate those effects are hard pressed to keep up with the industry’s pace of innovation. Given this situation, this article reviews the shape and size of the global supply of marketed alcoholic beverages, describes some of the forms this marketing is taking in developed and developing societies, summarizes research on the effects of that marketing, and then outlines possible public health policy responses. 59 The global alcohol market: An overview According to Impact Databank, a leading market research firm serving the alcoholic beverage industry, premium globalized (branded) spirits account for approximately 44% of the total spirits products available around the world (Banaag, 2009). The alcohol industry funded International Center for Alcohol Policies reports that branded beer accounts for at least 38% of globally-available beer, and branded wine makes up at least 27% of the global wine supply (International Center for Alcohol Policies, 2006). Global value of the branded sector is unknown; however, sales volume of a single market—the United States—was estimated at $154. 9 billion in 2004 (Adams Beverage Group, 2005). Advertising expenditures (on broadcast, in print, and out-of-home) in that market in 2005 were $2 billion (Center on Alcohol Marketing and Youth, 2007b). According to the U. S. Federal Trade Commission, total alcohol marketing expenditures in the United States are approximately double this figure, with the remainder spent on â€Å"unmeasured† marketing activities such as sponsorships, product placements, campus promotions, and point-ofpurchase advertising (Federal Trade Commission, 2008). According to Adams Beverage Group, another industry market research firm, spirits and beer marketing account for more than 93% of measured alcohol advertising expenses in the United States. These two sectors likely dominate in the rest of the world as well, and this section will focus on the activities of global marketers in these two categories. Within the global beer and spirits industries, a small number of companies dominate. As of 2007, 44. 9% of global branded spirits were marketed by the ten largest companies, as shown in Table 1. High levels of concentration have been the rule in this segment of the industry since at least 1991 (Jernigan, 2009), through multiple waves of mergers that have increased the size of the top five companies (now with a market share of approximately 36%) relative to the rest of the market. * 60 GLOBAL ALCOHOL MARKETING TABLE 1 Ten largest global distilled spirits companies, 2006 and 2007 *Not in the top 10 in 2006. SOURCES: Impact Databank 2008a, Impact Databank, 2008c. TABLE 2 Ten largest brewers, 1979/80 and 2007 *Not in the top 10 in 1979/80. SOURCE: Cavanagh and Clairmonte, 1985; Impact Databank 2008b) 61 The majority of the market share for globally-branded beer, in contrast, has only recently concentrated in the hands of the ten largest brewers. The five leading brewers directly control more than half of the global market as estimated by Impact. As of 2008, concentrating and combining continue: InBev recently acquired Anheuser-Busch, which in turn has the majority ownership stake in Grupo Modelo but does not have management control, and which also owns 27% of Qingdao; while SABMiller merged with Molson Coors to form MillerCoors. (Market share information after these mergers is not available at this writing—Table 2 reflects the most recent data available. ) According to Advertising Age, six of these alcoholic beverage producers are among the world’s 100 largest advertisers (Wentz, 2007). As Table 3 shows, the spending of these companies is heavily concentrated in the United States and Europe. Global advertising expenditures of these six companies alone totaled more than $2 billion in 2006. Advertising Age’s figures are probably not complete, and they do not add spending of wholly- or majority-owned subsidiaries into the spending of the parent company. The publication provides data on advertising spending in 86 countries, but only provides the top 100 globally, and the top 10 spenders by country. As shown in Table 4, the leading companies or their subsidiaries are among the top 10 in 15 of the 86 countries—12 developing countries, one emerging market, and two developed nations. The shape of contemporary alcohol marketing As branded products, alcoholic beverages build their identities with a complex mix of marketing technologies. As a leading marketing theorist has written, â€Å"The presence of a brand (or even the attitudes held toward it) can serve to define a person with respect to others† so that the â€Å"brand becomes an exten- 62 TABLE 3 GLOBAL ALCOHOL MARKETING World’s largest alcoholic beverage advertisers and their advertising expenditures by region, 2006 SOURCE: Wentz, 2007. Other includes Canada, Africa and the Middle East. TABLE 3 Alcohol marketers among the ten largest advertisers in a country, by region, 2006 63 SOURCE: Wentz. 2007. The Shape of Contemporary Alcohol Marketing. 64 GLOBAL ALCOHOL MARKETING sion or an integral part of the self† (Aaker, 1996). Marketers accomplish this extension of the self by embedding brands in the lives and lifestyles of the target consumers, positioning them as an integral part of cultural and sporting events, as well as cultures, lifestyles, and even value systems (Fleming & Zwiebach, 1999; Klein, 1999). The mix of technologies employed to accomplish this include traditional advertising as well as sponsorships, sweepstakes, couponing, product placement, new product development, point-of-purchase materials and promotions, person-to-person and viral marketing, distribution and sale of branded merchandise, and the use of new and emerging technologies such as mobile phones and the Internet. The advertising spending figures above are for traditional or â€Å"measured† advertising activity alone. In this arena, alcohol marketing gains enormous exposure to the population, both that of legal drinking ages and below that age. Researchers in China have estimated that a city-dwelling young person who watches an average of 2 hours of evening television will see more than 900 alcohol ads a year (Zhang, 2004). In Australia, a Curtin University research group used advertising industry data to compare the exposure of underage and young adult drinkers to alcohol advertising on television. The researchers found that 13- to 17-year-olds were exposed to the same level of alcohol advertising as 18- to 24-year-olds (the legal drinking age in Australia is 18), and that 90% of alcohol ads, mostly for beer and premixed â€Å"alcopop† drinks, were screened when more than 25% of the viewing audience was underage (MacNamara, 2006). In Spain, researchers analyzed alcohol advertising in youthfocused written mass media from 2002 to 2006. The study found that alcohol advertising comprised 3. 8% of all magazine advertising and 8. 6% of the advertising in magazines which permitted alcohol advertising in their pages. Three out of six youth-oriented magazines identified permitted alcohol advertising (Montes-Santiago, Muniz, & Bazlomba, 2007). 65 In the United States, the Center on Alcohol Marketing and Youth at Georgetown University has also used market research databases to find, for example, that U. S. television advertising for alcohol in 2007 reached 96% of the adult population (defined in the U. S. as those 21 and over) an average of 446 times. At the same time, the advertising reached 89% of youth under the legal drinking age (i. e. , ages 12 to 20) an average of 436 times (Center on Alcohol Marketing and Youth, 2008). Magazine advertising for alcohol in 2006 reached 94% of the adult population an average of 77 times, and 90% of youth (ages 12 to 20) 89 times (Center on Alcohol Marketing and Youth, 2007a). On radio, analysis of a sample of 67,404 airings of advertisements for the 25 leading brands of alcohol found that nearly half (49%) of the advertisements were placed in programming with disproportionate numbers of listeners below the legal drinking age, while 14% of the placements violated the 30% voluntary maximum for youth audience composition set by alcohol industry trade associations (Jernigan, Ostroff, Ross, Naimi, & Brewer, 2006). Because of disparities in access to health care, youth of Hispanic and African heritage in the U. S. are at higher risk of alcohol problems if they drink (Galvan & Caetano, 2003). They are also often exposed to substantially more alcohol advertising than youth in general: In English-language national magazines in 2004, Hispanic youth saw 20% more advertising per capita and African-American youth were exposed to 34% more alcohol advertising per capita than was the average for youth in general (Center on Alcohol Marketing and Youth, 2005b; Center on Alcohol Marketing and Youth, 2006). Analysis of Nielson television ratings data from September 1998 to February 2002 confirmed that young African-American males (ages 6 to 17) were exposed to 31% more alcohol advertising on television than white youth, and that young AfricanAmerican females were exposed to 77% more television advertising for alcohol than their white peers. Furthermore, the racial differences in levels of exposure appeared to be increasing over time (Ringel, Collins, & Ellickson, 2006). 66 GLOBAL ALCOHOL MARKETING. As stated above, this â€Å"measured† marketing activity is only a fraction of what the global alcohol marketers spend each year. According to Klein (1999), in the early 1990s the amount of money spent by marketers on â€Å"unmeasured† activities increased dramatically. In 2008, the U. S. Federal Trade Commission (FTC) reported for the first time on the measured and unmeasured marketing expenditures of 12 of the largest companies, accounting for approximately 73% of sales of alcohol in the U. S (Federal Trade Commission, 2008). According to the FTC, these manufacturers spent 44% of their marketing dollars on the traditional measured media of print, radio, television and outdoor. Other significant categories included point-of-sale advertising and promotions (18. 8%), sponsorship of sporting events, sports teams or individual athletes (10. 9%), and promotional allowances to wholesalers and retailers (7. 5%). The balance between measured and unmeasured activities may vary by company as well: In its 2005 Annual Report, Diageo reported spending ? 1,023 million ($1,760 million) on marketing, far more than the $409 million reported by Advertising Age as its expenditure on advertising for 2004. Alcohol companies typically employ a mix of unmeasured activities, tailored to the brand as well as to the cultural, religious and regulatory context. For example, sponsorship is a huge area of activity. Within this category, sponsorship of sporting events is widespread. Anheuser-Busch, for instance, sponsors the FIFA World Cup, while nearly every team in World Cup competition has an alcohol sponsor. In fact, Anheuser-Busch is the second highest spender on sponsorships in the U. S. , behind PepsiCo, Inc. , spending $260-265 million in 2004 (Sparks, Dewhirst, Jette, & Schweinbenz, 2005). Beer company sponsorship of sports in China is increasing, with Anheuser-Busch sponsoring the Budweiser University League Soccer Games, amateur soccer tournaments, the 2004 Chinese Olympic Team, and the 2008 Beijing Olympic Games, while Heineken sponsors the Heineken Open Shanghai tennis tournament (Sparks et al. , 2005). 67 Such sponsorships increase the televised visibility for alcohol brands. Various researchers in the U. S. have monitored alcohol advertising during televised sporting events every five years since 1990-1992. The most recent study, covering the years 2000-2002, found an increase from 10 years earlier in the number of alcohol commercials airing during professional sports telecasts, the appearance of ads for â€Å"alcopops† only during college sporting events, as well as substantial numbers of alcohol-themed on-screen graphics such as â€Å"Bud Play of the Day† or â€Å"Busch Racing Leaders† appearing at the same time that the amount of alcohol signage within stadiums themselves has declined (Zwarun, 2006). Sports are not the only events receiving sponsorship dollars from alcohol producers. For example, the two leading breweries in Nigeria—one controlled by Guinness/Diageo, the other by Heineken—sponsor the National Annual Essay Competition, fashion shows and beauty contests on university campuses, university sporting events, musical segments of radio programs, radio call-in shows about particular alcohol brands in which correct answers win prizes, tours of foreign musical stars, and end-of-year carnivals at beaches or in parks (Jernigan & Obot, 2006). Faced with marketing restrictions, alcohol producers have also carried their alcohol brand names into other areas, such as the Carlsberg Hot Trax stores selling comic books, sports trading cards, and compact disks in Malaysia in the mid-1990s (Jernigan, 1997). Point-of-purchase is another important form of marketing. Researchers in the United States studied 3,961 retail outlets selling alcohol in 329 communities across the country. The majority of the stores (94%) had some form of point-ofpurchase alcohol marketing, while close to half (44%) had interior alcohol marketing materials placed at low heights, that is, within 3. 5 feet of the floor, where it would be more likely to be seen by children and adolescents than by adults (TerryMcElrath et al. , 2003). 68 GLOBAL ALCOHOL MARKETING Product placement in film and television is another means to increase the visibility of alcohol brands. According to Anheuser-Busch’s website, in the past 20 years it has placed its products in 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. These placements ripple into theaters all over the world, and then onto television, where they promote alcohol brands even in markets with restrictions on broadcast advertising of alcohol. Product placement has also become common in popular music, particularly rap and hip-hop. A recent study of alcohol mentions in rap music found that from 1979 to 1997 such references increased five-fold, with a particular increase in appearances of liquor and champagne brands after 1994. From 1994 to 1997, 71% of the rap songs that mentioned alcohol in this study’s sample named a specific alcohol brand (Herd, 2005). Content analysis of 1,000 of the most popular songs from 1996 and 1997 revealed that this phenomenon is far more pronounced in rap music (47% of rap songs in the sample studied had alcohol references) than in country-western (13%), top 40 (12%), alternative rock (10%) or heavy metal (4%) (Roberts, 1999). These mentions were not always paid placements, but some certainly were according to news reports (Campbell, 2006). In Africa, Diageo went one step further than product placement in films. In 1999, the company introduced a fictional spokesman, Michael Power, for its Guinness Stout brand. Power appeared in billboards and in a series of mini-adventures on radio and television, culminating in a starring role in a full-length feature film, Critical Assignment, which Diageo offered for free throughout the continent, spending $42. 4 million on the brand in 2003 alone. The company’s commercial director for Africa credited this campaign with increasing sales of Guinness in Africa by 10% in 2003, five times the 69 increase the brand enjoyed worldwide that year (Jernigan & Obot, 2006). Mobile phones are a new frontier for alcohol marketing. Market research firms estimate that by 2010, spending on mobile phone advertising and marketing will total â‚ ¬700 million in Europe and $1. 3 billion in the United States (Pfanner, 2006). According to Advertising Age, 81% of 18 to 21 year-olds, 68% of 16 to 17 year-olds, and 49% of 13 to 15 year-olds in the United States have cell phones, with the latter group the most likely to use their phones to participate in TV or radio polls, purchase ringtones, play games, and send text messages. Despite these statistics, Anheuser-Busch recently announced its intention to broadcast 18 ads per hour in programming from ESPN, Fox, ABC, and MSNBC distributed over MobiTV’s 30 channels of programming for cell phone users (Mullman, 2006). For years, in the United States Anheuser-Busch has run its own sports programming production unit, filming sporting events that feature the company’s logo prominently for broadcast on commercial outlets such as ESPN (Buchanan & Lev, 1989). In August 2006, the company announced the establishment of its own entertainment programming production unit to produce humorous shorts and sitcom-type programs. The company announced a new distribution channel for this programming in September 2006, â€Å"BudTV,† a new on-line entertainment network that would carry at least six types of programming, including comedy, reality, sports, and talk. According to company vice president Anthony T. Ponturo, going forward â€Å"the Internet will be equal to or better than television,† particularly in reaching the company’s target audience of males 21 to 34 (Elliott, 2006). The company announced it would double its annual spending on Internet advertising, to an estimated $90 million. Alcohol marketing on the web easily transcends national boundaries (and regulations). Research in the U. S. has found 70 GLOBAL ALCOHOL MARKETING large numbers of underage persons making in-depth visits (i. e. , visits beyond the age verification screens at the front end of many alcohol Web sites) to branded alcohol Web sites (Center on Alcohol Marketing and Youth, 2004). According to a survey of alcohol Web sites in 2003, the sites were filled with â€Å"sticky content† that may be attractive in particular to youth: video games, downloadable audio and video files and screensavers, make-your-own-music-video features, opportunities to create an online avatar and interact with others, practical joke postcards, and humorous customizable e-mail features that have the advantage of turning users into marketers, engaging in â€Å"viral† marketing that makes them inadvertent promoters of the brand to their friends by sending branded ecards and the like. Evidence of the effects of this marketing on youth When the U. S. Federal Trade Commission looked at the issue of alcohol advertising and youth in 1999, it concluded that â€Å"while many factors may influence an underage person’s drinking decisions, including among other things parents, peers and media, there is reason to believe that advertising also plays a role† (Federal Trade Commission, 1999). In 2000, a special report to the U. S. Congress on alcohol decried the lack of longitudinal studies assessing the effects of alcohol advertising on young people’s drinking behavior, and concluded that, â€Å"survey studies provide some evidence that alcohol advertising may influence drinking beliefs and behaviors among children and adolescents. This evidence, however, is far from conclusive† (U. S. Department of Health and Human Services, 2000). The intervening years, however, have witnessed an outpouring of new studies, looking particularly at alcohol advertising’s impact on youth. The most recent systematic review identified 13 longitudinal studies published in peer-reviewed literature, following up a total of more than 38,000 young people. The 71 review concluded that these studies consistently suggest that exposure to media and commercial communications about alcohol is associated with a greater likelihood that adolescents will initiate alcohol consumption, or drink more if they are already drinking at baseline (Anderson, De Bruijn, Angus, Gordon, & Hastings, 2009). Beyond documenting youth exposure to alcohol marketing (described above) and quantifying the effects of that exposure (this literature has been systematically reviewed three times in recent years—see Hastings, Anderson, Cooke, & Gordon, 2005; Smith & Foxcroft, 2007; Anderson et al. , 2009), researchers have also sought to develop interpretive models to explain the effects of alcohol marketing on young people, to assess whether alcohol advertising targets young people, and to quantify the effectiveness of regulatory restrictions on marketing and other countermeasures. The following sections will review developments since 2004 in each of these three categories. Interpretive If alcohol advertising affects young people’s decision making models regarding alcohol use, how does this occur? Early work on alcohol advertising and youth tended to rest on a simple theoretical basis: Exposure to alcohol advertising influences youth drinking behavior. However, more recent studies have pointed to the importance of alcohol advertising in shaping youth attitudes, perceptions and, particularly, expectancies about alcohol use, which then influence youth decisions to drink. Thus, in addition to measuring exposure and drinking behavior, researchers have increasingly included measures of attitudes and expectancies about alcohol use, integrating these variables into media effects models. For example, the Message Interpretation Process (MIP) model posits that children process media messages using a combination of logic and emotion or wishful thinking, and that the latter may override the former, a viewpoint consistent with the neurobiological evidence described above. In the case of alcohol advertising, the MIP model has been shown in cross-sectional research to suggest a cognitive progression from liking of alcohol ads (an 72 GLOBAL ALCOHOL MARKETING affective response associated with the desirability of portrayals in the ads and a resulting identification with characters in the ads) to positive expectancies about alcohol use, to intentions to drink or actual drinking among young people (Austin & Knaus, 2000; Austin, Pinkleton, & Fujioka, 2000). What young people appear to like in alcohol advertising is elements of humor and story, with somewhat less appreciation of music, animal characters, and people characters. Liking of these elements significantly contributed the overall likeability of specific advertisements, and then to greater likelihood of intent to purchase the product and brand advertised (Chen, Grube, Benjamin, & Keefe, 2005 ). The same study also found that young people are not interested in alcohol advertising stressing product attributes or discouraging underage drinking, and exposure to these was associated with less desire to purchase the product. Testing of the MIP model on cohorts of young people (defined as ages 15 to 20) and young adults (ages 21 to 29) provided further evidence of the validity of this model for describing youth decision-making processes. While exposure to alcohol advertising shaped attitudes and perceptions about alcohol use among both cohorts, these attitudes and perceptions predicted only the young people’s positive expectancies about alcohol and intentions to drink, but did not affect the young adults’ expectancies and alcohol consumption (Fleming, Thorson, & Atkin, 2004). While improved specification of the model of how alcohol advertising may affect young people’s drinking has in turn strengthened the statistical relationships found in this body of research, the studies thus far have continued to be hindered by their cross-sectional designs, which render conjectures about causality more difficult than longitudinal surveys. The fourth group funded by the NIAAA to study alcohol advertising and youth is focused on this question of how young people’s interpretive processes might explain the influence of alcohol advertising on them. A cross-sectional analysis of the first 73 wave of data collection from the study confirmed that adolescents progressively internalize messages about alcohol, and that these messages affect their drinking behaviors. Subjects who watched more primetime television found portrayals of alcohol in alcohol advertising more desirable, and showed greater desire to emulate the persons in the ads. These were associated with more positive expectancies about alcohol use, which then positively predicted liking beer brands as well as alcohol use (Austin, Austin, & Grube, 2006). Early analysis of longitudinal data from the work of this research group has revealed a positive relationship between liking of alcohol ads at baseline and alcohol consumption over a follow-up period of three years, among a cohort of 9- to 16year-olds from nine counties in the San Francisco Bay Area. The effects of liking the ads were mediated through expectancies about alcohol use, as well as through normative effects of the exposure to alcohol advertising. Young people who liked alcohol advertising not only believed that positive consequences of drinking were more likely, but also were more likely to believe that their peers drank more frequently, and that their peers approved more of drinking. All these beliefs interacted to produce greater likelihood of drinking, or of intention to drink within the next year. Furthermore, the causal arrows all pointed in one direction—that is, positive expectancies about alcohol use did not predict greater liking of the alcohol ads, nor did assumptions about peer drinking or peer opinions of drinking (Chen & Grube 2004). While most alcohol advertising on television is for alcohol products, alcohol companies also place substantial amounts of what are dubbed â€Å"responsibility† ads, which may discourage drunk driving or underage drinking, or otherwise encourage people to use alcohol responsibly and in moderation. According to the Center on Alcohol Marketing and Youth, from 2001 to 2003 alcohol companies placed 21,461 such ads, compared with 761,347 product ads. Youth were substantially more likely to be exposed to product than to responsibility 74 GLOBAL ALCOHOL MARKETING ads: in 2003, they were 96 times more likely to see a product ad than an industry-funded ad about underage drinking, and 43 times more likely to see a product ad than an industry ad about drinking-driving (Center on Alcohol Marketing and Youth, 2005a). A recent study attempted to assess the impact of these messages on young people, and concluded that the advertisements were examples of strategic ambiguity, defined as â€Å"the strategic and purposeful use of messages with high levels of abstraction to simultaneously accomplish multiple, and often conflicting, organizational goals† (Smith, Atkin, & Roznowski, 2006). More so with teens (age 16 to 18 in the study’s sample) than with young adults (age 19 to 22), young people drew diverse messages from the advertisements. In the context of little evidence that such advertising is effective in encouraging responsible drinking behavior (DeJong, Atkin, & Wallack 1992), the study found that young people’s evaluative responses about the brewers who placed the ads were predominantly favorable, while interpretations taken from the ads were mostly pro-drinking. Grube and Waiters (2005) recently reviewed the evidence on the content of alcohol messages in the mass media and their effects on drinking beliefs and behaviors among youth. They begin by pointing to the largely positive message environment about alcohol that exists in the mass media outside of paid advertising, including television programming, film, popular music and music videos, Internet content (as opposed to paid Internet advertising, and including alcohol company Web sites), and magazine content. The impact of this content on young people’s drinking behavior has mostly gone unexamined in the scientific research literature. Their review of the evidence regarding alcohol advertising’s effects concludes that â€Å"survey research studies on alcohol advertising and young people consistently indicate that there are small, but significant, correlations between awareness of and liking of alcohol advertising and drinking beliefs and behaviors among young people† (Grube & Waiters, 2005). 75. Whether alcohol advertising targets young people Even if there is a relationship—which longitudinal research studies suggest may be causal—between youth exposure to alcohol advertising and youth drinking behaviors, is the level of youth exposure to alcohol advertising in the mass media the result of intentional targeting, or simply incidental to the alcohol industry’s efforts to reach its principal target (usually identified in the United States as young adults age 21-34 [Theodore, 2001; Riell, 2002])? In 2003, an article appeared in the Journal of the American Medical Association alleging that magazine advertising by beer and liquor companies is associated with adolescent readership (Garfield, Chung, & Rathouz, 2003). Based on a census of the alcohol advertising in 35 major U. S.magazines appearing from 1997 to 2001, the study used market research data to estimate adolescent (ages 12 to 19), young adult (ages 20 to 24) and older adult (ages 25 and above) readers of those magazines, and found that, after adjusting for magazine characteristics, every additional million adolescent readers predicted a 60% increase in the rate of beer or distilled spirits advertising appearing in the magazine.