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Article Excerpt
Introduction and literature synopsis
In this article we focus on U.S. national developments in alcohol advertising and counter-advertising in the 1980s and 1990s. Our expectation was that by taking a sharp look at some specific policies and legislative proposals, we could discover principles of the policy process that might be applied in situations beyond the ones we chose to study. Several questions are examined: What important federal policy initiatives took place in the promotion and control of alcohol advertising during the 1980s and 1990s, and how did they evolve? What is the perspective of key players looking back on these initiatives, and what do they say about such factors as the impact of jurisdictional considerations, intra-industry dynamics, and the relative power of the alcohol industry in influencing the policy process versus the relative power of the public health sector? How do the policy experiences examined here fit and interplay with alcohol research and public opinion? What suggestions emerge for further research and positive policy development in the decades ahead? To set the stage, we provide a synopsis of recent research on alcohol advertising and counter-advertising. This is followed by a brief description of the methods used, discussion of five national developments that occurred within the selected time period, and an analysis of highlights from the perspectives of major players whom we interviewed.
Research on advertising and per capita consumption
Advertising is a form of alcohol promotion, along with sponsorship, competitive pricing, low taxes, high outlet density, long hours of sale, and other environmental boosters in purveying alcoholic beverages. It continues to receive attention in public health, commercial, and government communities in many countries (Montonen, 1996; Sulkunen, 1998; Babor et al., 2003; Giesbrecht and Greenfield, 2003). Research on the effect of advertising on per capita consumption and youth is especially relevant to deliberations about controls on advertising. Advertising communicates "a legitimizing meta-message contributing to the social availability of alcoholic beverages" (Montonen, 1996, p. 70; see also Atkin, 1990; Strasburger, 1993).
While several studies suggest that advertising has a small contributory impact on sales and therefore on consumption (Duffy, 1991; Makowsky & Whitehead, 1991; Saffer, 1991, 1993, 1995, 1996, 2000), the effect of advertising on per capita consumption found in empirical studies has been weak, which may be due to confounding cultural, social, and economic influences. Some of these studies neglect indirect but powerful forms of advertising, such as sponsorship of sporting events (see Hill & Casswell, 2001). A common industry argument is that "advertising affects only market share and does not increase the overall consumption of alcoholic beverages" (review in Montonen, 1996, p. 70; see also Denig and The Amsterdam Group, 1993; Smart, 1988). Econometric studies of advertising linkages with total consumption conducted in the U.S. and other "mature markets" (i.e., fairly saturated markets in which there is already extensive alcohol promotion) have shown only a modest impact of advertising on sales (Franke & Wilcox, 1987; Lee & Tremblay, 1992). Hence, in a mature market only marginal returns on advertising expenditure are expected (Pittman & Lambert, 1978; Smart, 1988; Strickland, 1983, 1984), and some economists do not weigh the evidence as indicating that advertising expenditures have any marketwide expansion effect (Nelson, 2001).
Nevertheless, Saffer (1991) found, in an international study of 17 countries using time-series data over 13 years, that bans on alcohol advertising contributed significantly to a reduction in total alcohol consumption and motor vehicle fatality rates (but not liver cirrhosis mortality). (1) A short-term partial advertising ban in Canada was associated with a small impact on sales (Smart & Cutler, 1976; Ogborne & Smart, 1980). Others reviewing the numerous studies of advertising bans argue that there is no consistent support for such a policy in terms of either consumption or abuse (Nelson, 2001). Whether a partial restriction on advertising--as opposed to a ban--can be expected to achieve a significant impact on overall consumption remains even more debatable. Nonetheless, a U.S. federal court upheld a ban on advertising in the state of Mississippi in the 1980s, partly on the grounds that "sufficient reasons existed to believe that advertising and consumption were linked" (Trauth & Huffman, 1987), though it is very doubtful that such an outcome could be obtained today at the federal level.
Alcohol advertising and youth
Young persons are usually, by definition, naive drinkers, combining low tolerance for alcohol with high motivation to experiment. The risks they take and the damage they cause to themselves and others are well documented, including drunk-driving crashes, recreational events that end in tragedy, noisy parties, property damage, date rapes, unwanted pregnancies, and sexually transmitted diseases (STDs) (e.g., U.S. Department of Health and Human Services, 1997, pp. 22-24, 247-274).
Efforts to protect youth from the dangers of alcohol win wide public support among the U.S. population. Coalitions with different agendas have joined forces on issues related to youth. Advertising that deliberately appeals to minors is considered potentially harmful by a number of groups and governmental bodies (see Atkin, 1993; Breed & DeFoe, 1981; Breed et al., 1990; Edwards et al., 1994, pp. 171-174; U.S. Department of Health and Human Services, 1997; and World Health Organization--see Jernigan, 2001). Advertising codes adopted by alcohol trade associations signal the sensitivity of some producers to pressure about this issue.
Public health policy advocates nevertheless believe that the content of some alcohol advertisements is deliberately designed to court underage, young, and potential drinkers (e.g., Jackson et al., 2000; Garfield et al., 2003). (2) Demographic changes--involving an aging population where older persons tend to drink less--these advocates say, have resulted in a special attractiveness of youth to the alcohol industry compared with a market consisting of older abstainers and middle-aged drinkers. Others dispute whether or not alcohol advertisements intentionally target persons below the legal drinking age (e.g., Slater et al., 1996a).
Studies have shown that children like alcohol advertising, and some researchers interpret this as encouraging drinking (Grube, 1993, 1995; Lieberman & Orlandi, 1987). Exposure to broadcast advertising of alcohol--both radio and television, but especially television--begins at an early age and is continuous, whereas exposure to school-based alcohol-related education begins later and is infrequent and sporadic (Weintraub & Meili, 1994). Some research has found an association between enjoyment of image advertising and children's intention to drink in later life (Kelly & Edwards, 1998). Studies have identified televised sporting events as being particularly conducive to a high level of exposure to televised alcohol advertising (mainly beer) on the part of youth (e.g., Grube, 1993, 1995; Grube & Wallack, 1994; Madden & Grube, 1994). Recent work has also noted that 82% of Internet beer sites appeal to youth through games, offers of merchandise, etc. (Pirisi, 2000). Other analyses explore the relationship between such exposure and favorable beliefs about drinking. One study reports: "Our research indicates that children who are more aware of television beer advertisements hold more favorable beliefs about drinking and intend to drink more frequently as adults" (Grube, 1995, p. 117; also Grube & Wallack, 1994).
Research from New Zealand found that positive responses to beer advertisements were associated with frequency of current drinking and expectations of future drinking among children (Wyllie et al., 1998a). Other work showed that a positive response to televised beer advertisements was associated with quantity consumed per drinking occasion, which in turn contributed to the level of alcohol-related problems. Furthermore, Casswell and Zhang (1998) reported a positive association between appreciation of alcohol advertising and brand allegiance at age 18 and subsequent volume consumed and self-reported alcohol-related aggressive behavior at age 21. In summary, the gist of research findings to date is that alcohol advertising has small, if any, impact on sales in the short term, but likely has a substantial impact as educator, especially of the young, in the long term (Casswell, 1995).
Counterpromotion
As noted by Grube (1993, pp. 65-66), promising strategies for prevention include restriction of alcohol advertising on television during prime-time hours; cooperation among members of the alcohol industry and the broadcasting industry in deliberately reducing the appeal of television advertising to youth; airing of counter-advertising; health warnings included as part and parcel of alcohol advertising; and education to help children improve their critical skills. The purpose of counter-advertising is to challenge the perception of drinking as a problem-free practice and to promote environmental approaches to prevention as opposed to individual-oriented approaches that put the onus of responsibility on the drinker (DeJong & Atkin, 1995; Dorfman & Wallack, 1993; Mosher, 1995).
Citizen and public health groups have tried a variety of strategies to challenge the seductive content of alcohol advertising, including education (Slater et al., 1996b); media campaigns against binge drinking on campus (Haines & Spear, 1996); targeting of young heavy drinkers by health promotion initiatives (Wyllie & Casswell, 1997); challenge of regulations (Dorfmann & Wallack, 1993); strengthening of codes (e.g., to eliminate sexism and glamorization of high-risk behavior); use of counter-advertising to expose sexism (Woodruff, 1996); and legislative attempts to mandate the inclusion of health messages within alcohol advertising material.
A major U.S. development was the federal law that began requiring warning labels on alcoholic drink containers in 1989 (Kaskutas, 1995). Research shows that the public is aware of these labels but is not greatly influenced by them in terms of behavioral change (e.g., MacKinnon, 1993). Nevertheless, many underage drinkers and young adults at elevated risk for drinking problems are reached by warning labels (Kaskutas & Greenfield, 1997; see also Greenfield, 1997; Greenfield et al., 1993; Greenfield & Kaskutas, 1993). Those recalling the labels' message on drunk driving were more likely than others to engage in precautionary behaviors such as not driving after drinking (Greenfield & Kaskutas, 1993). Those who have seen warning labels are more likely to report conversations about drinking during pregnancy and about drinking and driving than those who have not seen the labels. Those who have seen the labels are also more likely to say they have taken steps to limit their drinking for health reasons (Greenfield et al., 1999b).
Alcohol industry efforts in the direction of "responsible advertising" include voluntary codes by trade organizations that discourage sexually provocative advertising and promotion to persons under the legal age of purchase (Beer Institute, n.d.; California Wine Institute, 1993; Distilled Spirits Council of the United States, n.d.). Diverse interests develop and sponsor prevention and harm-reduction messages directed at pregnant women, problem drinkers, and children. There is a strong alcohol industry presence in messages against drinking and driving (Anglin et al., 2000; Giesbrecht, 2000), including the...
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