The 11 to 20 percent of American youth who own clothes or other merchandise advertising alcohol are more likely to begin drinking earlier than their peers, according to a recently published study by pediatricians at Dartmouth-Hitchcock Medical Center.
The study surveyed 6,522 youth between ages 10 and 14 in 2003, according to lead author DHMC pediatrician Auden McClure.
The team then conducted three follow-up surveys every eight months, in which participants answered questions about changes in their drinking habits and ownership of alcohol-branded merchandise.
Although the study does not prove that there is a causal link between owning merchandise that promotes alcoholic products and underage drinking, it suggests that pediatricians should caution parents and educators about the potential risks of such products, McClure said.
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," the authors wrote in their conclusion to the study.
Currently, the alcohol industry's policies regulating companies' marketing to youth lag behind those of the cigarette industry, co-author Dartmouth Medical School professor Susanne Tanski, also a DHMC pediatrician, said.
After major tobacco companies voluntarily signed the Master Settlement Agreement, which established marketing restrictions to be enforced by an independent agency, the prevalence of tobacco-related merchandise and its use by youth decreased drastically, Tanski explained.
Marketing restrictions on alcohol products and promotional merchandise, though, are self-enforced, and are largely unsuccessful, Tanski said.
Approximately 3 million teens own alcohol-branded merchandise, despite a Beer Industry Code provision that "no beer identification, including logos, trademarks, or names, should be used or licensed for use on clothing, toys, games or game equipment, or other materials intended for use primarily by persons below the legal drinking age," according to a DHMC press release.
The study's authors pointed to this statistic as evidence that self-regulation was ineffective.
"It seems to me that it would be very helpful if the alcohol industry had more stringent guidelines," Tanski said. "Currently, kids are developing brand identification before they even start using [alcohol] because of this merchandise."
David Jernigan, a professor at the Johns Hopkins Bloomberg School of Public Health, wrote a March 4 editorial response to the Dartmouth researchers' paper in the Archives of Pediatric and Adolescent Medicine that argued the alcohol industry's self-regulation is not working.
"Voluntary approaches have been ineffective in reducing the risk," he wrote. "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."
New policies should be modeled after those of the tobacco industry, senior study author and DMS professor and DHMC pediatrician Jim Sargent said.
"In the Master Settlement Agreement, the tobacco industry gave up distributing similar items after it was shown that they were a cause of teen smoking," Sargent said in a statement released by DHMC last week. "It's hard to imagine an industry more irresponsible than big tobacco, but the beer industry is way behind in limiting advertising that affects teens. Anheuser-Busch could make almost half of this problem go away just by unilaterally ending distribution of Budweiser alcohol branded merchandise."
Sargent could not be reached for comment by press time.
Tanski said she believes there is probably a similar correlation between alcohol-branded merchandise and drinking among college-aged students and late high school-aged youth, but the current study did not focus on this age group.
"We have a hypothesis; it's not a proven thing yet, but we believe that kids who are going to own and keep their merchandise are likely to go on and continue their drinking," she said. "Then, the other big compelling thing is that every time a kids wears something with Absolut or Budweiser on their T-shirt, they become a walking advertisement for that product ... so even where drinking is a normative thing, like at Dartmouth, if the coolest kid on the hockey team is wearing a Captain Morgan shirt, it might subconsciously affect a geeky kid like me to try Captain Morgan."
Co-authors Keilah Worth, of the Norris Cotton Cancer Center, and Mike Stoolmiller, of the University of Oregon, did not return requests for comment by press time.
