2014 marks the 50th anniversary of the release of the landmark Surgeon General's Report on Smoking and Health. The 1964 report was the first Federal government report linking smoking to health consequences, including lung cancer and heart disease.
The report set the groundwork for the next five decades of tobacco control programs and policies, including those limiting exposure to tobacco advertising and marketing. In 1969, cigarette advertising on U.S. TV and radio was banned, effective September 1970. And decades later the 1998 Master Settlement Agreement eliminated cigarette billboard advertising and print advertising directed to underage youth.
Many readers are old enough to remember being bombarded with images designed to convince the viewer that cigarettes were sexy, glamorous -- healthy even! We shake our heads now, but at the time, many were persuaded by these powerful images.
Like tobacco, we know that the way alcohol is portrayed in advertisements and marketing affects decisions to drink, particularly in kids. Alcohol is the most commonly used drug among young people, accounting for an estimated 4,300 deaths among underage youth in the U.S. each year. At least 14 long-term studies have shown that exposure to alcohol marketing increases the chances that underage youth will begin drinking -- and drink more if they do -- further raising the risk of health problems such as car crashes, violence, sexually transmitted diseases, and unintended pregnancy.
Unlike tobacco, where the marketing is overseen by the FDA, alcohol advertising in the U.S. is primarily regulated by the alcohol companies themselves. According to this voluntary standard adopted in 2003, alcohol companies agreed not to place any ads on television programs where greater than 30 percent of the audience was likely to be younger than 21.
For the past twelve years, the Center on Alcohol Marketing and Youth has been monitoring the advertising and marketing practices of the alcohol industry to determine whether they are following their own rules. What we've found is that while there is high compliance, there is still considerable youth exposure.
For example, in 2009, we found that the average young person between the ages of 12 and 20 saw 366 alcohol ads on television alone -- an average of one every day just from TV! And we recently reported that exposure for underage (18-20-years-old) viewers grew from 2005 to 2011 faster than any adult age group.
The take-home here is that the self-regulated guidelines are not protecting youth from alcohol exposure. As a parent, what I'd most want to know is the following: Are these companies targeting advertising for their products to my child?
My colleague Craig Ross and I recently published a paper in the Journal of Public Health Policy in which we applied a definition of targeting from tobacco case law (Lockyer v Reynolds) to the alcohol industry. Under this judicial definition, we found evidence of alcohol advertisers targeting 18-20 year olds relative to 21-24 year olds with alcopops, beer and spirits ads every year from 2008 to 2011. Moreover, the companies did this for the most part without violating their own very weak placement guidelines.
Importantly, we also demonstrated that ages 18-20 exposure to alcohol advertising can be reduced while maintaining exposure to adults as young as ages 21-24. There is a choice for advertisers.
There's little doubt that the decades of public health efforts on tobacco spurred by the Surgeon General's report have produced tangible results. Cigarette smoking has continued to decline among adults; in 1965 more than four in ten Americans smoked. That number is now less than one in five. A recent paper in the Journal of the American Medical Association found about 5.3 million men and 2.7 million women live longer thanks to tobacco control.
April is alcohol awareness month. The time is now for concerned parents, educators and citizens to call upon alcohol companies to change their practices so youth are better protected from the consequences of advertising and marketing exposure.
With more than 4,300 annual deaths among underage youth from alcohol, with more than 80,000 deaths in the general population every year, with the risk of adverse consequences from alcohol use rising the earlier kids start to drink, and with the risk of initiation and heavier drinking growing the more young people are exposed to alcohol advertising, parents and the public health community have a strong interest in reducing youth exposure to alcohol advertising. We cannot wait 50 years.