Alcohol-Branded Merchandise Ownership and Drinking
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Alcohol-Branded Merchandise
Ownership and Drinking
Sandra C. Jones, BA, MBA, MPH, MAssessEval, PhD
CONTEXTS: Alcohol-branded merchandise (ABM) has a longer shelf-life than other forms of abstract
alcohol marketing and the potential to become integrated into children’s self-identities.
OBJECTIVE: This review sought to explore the current literature on children’s exposure to, and
the impact of, ABM.
DATA SOURCES: PsycInfo, Proquest, Science Direct, and ABI-Inform databases were searched
from the earliest available date to May 2015. Additional studies were identified by a manual
review of the reference lists of retrieved articles and contacting the corresponding author of
each included study.
STUDY SELECTION: Articles that reported on child or adolescent ownership of ABM and/or the
relationship between ABM ownership and drinking were included.
DATA EXTRACTION: Data on key measures were tabulated; where data of interest were not
reported, requests for further information were sent to the articles’ authors.
RESULTS: Nine cross-sectional and 4 longitudinal studies were identified. ABM ownership
ranged from 11% to 59% and was higher among older children and males. Seven cross-
sectional studies reported associations between ABM ownership and drinking-related
behaviors. All 4 longitudinal studies reported a significant relationship between ownership
at baseline and drinking initiation at follow-up.
LIMITATIONS: The small number of available studies, with different measures of ABM ownership
and of associations/effects.
CONCLUSIONS: The few studies exploring ABM ownership are consistent in showing high rates
of ownership and associations between ownership and current and future drinking. There is
a need for further research into specific aspects of ABM ownership. However, there is also a
need for policy interventions to reduce children’s access to and ownership of ABM.
Centre for Health and Social Research, Australian Catholic University, Melbourne, Australia
DOI: 10.1542/peds.2015-3970
Accepted for publication Feb 10, 2016
Address correspondence to Sandra C. Jones, Director, Centre for Health and Social Research (CHaSR), Australian Catholic University, Level 5, 215 Spring St,
Melbourne, Victoria 3000, Australia. E-mail: sandra.jones@acu.edu.au
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2016 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The author has indicated she has no financial relationships relevant to this article to disclose.
FUNDING: Dr Jones is supported by an Australian Research Council Future Fellowship (FT120100932).
POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose.
To cite: Jones SC. Alcohol-Branded Merchandise Ownership and Drinking. Pediatrics. 2016;137(5):e20153970
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PEDIATRICS Volume 137, number 5, May 2016:e20153970 REVIEW ARTICLEAdolescent alcohol use is and current and future consumers.12,13 keywords used were “alcohol brand*
associated with a range of physical, Young people, who are developing merchandise OR alcohol brand
psychological, and social harms; their self-concepts, use brand ownership OR alcohol promotional
and there is increasing evidence ownership as a way of constructing items.” A separate search was
that earlier alcohol initiation is and communicating their self-image conducted by using “ABM” as the
associated with greater drinking and group membership.13–15 There keyword, but this identified >2000
problems in adult years.1,2 Although is evidence that adolescents actively articles (due to the multiple terms
there are numerous influences engage with alcohol marketing and that use that abbreviation), only 8 of
on adolescent drinking, including incorporate alcohol brands into which were potentially relevant and
individual, family, peer/social group, their self-identity.16,17 Even among all of which were also identified in
and community influences, there is children, preference for alcohol- the initial search.
substantial evidence that alcohol branded promotional items over The inclusion criteria were as
advertising affects alcohol initiation nonalcohol-branded items appears to follows: reported on child or
as well as frequency and quantity of prime future drinking.18,19 adolescent ownership of ABM
consumption.3–5 (whether as the sole alcohol
Much of the research into the effects There have been several systematic marketing exposure variable or
of alcohol marketing on young people reviews of the impact of alcohol one of several variables) and/or
has focused on print and broadcast advertising and/or promotions on the relationship between children’s
media, where advertisements adolescent alcohol use, but these or adolescents’ ABM ownership
appear in locations and at times have incorporated a wide range and drinking (initiation, frequency,
determined by the marketer. In the of exposures. A review of alcohol or degree), cross-sectional and
current environment, the Internet advertising effects identified 7 longitudinal study designs, and
and social media provide a platform studies, none of which included written in English. Articles excluded
for alcohol marketing that blurs ABM.4 A subsequent review of 13 were those in which information on
the lines between “advertising” and longitudinal studies5 included 2 that ABM ownership was not provided,
social discourse6–8; and alcohol brand focused specifically on ABM20,21 and 2 such as studies that reported
sponsorship of sporting and cultural that included ABM ownership among generically on exposure, opinion
events enables messages developed a wider range of alcohol marketing pieces, or policy/position statements.
by the marketer but communicated exposures.22,23 The authors
The searches identified a total of
by (or on) the performers, such as concluded that 12 of the 13 studies
435 unique articles, the abstracts
on players’ jerseys.9–11 The majority showed that exposure to alcohol
of which were reviewed by 2
of these forms of advertising are marketing predicts drinking initiation
researchers to identify those that
“perishable,” in that they appear at a and increased levels of consumption.
referred to or mentioned ABM.
place in time and are then replaced However, they did not draw specific
Forty-two articles were identified as
by other stimuli (eg, the reader conclusions about the effects of ABM, potentially relevant and uploaded
turning the page in a magazine or an important distinction given that into Covidence software (www.
newer Facebook posts pushing several studies have identified that covidence.org) for full-text review.
previous ones down the feed). the association between drinking and On full-text review, 31 articles were
ABM ownership is stronger than that excluded (see Table 1); the remaining
Alcohol-branded merchandise for other marketing variables.22–25
(ABM), also referred to as alcohol 11 articles consisted of 7 cross-
Thus, this review sought to explore sectional and 4 longitudinal studies.
promotional items, has a longer shelf- the current literature on child and
life than other forms of advertising. adolescent ownership of ABM and The second stage was a manual
For example, a branded keyring may the effects of ABM ownership. review of the reference lists of
be used, and seen, on a daily basis or retrieved articles, which resulted
a branded clothing item may be worn in the inclusion of 1 additional
many times and in many locations. article.57 Because this article was
Because ABM is generally something METHODS not identified in the database
that a person wears or carries on searches and used the term “alcohol
their person, it has the potential A 3-stage approach was taken to
*Respondents were considered “susceptible” if
to become part of, or be used to identifying relevant articles for
convey, their self-image. Marketers inclusion in the review. The first was their answer to the question “Do you think you
will use alcohol in the next 2 months?” was “yes,”
seek not only immediate sales of a systematic search of electronic
“probably,” “I don’t know,” or “I don’t think so”
their products but also to form databases (PsycInfo, Proquest, and “nonsusceptible” if their answer was “no,
“relationships” between their brands Science Direct, and ABI-Inform). The definitely not.”
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2 JONESpromotional clothing items,” a search TABLE 1 Reasons for Exclusion at Full-Text Review
was re-run in all 4 databases using Reason Number Article Details
this term, which resulted in the of
identification of 1 additional article Articles
(by the same author) for inclusion in Did not include data 6 Commentaries, policy, or position statements26–31
review.58 Not about ABM, other 12 Briefly referred to ABM in the context of broader aspects of alcohol
marketing marketing,32–34 including specific forms such as point-of-sale,35,36
The third stage was to contact sponsorship,37 outdoor advertising,38 broadcast media,39,40 video-
sharing sites,41 music,42 and provision of free alcohol43
the corresponding author of each
Not about alcohol 3 Other products or substances than alcohol44–46
included article and ask whether Not about ownership 2 Assessed preferences for, or exposure to, rather than ownership of
they were aware of any further ABM37,47,48
studies that addressed this topic. The Not about ABM, brand- 3 Brand choice,49 brand/advertising awareness,50 or using brand
contacted authors provided details of related information to assess consumption51
Not about ABM, 4 Other predictors of susceptibility to drinking52,53 or the development
2 further studies they had authored
susceptibility of programs to reduce susceptibility54,55
and 7 authored by others; however, Not about ABM, 1 About industry trends56
all of these had already been industry
included in the review (3 articles) or
excluded because they did not meet
the inclusion criteria (6 articles).
Thus, a total of 13 articles were
included in the review: 9 reported
on cross-sectional studies and 4 on
longitudinal studies (see Fig 1 for the
PRISMA [Preferred Reporting Items
for Systematic Reviews and Meta-
Analyses] flow diagram).
In cases in which information
important for the review was not
reported in the original articles, the
corresponding author was asked (in
the same e-mail as the request for
further relevant studies) to provide
this information; for example, 8
articles did not report ownership
by gender and 6 did not provide the
wording of the question(s) asked. In 5
cases, no response was obtained from
the corresponding author or he or she
was unable to provide these data.
RESULTS
Cross-sectional Studies
FIGURE 1
Of the 9 cross-sectional studies, 6 Study selection.
were conducted in the United States
and 1 each in the Philippines, Uganda,
reported; where odds ratios (ORs) ABM ownership was twice as likely
and Australia. The articles were
and/or adjusted ORs (aORs) for among susceptible adolescents as
published between 2003 and 2015,
drinking initiation were provided nonsusceptible adolescents† and 4
with data collected between 2000
these are reported below. †Respondents were considered “susceptible” if
and 2012 (see Table 2 for ownership
and Table 3 for associations). There A survey of 7th- to 12th-grade their answer to the question “Do you think you
will use alcohol in the next 2 months?” was “yes,
was considerable variation between students (N = 260) in a Midwestern
” “probably,” “I don’t know,” or “I don’t think so”
the articles in the nature of the US state found that >36% owned ≥1 and “nonsusceptible” if their answer was “no,
analyses conducted and statistics items of ABM (mean: 4.5 items).57 definitely not.”
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PEDIATRICS Volume 137, number 5, May 2016 3TABLE 2 Ownership of ABM
Study Country (Data Study Sample ABM Extent of Ownership Survey Item(s)
Collection Period) Design Type
Workman (2003)57 USA (2000–2001) C-S N = 260 seventh- to Clothing 36.5%; boys = girls “Do you own something that has
twelfth-graders; an alcohol brand name on it,
aged 12–18 y; 59.2% such as a T-shirt or a hat?”
female [yes/no]a
“If you own something with an
alcohol brand name on it, what
is it? Please check every item
that you own. For each item
that you check, please estimate
how many items you own”a
“Do you want to own something
(or something else) with an
alcohol brand name on it?”
[yes/no]a (plus questions re
brand names and source of
ABM)
Workman (2004)58 USA (2001) C-S N = 320 university Clothing 44.7%; males > “Do you own an item of clothing
students; aged females that has an alcohol brand
18–24 y; 43.7% name on it?” [yes/no]a
female “If you own a clothing item with
an alcohol brand name on it,
what is it? Please check every
item that you own. For each
item that you check, please
estimate how many items you
own”a
“Do you want to own something
(or something else) with an
alcohol brand name on it?”
[yes/no]a (plus questions re
brand names and source of
ABM)
McClure et al (2006)21 USA (2000–2001) C-Sb N = 2406 fifth- to Any 14.2%; boys > girls “Do you own something that
eighth-graders; has the name of a beer or
aged 10–14 y; 53.8% an alcohol brand on it, like a
female T-shirt, a backpack, or a hat?”
[those answering yes were
asked to list the types of items
owned]
Hurtz et al (2007)24 USA (2003) C-S N = 2125 sixth- to Any 20%; boys > girls “Have you ever owned an item—
eighth-graders; age like a T-shirt, lighter, matches,
not stated; 53.1% hat, or sunglasses—with an
female alcohol brand name on it?”
[yes/no/don't know]
Gordon et al (2011)59 Scotland (2007) C-S N = 920 second-year Any 45% (clothing); boys “Can you look at each of these
students; aged > girlsc cards and tell me which, if any,
12–14 y; 52.9% of these you have ever done?...
female Owned clothing, such as
football or other sports-tops,
or other personal items with
an alcohol brand name or logo
on it” [yes/no/don't know]a
McClure et al (2013)25 USA (2009) C-Sd N = 1734 ever-drinkers; Any 33%; not reported by Single item: “Do you own
aged 15–20 y (65% gender something with an alcohol
18–20 y); 49% brand on it?”
female
Swahn (2013a)60 Philippines (2011) C-S N = 5290 students; Any 14.7%; not reported …students who have a T-shirt,
aged 11–16 y by gender pen, backpack, or other item,
(primarily 13–16 y); with an alcohol brand logo
56.4% female on it [question wording not
reported]
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4 JONESTABLE 2 Continued
Study Country (Data Study Sample ABM Extent of Ownership Survey Item(s)
Collection Period) Design Type
Swahn (2013b)61 Uganda (2011) C-S N = 457 urban youth; Any 25.9%; not reported …youth who have a T-shirt,
aged 14–24 y; 69% by gender pen, backpack, or other item,
female with an alcohol brand logo
on it [question wording not
reported]
Jones et al (2015)62 Australia (2012) C-S N = 210 secondary Any 59.0%; boys = girlse Six items: “Do you own any
students; aged [hats/T-shirts/cups or bottle
12–17 y (primarily holders/bags or coolers/
13–15 y); 52.3% sports equipment/other
female products]?”
Collins et al (2007)22 USA (2001–2002) L N = 1786 sixth- Any 19%; not reported by “Do you own any hats, posters, or
grade students gender T-shirts that advertise alcohol
(resurveyed seventh (beer, wine, liquor, or wine
grade); mean: 11.8 coolers) [yes/no]
y at baseline; 51%
female
Fisher et al (2007)23 USA (1998–1999) P-C N = 5511; aged 11–18 Any 26% owned or willing “Have you ever bought or been
y at baseline; 59.6% to use; boys > girls given stuff like a hat, T-shirt,
female bag, or cards with the name
of an alcohol drink on it (like
Coors beer, Absolut vodka, or
Kahlua)?” [yes/no]a
“Do you think you would ever use
something with the name of an
alcohol drink on it?” [yes/no]a
Henriksen et al (2008)20 USA (2003–2004) L N = 1080; sixth- to Any 21% owned, 19% “Have you ever owned an item—
eighth-graders wanted to own; like a T-shirt, lighter, matches,
(never-drinkers boys > girls hat, or sunglasses with an
at baseline); aged alcohol brand name on it?”
10–15 y; 57.3% [yes/no]
female “Would you want to own or use
an item with an alcohol brand
name on it?” [yes/no]
McClure et al (2009)63 USA (2004–2005) L N = 6522 at baseline Any 11% at wave 2, Asked about ownership, type,
(5503 wave 2, 5019 increasing to 20% brand, source [question
wave 3, 4575 wave at wave 4; boys > wording not reported] (plus
4); aged 10–14 y girls questions re brand names and
source of ABM)
C-S, cross-sectional; L, longitudinal; males = females, ownership does not differ between male and females; males > females, indicates ownership higher among males than females; P-C,
prospective cohort.
a Additional detail obtained from corresponding author.
b Longitudinal survey (2 time points) but ABM ownership only collected at follow-up.
c Not reported in article; data obtained from author (July 17, 2015).
d Remaining sample from McClure et al21 study.
e Not reported in article; data obtained from author (July 27, 2015).
times as likely among established last 7 days, more than twice as likely characteristics, parenting style, and
drinkers, suggesting a relationship to be weekly drinkers, and 3 times as peer drinking) and accounting for
with both susceptibility and drinking likely to report having been drunk in clustering by school (aOR = 1.5).
initiation. A subsequent study in the last 7 days.
Of 2125 California middle school
university students aged 18 to 25 A survey of fifth- to eighth-grade students in sixth to eighth grade,
years (N = 320) found a higher rate students (N = 2406) in New England one-fifth (20.0%) reported owning
of ownership of (clothing) ABM: found 14.2% (n = 341) reported ≥1 items of ABM.24 ABM ownership
44.7% owned ≥1 items.58 Ownership owning ≥1 ABM items.21 ABM was associated with an increased
was significantly higher among owners were significantly more likelihood of ever drinking (OR = 6.7)
established drinkers than susceptible likely to have initiated alcohol and having drunk alcohol in the last
experimental drinkers, and ABM use (OR = 2.3), adjusting for 30 days (OR = 1.8). After controlling
owners were significantly more likely covariates (including demographic for demographic characteristics,
to report having drunk alcohol in the characteristics, personality peer and parent drinking, risk taking,
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PEDIATRICS Volume 137, number 5, May 2016 5TABLE 3 Cross-sectional Studies: Association Between ABM Ownership and Drinking
Study Country (Data Collection Sample ABM Type Association
Period) Initiation Recency Drunkenness
Workman (2003)57 USA (2000–2001) 260 Seventh- to twelfth-graders; 59.2% female Clothing + NR NR
Workman (2004)58 USA (2001) 320 University students (18–25 y); 43.7% Clothing + + +
female
McClure et al (2006)21 USA (2000–2001) 2406 Fifth- to eighth-graders (never-drinkers Any + NR NR
at baseline); 53.8% female
Hurtz et al (2007)24 USA (2003) 2125 Students in sixth to eighth grade; 53.1% Any + + NR
female
Gordon et al (2011)59a Scotland (2007) 920 Junior secondary students aged 12–14 y; Any + NR NR
52.9% female
McClure et al (2013)25 USA (2009) 1734 Ever-drinkers aged 15–20 y; 49% female Any NR NR +
Swahn (2013a)60 Philippines (2011) 5290 Students, primarily aged 13–16 y; 56.4% Any NR ? ?
female
Swahn (2013b)61 Uganda (2011) 457 Urban youth aged 14–24 y; 69% female Any NR ? ?
Jones et al (2015)62 Australia (2012) 210 Secondary students aged 12–17 y; 52.3% Any + — NR
female
NR, not reported/assessed; +, significant association between ABM ownership and behavior; 0, no significant association; ?, significant in bivariate, not significant in the multivariate
analysis.
a A subsequent article by the same authors on wave 2 of this project (2-stage cohort study) reported that involvement with alcohol marketing at baseline was predictive of uptake of
drinking and increased frequency of drinking, but data were not separately reported for individual forms of marketing (eg, ABM).
and parental supervision, both analysis this was associated with limited variables, and/or did not
associations remained significant an increased likelihood of current separately report the associations
(aORs = 3.3 and 1.5, respectively). alcohol use (OR = 1.86) and for ABM when controlling for other
experience of drunkenness (OR = variables.57–62 Three controlled for
In a cross-sectional survey25 of
1.43). A survey of urban youth aged demographic characteristics (age/
1734 ever-drinkers aged 15 to 20
14 to 24 years living in the slums of year level, gender, race/ethnicity),
years (remaining participants from
Kampala, Uganda (n = 457), found individual characteristics (eg, school
an earlier longitudinal study63
25.9% of these vulnerable young grades, personality factors), and
supplemented by a sample of African-
people owned ≥1 items of ABM61; in social influences (eg, peer drinking,
American youth), one-third (33%)
bivariate analyses, ABM ownership parental drinking, parenting
reported owning ABM and ownership
was associated with increased style).21,24,25
had both a direct association
likelihood of current alcohol use
with binge drinking and indirect Longitudinal Studies
(OR = 6.34), problem drinking (OR =
associations (mediated by drinker
6.36), and reported drunkenness All 4 of the longitudinal studies were
identity and having a favorite alcohol
(OR = 5.91). However, in both of conducted in the United States. ABM
brand). The article did not report on
these studies, the relationship was the sole exposure focus in 1
drinking initiation or recent drinking.
between ABM ownership and article,63 1 of 2 components of alcohol
A survey of 920 adolescents in the drinking behavior was not significant marketing awareness or receptivity
second year of high school (aged in the multivariate analyses. in 2 articles,20,23 and 1 of several
12–14 years) in Scotland found 45% alcohol marketing exposures in 1
owned ≥1 items of alcohol-branded Of 210 secondary students aged 12 article.22 The articles were published
clothing, far exceeding any other to 17 years surveyed in New South between 2007 and 2009, with data
form of involvement with alcohol Wales, Australia, 59.0% reported collected between 1998 and 2005
marketing.59 ABM ownership was owning at least 1 item of ABM.62 (see Table 2 for ownership and Table
significantly higher among drinkers ABM ownership was significantly 4 for effects). All 4 studies controlled
than nondrinkers (51% compared associated with alcohol initiation for a range of known covariates, as
with 43%; P < .05).64 (but not drinking recency among well as baseline drinking.
initiators), perceived peer drinking,
The Philippines’ arm of the Global and perceptions that friends would A study in South Dakota elementary
School–based Student Health Survey think it was a good idea for them to school students explored associations
asked 5290 students aged 11 to 16 drink alcohol. between exposure to alcohol
years about their alcohol use and marketing in sixth grade (mean
exposure to alcohol marketing.60 Six of the cross-sectional studies age of 11.8 years) and drinking
One in eight (14.7%) reported did not report controlling for intentions and behaviors in seventh
owning an item of ABM; in bivariate covariates, controlled for only a few grade.22 A total of 1786 students
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6 JONESTABLE 4 Longitudinal Studies: Impact of ABM Ownership on Drinking
Study Country (Data Sample Predictor Drinking Initiation Other Drinking Behavior
Collection
Period)
Collins et al USA (2001– 1786 Elementary school Owned ABM at Unadjusted OR = 3.5; aOR = 1.8 OR = 1.8 for drinking in last year; OR
(2007)22 2002) students surveyed in sixth baseline (year 7 drinking controlling = 1.6 for intending to drink in next
grade and seventh grade; for year 6 drinking) 6 months
51% female
Fisher et al USA (1998– 5511 Adolescents aged 11 to 18 Owned/willing aOR = 1.7 for girls and 1.8 for aOR = 1.8 for binge drinking for girls
(2007)23 1999) y at baseline; 59.6% female to use ABM at boys (not significant for boys)
baseline
Henriksen et USA (2003– 1080 Sixth- to eighth-graders Owned/wanted Unadjusted OR = 2.8; aOR = 1.8 Drinking last 30 d: unadjusted OR =
al (2008)20 2004) (never-drinkers at baseline); to own ABM at (never-drinkers at baseline 3.2; aOR = 1.7
57.3% female baseline who initiated drinking)
McClure et al USA (2004– 6522 Adolescents aged 10–14 Owned ABM at HR = 1.4 at wave 3; HR = 1.6 at HR = 1.8 for binge drinking at wave
(2009)63 2005) y at baseline (5503 wave 2, wave 2 wave 4 3; HR = 1.4 for binge drinking
5019 wave 3, 4575 wave 4) at wave 4; also, indirect impact
via increases in susceptibility to
drinking
HR, hazard ratio
completed the survey at both time (8 months), wave 3 (16 months), characteristics, individual
points; 19% owned an item of ABM at and wave 4 (24 months).63 The characteristics, and social influences.
baseline. Controlling for sixth-grade prevalence of ABM ownership One study also controlled for
drinking, baseline ownership of ABM increased from 11% at wave 2 to exposure to a range of other forms
was associated with an increased 20% at wave 4. Using a cross-lagged of alcohol marketing,22 1 study
likelihood of drinking in the seventh panel model, the authors identified controlled for television viewing
grade (OR = 1.76) and intending to a reciprocal relationship between and exposure to alcohol portrayals
drink in the next 6 months (OR = ABM ownership and susceptibility in movies,63 1 controlled for alcohol
1.65). to drinking (3 items that assessed brand recall and recognition,20 and 1
A national survey of 5511 response to peer offers, intentions, controlled for talking to friends about
adolescents aged 11 to 18 years at and positive expectancies) and alcohol advertisements.23
baseline found 26% owned or were both direct and indirect effects
of ABM ownership on drinking Demographic Correlates of ABM
willing to use an item of ABM.23 At Ownership
12-month follow-up 19% of girls initiation. Adolescents who owned
and 17% of boys who were never- ABM at 8 months were more likely Studies that focused on younger
drinkers at baseline had initiated to have initiated drinking at 16 adolescents, and reported data
alcohol use; those who owned or months (hazard ratio‡ =1.41) and by age, generally found that ABM
were willing to use ABM were more nonsusceptible adolescents who ownership increases with age21,63
likely to have done so (OR = 1.74 for owned ABM at 8 months were and/or with increasing grade level.57
girls, OR = 1.78 for boys). more likely to become susceptible The majority of cross-sectional
to drinking by 16 months (hazard studies found that ABM ownership is
A study of alcohol marketing ratio = 1.66). They found a similar higher among males in both
receptivity in 1080 California middle reciprocal relationship between ABM school20,21,24,59,63 and university58
and high school students (never- ownership and susceptibility, and samples. Two studies, 1 in the United
drinkers at baseline) found 21% direct and indirect effects of ABM, for States57 and 1 in Australia,62 found
owned at least 1 item, and 19% binge drinking. that boys and girls were equally
wanted to own an item, of ABM.20 likely to report owning ABM, although
The longitudinal studies20,22,23,63
Those who owned or wanted to own in the US study boys owned more
all reported data from analyses
ABM at baseline were more likely items on average.57 Ownership by
that controlled for a wide range of
to have initiated alcohol use at the gender was not available for 4
known covariates, demographic
12-month follow-up (OR = 1.77) and articles.22,25,60,61 Although most of
to be current drinkers (OR = 1.75). ‡More commonly used in medical sciences to the studies did not separately report
A 4-wave national survey of 6522 describe survival rates or treatment effects, in and/or did not find differences in
this context a hazard ratio is the percentage
US adolescents (4309 of whom effects by gender, 1 study found that
change in the hazard (eg, drinking initiation) for
were never-drinkers) collected a 1-unit increase in the predictor (e.g., ownership after adjusting for covariates the
data on ABM ownership at wave 2 of ABM). relationship between ABM ownership
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PEDIATRICS Volume 137, number 5, May 2016 7and early alcohol initiation was only study was conducted more recently all of the countries in which this
significant for girls (aOR = 3.3)21 than the US studies. issue has been studied. Studies from
and another found that ABM outside the United States suggest
ownership was a significant predictor Source of ABM lower rates of ABM ownership in
of initiation for both genders but lower-income countries than in
McClure et al21 noted that it is
of binge drinking only for girls higher-income countries; however,
important to consider the source
(OR = 1.79).23 differences in the nature of the
of ownership of ABM because of
question(s) asked make comparisons
likely differences in the influences
ABM ownership has also been found across countries and time points
on youth drinking. They posited that
to be higher among those who report difficult.
an adolescent who purchases their
that their peers drink21,23 and those own ABM may have a preexisting Of the 8 cross-sectional studies
scoring high on rebelliousness, positive attitude toward drinking, that focused on children/younger
sensation seeking, and engagement whereas an adolescent who receives adolescents (ie, sample solely or
in risk behaviors,21 with inconsistent an item of ABM from a parent may predominantly agedever-drinking and nonsignificant for single yes/no question to detailed and thus contributes to social
current drinking (compared with 3.3 exploration of the number and type norms. Few studies have assessed
and 1.5 for ABM ownership),22 of items owned). Future research in exposure to ABM owned/worn by
and no significant association for this area would benefit from the use peers,§ and none have asked about
other measures of receptivity such as of consistent questions across time exposure in the home beyond
being able to name a favorite alcohol points and jurisdictions. personal ownership; future research
brand.20 could explore the effects of ABM
An Internet survey of reasons for Given the wide variations in reported exposure via important others as
selection of specific alcohol brands prevalence of ABM ownership well as cumulative exposure (dose-
among 13- to 20-year-olds in the between studies conducted in response effects). Future research
United States identified that 10.2% different countries, future research could explore parents’ awareness
stated that their choice of brand was could explore the nature and extent of the effects of ABM and the
influenced by their ownership of of ABM available in the different messages parents believe they are
products with the brand’s logo.49 It is jurisdictions as well as whether communicating (and adolescents
noteworthy that 30.8% of these 1031 this availability has changed over believe they are receiving) by
young people also reported that their time. Cross-jurisdictional studies parental provision, or condoning of
choice was influenced by the fact that could explore the differential extent ownership, of ABM.
they “identify with this brand,” given and effects of ABM ownership in
Implications for Policy
that having a favorite alcohol brand countries with differing social norms
or advertisement has been shown to and legal drinking ages. Including Although this review identified a
be an indicator of susceptibility to a broad age range of participants surprisingly small number of studies
future drinking.20,65 in such studies would enable on adolescents’ ownership of ABM
exploration of reasons for age-related and the effects of this ownership on
There is preliminary evidence that drinking behaviors, these studies
differences in ABM ownership,
even very young children may have showed strong and consistent
including differences in accessibility
an interest in ABM, with parents in effects of ABM ownership on young
as well as appeal of different ABM
a qualitative study describing ABM people’s drinking-related attitudes
product types.
items that appealed to their primary and behaviors. Given that these
school–aged children.62 A study associations were stronger than for
of preferences for ABM compared Studies not included in this
other marketing variables, which
with similar nonalcohol-branded review that focused on alcohol
are subject to legislative controls in
items among third- to fifth-graders media literacy often included a
many jurisdictions to reduce youth
(not included in the review because measure of preference for ABM
exposure, there is a clear need for
did not assess ownership of ABM) over other branded or nonbranded
strategies to reduce youth ownership
identified an association between merchandise.18,66 These studies
of ABM.
preferences for ABM and perceived generally positioned preference for
ABM as a measure of receptivity to There are a number of gaps in the
desirability and identification with
alcohol marketing. Future research evidence base to be addressed before
alcohol ads.47 This was a cross-
could explore the extent to which we can fully understand the extent
sectional survey that did not assess
allowing young children to own ABM of, and reasons for, this apparently
causation, and further research could
may enhance their attention to and strong association between ABM
explore whether allowing young
engagement with alcohol brands and and current and future drinking.
children to own ABM may enhance
alcohol advertising more generally, However, as set out in the first part of
their positive views of alcohol
the extent to which preference for this review, there are aspects of ABM
advertising and alcohol per se.
ABM drives and/or reflects interest that differentiate it from other forms
Implications for Research in alcohol, and children’s motivations of alcohol marketing. Unlike alcohol
for wanting to purchase or own ABM. advertising in traditional or even
The small number of studies new (electronic) media, ABM has the
identified suggests a need for more potential to become a part of, and to
research into the nature, extent, and This research gap is particularly
communicate, a young person’s self-
effects of ABM. The questions used important given that ABM is a
identity. Qualitative research from
to measure ABM ownership varied largely unregulated form of alcohol
both New Zealand and the United
between studies, in terms of both marketing; exposure to ABM occurs
their breadth (eg, some focused only in home, social, and educational §Workman58 asked respondents whether they had
on clothing and others on all forms environments; and this exposure seen someone at school/university today wearing
of ABM) and depth (ranging from a is mediated by friends and family something with an alcohol brand on it.
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PEDIATRICS Volume 137, number 5, May 2016 9Kingdom has found that teenagers questionnaire regarding alcohol The small body of evidence that does
associate desirable characteristics policies but not ABM). exist shows a high prevalence of ABM
with specific alcohol brands, identify Restrictions on the placement of ownership among adolescents and
brands that fit their self-image, and alcohol advertisements, such as on associations between ownership
believe that this association endows television or in magazines, are put and current and future drinking.
them with positive attributes that are in place by governments due to the There is a need for further research
associated with that brand in the eyes recognition that these exposures into specific aspects of ABM
of their peers.16,17 ABM is accessible have the potential to increase young ownership, including types and
to children and teenagers and people’s susceptibility to drinking. sources of ABM, and more current
enables them to identify with a brand Due to its nature, it would not longitudinal studies that reflect
even before they begin drinking; this be feasible to impose placement changes in the alcohol marketing
relationship with an alcohol brand restrictions on ABM (governments landscape. However, there is also a
as part of “who I am” may thus have would be unlikely to legislate where clear need for policy interventions to
the potential to facilitate drinking people could wear their branded reduce young people’s access to and
initiation. hat or use their branded keyring), ownership of ABM and to increase
In 2008, reporting the strong although it would be possible to parents’ and other stakeholders’
association between ABM impose restrictions on where ABM awareness of the insidious nature of
ownership and drinking status can be sold or distributed. Perhaps this form of alcohol marketing.
12 months later, Henriksen et al20 more feasible, given governments’
called on government to take action general unwillingness to legislate ACKNOWLEDGMENTS
to document the nature and extent alcohol marketing, would be to exert
of ABM: “more detailed information pressure on the alcohol industry I thank Ms Georgia Draper for
is needed about the production and to self-regulate to restrict the assistance with the identification and
distribution of alcohol promotional distribution of ABM in forms that screening of articles for inclusion in
items” (p 34). They also noted that would be appealing, and locations the review, Ms Kelly Andrews for her
the findings on alcohol marketing that would be accessible, to young advice and review of the manuscript,
receptivity (measured by ownership/ people. and Ms Kate Francis and Dr Mairtin
desire to own ABM) are “consistent McDermott for assistance with
with the research on tobacco Conclusions interpreting varying study findings.
marketing receptivity, which formed This review identified a surprisingly I also thank the several authors of
the evidence base for banning small number of studies on the included studies who took the time to
cigarette promotional items in the prevalence and effects of ABM provide additional unpublished details
United States” (p 34) and called for ownership by young people. A total of of their methodology and findings.
a similar policy for ABM. However, 7 14 articles were identified, with the
years later, there is still no systematic earliest in 2003 and the most recent
collection of data on its production, in 2015. The most powerful evidence ABBREVIATIONS
availability, or restrictions (in the comes from longitudinal studies;
ABM: alcohol-branded
United States or elsewhere; the however, there is an absence of such
merchandise
World Health Organization asks data reported in the past decade
aOR: adjusted odds ratio
about sponsorship and product (the included studies collected data
OR: odds ratio
placement in their periodic between 1998 and 2005).
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12 JONESAlcohol-Branded Merchandise Ownership and Drinking
Sandra C. Jones
Pediatrics 2016;137;
DOI: 10.1542/peds.2015-3970 originally published online April 1, 2016;
Updated Information & including high resolution figures, can be found at:
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Downloaded from www.aappublications.org/news by guest on February 15, 2021Alcohol-Branded Merchandise Ownership and Drinking
Sandra C. Jones
Pediatrics 2016;137;
DOI: 10.1542/peds.2015-3970 originally published online April 1, 2016;
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
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