1. Young people's exposure to television alcohol advertising in the UK, the Netherlands and Germany Sunil Patil, Eleanor Winpenny, Marc Elliott, Charlene Rohr, Ellen Nolte Cambridge Institute of Public Health Away Day, 25 June 2014

2. Background Alcohol use among young people, and adolescents in particular, is a concern across Europe Alcohol advertising has been shown to increase the likelihood that adolescents will start to drink alcohol and may increase alcohol use among those who already consume alcohol (Anderson et al. 2009) The EC Executive Agency for Health and Consumers asked RAND Europe to carry out an assessment of young people’s exposure to alcohol advertising on television Anderson, P., de Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of Alcohol Advertising and Media Exposure on Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies. Alcohol and Alcoholism.

3. What are the current policies and regulations on alcohol advertising? UK Regulations on alcohol advert content (non-statutory) No advertising on public channels (non-statutory) Netherlands Regulations on alcohol advert content (non-statutory) No alcohol adverts between 06:00 and 21:00 (statutory) Germany Regulations on alcohol advert content (non-statutory) Limited advertising on public channels (statutory) No alcohol adverts in children’s programming (statutory)

4. What data did we use? From Ebiquity (market research) we obtained: 1.Viewership data on the television audience 2.Data on placement of alcohol advertising 3.Data on alcohol advert impacts – number of times each advert is viewed All data was for: 6 months, Dec 2010 to May 2011 3 countries, UK, Netherlands, Germany 10 most viewed television channels in each country Disaggregated by month, channel and daypart Audience data was broken down by age: UK & Germany: 4-9, 10-15, 16-24, 25+ Netherlands: 6-12, 13-19, 20+

5. Analysis For each country: 1.Basic descriptive analyses to understand and characterise viewership and alcohol advertising across dayparts, channels and months 2.Analysis of advert incidence to understand exposure to alcohol advertising in different youth age groups relative to adults Audience data Advertising occurrence Advert incidence and viewing by different age groups

6. Regression analysis Model: negative binomial regression model Considered each combination of channel, month, daypart as a single data point Independent variables: Viewership proportion made up by each age group Dependent variable: number of alcohol adverts Exposure variable: length of daypart [hours] x average viewership in that daypart Results were presented as Incidence Rate Ratios (IRRs): Whether each age group were more/less exposed to alcohol adverts compared to reference population (here: adults)

7. Patil S et al. Eur J Public Health 2014;eurpub.cku060 Alcohol advert exposure of youth age groups compared to adults

8. Patil S et al. Eur J Public Health 2014;eurpub.cku060 Alcohol advert exposure of youth age groups compared to adults

9. Patil S et al. Eur J Public Health 2014;eurpub.cku060 Alcohol advert exposure of youth age groups compared to adults

10. Patil S et al. Eur J Public Health 2014;eurpub.cku060 Alcohol advert exposure of youth age groups compared to adults

11. Patil S et al. Eur J Public Health 2014;eurpub.cku060 Exposure of adolescents to adverts for different alcohol beverage types, compared to adults

12. Conclusions Children and adolescents in the UK (age 10-15) and the Netherlands (age 13-19) were significantly more exposed to alcohol advertising compared to adults Young children were significantly less exposed to alcohol advertising compared to adults In Germany we did not find evidence of higher exposure of children and adolescents to alcohol advertising compared to adults. Youth exposure varies by product category Current regulations are not sufficient to protect young people from alcohol advertising on television.

13. Unanswered questions Why was increased exposure among young people seen in UK and Netherlands but not in Germany? How representative are our 3 countries for the rest of Europe? What has most effect on consumption levels in young people – exposure levels or content of advertising? How can we best protect young people from the effects of advertising?

14. Acknowledgements Those who worked on the project: Sunil Patil Charlene Rohr Ellen Nolte Marc Elliott Our Funders: This work was conducted within a Service Contract with the Executive Agency for Health and Consumers, funded by the EU Health Programme.

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