Exploring industry driven marketing influences on young people who drink alcohol

Abstract

Background: While the overall proportion of young people who report drinking alcohol in the UK appears to have decreased over the past fifteen years, those who do drink are consuming in larger quantities, and drinking more frequently. An association between industry-driven alcohol marketing and young people’s drinking behaviour has been demonstrated in a number of cross-sectional, longitudinal and qualitative studies, but less is known about how young people are affected by alcohol marketing and how marketing processes knit with other widely studied influences on young people’s drinking behaviour. This study aimed to investigate the influence of industrydriven alcohol marketing processes (price, promotion, product branding and placing) on young people’s drinking choices and behaviour. Methods: A mixed-methods approach underpinned by a critical realist perspective was adopted. A systematic review examined empirical studies concerning the impact of industry-driven price and other marketing techniques on young people’s drinking behaviour. Qualitative interviews were conducted with young people aged 14-17 from NE England (n=31) to explore accounts of when, why, where and how they drink alcohol. Q methodology was used to derive ‘factors’ underlying alcohol choices, based on the results of a card sorting procedure undertaken with young people aged 14-17 from NE England (n=28). Findings: The systematic review identified 32 papers which were predominantly crosssectional in design, and focused on the impact of alcohol promotion on young people’s alcohol use. Although industry-driven alcohol marketing appeared to influence young people’s drinking behaviour, studies reported on a variety of populations, study designs, exposure measures and outcome measures, making synthesis and extrapolation difficult, as well as underlining a shortage of longitudinal work establishing the effect of alcohol marketing over time. The review highlighted a paucity of studies conducted in the UK as well as a lack of research examining the influence of price for those under the legal drinking age only and exploring the impact of digital or social media marketing on young people’s drinking behaviour. Young people interviewed in the qualitative study appeared to make micro-level choices about alcohol (between products and brands), positioning themselves as autonomous agents and unaffected by overt forms of alcohol marketing. However, the majority of participants were able to recount brands and slogans, did not recognise less visible aspects of promotion (e.g. sponsorship, viral and digital marketing) and did not associate the pricing of alcohol as a form of marketing. Therefore, advertising and other promotional activity seemed to play a role in building recognisable imagery linked to alcohol products, as well as associations and expectancies related to drinking. The advisability of drinking per se did not appear to have been questioned by participants and was considered an acceptable and normal practice. Participants reported that they were not exclusively price-led and choices were made in conjunction with other criteria (e.g. taste, availability, strength and image). Q factor analysis revealed three accounts: Factor one illustrates a sense of individuality, autonomy, and maturity in alcohol choices; factor two is price-led, choosing to drink whatever is most accessible, cheapest or on special offer; and factor three is an account of bounded adventure, pleasure and hedonism. Conclusions: Bourdieu’s concept of ‘habitus’ is drawn on to illustrate that young people’s alcohol choices are influenced by structural predispositions (including industry processes and alcohol marketing) but that ‘taste’, social norms and interpersonal relationships (recognised as agency) can also play a role in reinforcing, normalising and driving behaviour. Deeply embedded social norms and industry processes culminate in ‘political economies of health’ where health behaviours are governed by historical traditions and the logic of advanced capitalism (the need to make a profit), and choices constrained into seemingly free, naturalised directions. Thus, a description of young people as individual, rational agents, who can make the ‘correct’ choices about alcohol use, minimises structural and cultural factors that are, in part, shaped by the alcohol industry in conjunction with other influences such as inter-personal relationships and social norms, and which constrain health choices and behaviours of young people. Public Responsibility Deals and voluntary self-regulation of alcohol marketing may be inadequate to counter this. Instead, it needs to be identified that young people are being subtly bombarded and further work is required to ‘unravel’ this impact. Nevertheless, tighter restrictions on the marketing of alcohol, such as a policy resembling France’s Loi Evin should be given consideration. The current alcohol strategy for England and Wales includes a commitment to implementing an alcohol minimum unit price. However, findings from this doctoral work demonstrate that it is difficult to disentangle the four elements of the marketing mix. Price encompasses just one facet of alcohol marketing and makes up only a small part of the external world in which young people are becoming acculturated. The effect that price changes alone could have on young people’s alcohol use should not be overemphasised. Thus, as well as examining the impact of price on young people’s drinking behaviour pre and post legislative change, further work should also explore the changing nature of industry-driven alcohol marketing processes. In particular, the influence of digital and social media marketing on young people’s drinking behaviour needs to be examined further, as well as the combined contribution that alcohol marketing, long-standing social norms and inter-personal relationships (‘the alcohol habitus’) all can make towards a ubiquitous culture of alcohol consumption.