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#Alcohol: Portrayals of Alcohol in Top Videos on TikTok
Abstract
Objective:
The purpose of this study was to characterize the content and themes present in user-generated TikTok videos portraying alcohol.
Method:
We captured the 100 most popular videos including the #alcohol hashtag on the popular social networking site TikTok. We used an iterative process to codebook development, resulting in codes for user sentiment toward alcohol, type of alcohol depicted, brand references, degree of alcohol use, and positive/negative associations with alcohol use. Videos were independently double coded, evaluated for inter-rater agreement, and adjudicated if differences were present.
Results:
The videos in our sample were collectively viewed 291,999,100 times. The vast majority (98%) of videos expressed pro-alcohol sentiment. Nearly half of videos (41%) were guide videos demonstrating drink recipes. The majority of videos (72%) included liquor. Consuming multiple drinks quickly was depicted in more than half of videos (61%), whereas intoxication (13%) was exhibited less frequently. Positive associations with alcohol were prevalent; 69% of videos conveyed positive experiences with alcohol, 55% of videos contained humor, and 45% included associations of alcohol with camaraderie. Negative associations with alcohol were rarely portrayed (4%).
Conclusions:
Top alcohol-related videos on TikTok are heavily viewed. Their contents demonstrate a propensity to promote rapid consumption of multiple drinks and to juxtapose alcohol use with positive associations such as humor and camaraderie, while rarely depicting negative outcomes associated with hazardous alcohol use.
... High alcohol consumption increases drunk driving, physical altercations, sexual assault, and the use of illicit drugs, and also has detrimental effects on brain development, neuropsychological performance and increases the risk of becoming alcohol dependent [1]. Worldwide, according to the World Health Organization (WHO, 2022), more than a quarter of [15][16][17][18][19] year old reported drinking alcohol in 2016, amounting to 155 million adolescents, and the prevalence of heavy episodic drinking among them was 13.6%, although that consumption is declining [2]. ...
... The influence of digital marketing by alcohol brands is a significant contributing factor to high alcohol consumption in young people and other segments of the population [3][4][5]. In the world, 4.76 billion people are social media users [6], a large market for the alcohol industry to target, and among them, 12% of users are aged [13][14][15][16][17][18][19], and 31% are aged 20-29 [7]. Young people are the largest group of TikTok users, with those aged 13-17 representing a third of all users on the platform [8]. ...
... Hendriks et al. [15] revealed that 63% of content created by Instagram influencers had at least one post related to alcohol, and all these posts were positive: they reinforce the "fun" image of alcohol and normalize it. Focusing on the 100 most popular videos of TikTok© alcohol-related user-generated content, Russell et al. [16] showed positive content (humour and camaraderie) and the promotion of rapid alcohol consumption. Vranken et al. [17] noted that young people are frequently exposed to Instagram influencers who hold alcoholic beverages, provide positive reviews for brands, and promote their own beverages. ...
Background
Despite widespread use of the short-video social media platform TikTok©, limited research investigates how alcohol is portrayed on the platform. Previous research suggests that a driver of alcohol content on TikTok©, in part, comes from bartenders demonstrating how to make drinks. This study aims to explore the characterizing patterns of how bartender influencers on TikTok© feature and incorporate alcohol in their videos.
Methods
We identified the global top 15 most followed bartenders on TikTok© in 2021 (cumulative 29.7 million subscribers) and the videos they posted in November and December 2021, the period just before Christmas and New Year, when alcohol tends to be more marketed than in other periods. The videos were coded based on five criteria: (1) the presence of alcohol or not; (2) alcohol categories; (3); alcohol brand(s) if visible; (4) the presence of candies and other sweet products; (5) presence of cues that refer to young people’s interests.
Results
In total, we identified 345 videos, which received 270,325,600 views in total, with an average of 18,021,707 views per video. Among these 345 videos, 92% (n = 317) displayed alcohol in their cocktail recipes (249,275,600 views, with an average of 786,358 views). The most common types of alcohol present in videos were liquor, vodka, rum, and whiskey, all of which are high-ABV beverages. 73% (n = 230) displayed or mentioned an alcohol brand. 17% (n = 55) associated alcohol with sweet products such as different types of candy (53,957,900 views, with an average of 981,053 views per video). 13% (n = 43) contained cues appealing to young people (e.g., cartoons, characters) (15,763,300 views, with an average of 366,588 views per video).
Conclusions
Our findings suggest a large presence of positively framed alcohol content posted by popular bartenders on TikTok©. As exposure to digital marketing is related to an increase in alcohol consumption, particularly among young people, regulations are needed to protect the public from alcohol-related harms.
... encouragement and support, benefits/barriers mentioned; Rosenstock 1974, Yeomans 2019, de Visser and Nicholls 2020, de Visser and Piper 2020. For example, evidence suggests that the vast majority of alcohol-related social media posts positively portray alcohol, often incorporating humor to normalize heavy drinking behaviors and to downplay alcohol-related negative consequences (Cavazos-Rehg et al. 2015, Russell et al. 2021. With regard to prior studies examining Dry January participation, there is evidence that opting to receive additional encouragement and support (e.g. ...
... Overall, the majority of tweets in our sample were classified as having positive or neutral sentiment toward Dry January; however, this sentiment was less pronounced among individual user accounts. Prior research examining alcoholrelated content on social media has demonstrated that the vast majority of content portrays drinking in a positive manner, often times glamorizing heavy drinking behaviors (Cavazos-Rehg et al. 2015, Russell et al. 2021Russell et al. , 2022a. Moreover, prior work has shown that negative alcohol-related consequences are seldom presented in alcohol-related social media content; rather, posts emphasize rewarding appeal characteristics, such as achievement, social camaraderie, positive emotional experiences, and rarely, if ever, advocate for moderation (Barry et al. 2018a(Barry et al. , 2018b. ...
... Moreover, prior work has shown that negative alcohol-related consequences are seldom presented in alcohol-related social media content; rather, posts emphasize rewarding appeal characteristics, such as achievement, social camaraderie, positive emotional experiences, and rarely, if ever, advocate for moderation (Barry et al. 2018a(Barry et al. , 2018b. When alcohol-related consequences are depicted in social media content, they are often coupled with humor that serves to downplay their severity (Russell et al. 2021). Our findings highlight parallels from previous literature in that individual tweets often expressed pro-drinking sentiments and directed sarcasm toward those participating in Dry January (e.g. ...
With roots as a public health campaign in the United Kingdom, "Dry January" is a temporary alcohol abstinence initiative encouraging participants to abstain from alcohol use during the month of January. Dry January has become a cultural phenomenon, gaining increasing news media attention and social media engagement. Given the utility of capturing naturalistic discussions around health topics on social media, we examined Twitter chatter about Dry January and associated temporary abstinence experiences. Public tweets were collected containing the search terms "dry january" or "dryjanuary" posted between 15 December and 15 February across 3 years (2020-2). A random subsample stratified by year (n = 3145) was pulled for manual content analysis by trained coders. Final codebook accounted for user sentiment toward Dry January, user account type, and themes related to Dry January participation. Engagement metadata (e.g. likes) were also collected. Though user sentiment was mixed, most tweets expressed positive or neutral sentiment toward Dry January (74.7%). Common themes included encouragement and support for Dry January participation (14.1%), experimentation with and promotion of nonalcoholic drinks (14.0%), and benefits derived from Dry January participation (10.4%). While there is promise in the movement to promote positive alcohol-related behavior change, increased efforts to deliver the campaign within a public health context are needed. Health communication campaigns designed to inform participants about evidence-based treatment and recovery support services proven to help people quit or cut down on their drinking are likely to maximize benefits.
... Although we are beginning to understand the potentially important role of social media in substance use and SUD, prior research has concentrated mainly on Facebook, Twitter, Instagram, and TikTok (Cavazos-Rehg et al., 2015;Hendriks et al., 2018;Moreno et al., 2012;Russell, Bergman, et al., 2021). Moreover, previous research has focused on portraying the substance rather than the persons on SUD treatment or recovery support (Cavazos-Rehg et al., 2015;Hendriks et al., 2018;Moreno et al., 2012;Russell, Bergman, et al., 2021;Russell, Davis, et al., 2021). The only study that has examined social media-based recovery support focuses on TikTok videos (Russell, Bergman, et al., 2021). ...
... Hence, YouTube might be more likely to impact users' behavior than shorter and superficial TikTok videos. Although there are two content analyses of YouTube videos on alcohol brands and cannabis vaping, little is known about the YouTube content on persons with SUD treatment or recovery support (Lim et al., 2021;Russell, Davis, et al., 2021). Therefore, this study was conducted to (a) explore the content and tone of YouTube videos on persons seeking SUD treatment or recovery support, (b) describe the users' exposure and engagement metrics, and (c) explore viewers' perspectives on the video content. ...
... Some of these codes were based on a study on media portrayal of mental illness by Whitley and Wang (2017), such as using stigmatizing words/tone; propagating public stigma; propagating internalized stigma; video speaking about the criminalization behavior of drug users. Terms like abuser, addict, junkie, dirty, etc. were considered stigmatizing language coded dichotomously (Russell, Davis, et al., 2021). The other implicit codes were themes and subthemes identified by the thematic analysis. ...
Background and aim
Emerging literature suggests the role of social media in substance use disorders (SUD). This study aimed to explore the content of YouTube videos for persons on SUD treatment/recovery, describing the users’ exposure and engagement metrics and understanding viewers’ perspectives.
Methods
We generated a set of 10 key phrases to search on YouTube. Eighty eligible videos were analyzed using a mixed-methods approach. Content analysis of all videos and thematic analysis of 30 videos were done using the three most viewed videos from each key phrase. The reliability of videos was assessed using a modified DISCERN. The total number of views, likes, dislikes, and comments were noted and created engagement metrics. The linguistic analysis of viewers’ comments was done to assess their perspectives.
Results
Sixty-three (78.8%) videos were from the US, and 59 (73.8%) were intended for persons or families with substance misuse. Persons in recovery uploaded 23 (28.7%) videos. We identified five themes – reasons for using drugs, symptoms of addiction, consequences of drug use, how to stop drug use, and expressed tone in the language. The positivity and relative positivity ratios were highest for videos developed by persons in recovery. There was a negative correlation between the relative positivity ratio and content fostering internalized stigma. Words with negative emotional experiences dominated the viewers’ comments.
Conclusion
YouTube content on SUD treatment and recovery is popular and revolves around the biopsychosocial understanding of addiction. There is an urgent need for a language policy and regulation of non-scientific content.
... The portrayal of alcohol and e-cigarettes on TikTok has previously been examined [14,15], however, the portrayal of EDs in this space remains to be studied. This bears importance as the digital promotion of EDs is more strongly linked to consumption than other forms of marketing such as broadcast, print, in-store, sponsorship, or endorsement [9]. ...
... All 200 videos were independently coded in randomized order by three researchers, with coding differences discussed and reconciled by a further two researchers. ED-related coding categories were based on data used previously in digital ED marketing [9] and previous content analyses on TikTok [14,15]. These included: engagement (views, likes, and shares), content ('blue tick' status, disclosure of paid advertisement/sponsorship; apparent age, under or over 18, of primary actor/s; gender of primary actor/s, ED present, ED consumed, over or rapid consumption, use of sexual elements and music), and sentiment toward EDs (negative, neutral, and positive). ...
... This study was limited by sample size; however, the video count is comparable to previously published studies investigating the portrayal of alcohol and vaping on TikTok [14,15]. Future research would incorporate a larger sample, spanning a wider range of ED hashtags. ...
Purpose:
Energy drinks (EDs) are not recommended for minors' consumption due to a myriad of health risks, but marketing initiatives persist. This study explored the promotion of EDs on TikTok, a platform frequented by children and adolescents.
Methods:
197 highly viewed videos from the four top ED-related hashtags on TikTok were coded for engagement variables, user information, sponsorship status, video content, and sentiment toward EDs.
Results:
Of the 197 videos analyzed (combined 70 + million views), 29% disclosed sponsorship and 22% featured a child/adolescent. ED consumption appeared in 46% of videos, with 15% depicting hazardous consumption. Most videos (67%) had a positive sentiment toward EDs.
Discussion:
ED-related TikTok videos are positively framed, have high engagement, and are not restricted for viewing by minors. As the platform's underage user-base grows, such videos may encourage heightened consumption. Given the known health risks, effective age-gated content restrictions are needed to reduce minors' exposure.
... Of the 50 most popular movies on Netflix in 2020, 76% included alcohol use by secondary characters and 66% by primary characters (Giannakodimos et al., 2022). These depictions are disproportionately positive, often displaying the benefits of alcohol use (e.g., fun, stress relief) more than the risks (Sargent et al., 2002;Russell et al., 2021;Merrill et al, 2023;Gosselt et al., 2017;Bhatia et al., 2023). ...
... This is concerning given the extent of media substance exposures across media modalities, including television, streaming services, social media, online marketing. For example, alcohol depictions and marketing content are common and accessible to underaged youth on TikTok (Russell, 2021), Twitter (Barry et al., 2016;Cabrera-Nguyen et al., 2016;Litt et al., 2018), and YouTube (Barry et al., 2015). Qualitatively, adolescents report seeing alcohol content on social media frequently, originating from both influencers and peers and including both branded and unbranded content (Corcoran et al., 2023). ...
Objective
Alcohol is the most frequently depicted substance in the media, and adolescent exposure to alcohol in the media predicts alcohol use. There is relatively little research on exposure to cannabis in the media, but exposure to alcohol content may exert cross-substance effects on cannabis use. Given the social and health risks associated with early cannabis use, the present study aims to assess the cross-substance effects of exposure to alcohol media content on age of cannabis initiation.
Method
A sample of 830 middle school students (53% female) reported on movie alcohol exposure and cannabis initiation longitudinally until high school completion. Discrete-time survival models examined whether movie alcohol exposure predicted subsequent initiation among students who were cannabis-naïve at baseline, controlling for demographic, social, and behavioral covariates. The interaction between sex and movie alcohol exposure was also explored.
Results
One third (33%) of participants reported cannabis initiation with a mean of 5.57 estimated hours (SD = 4.29) of movie alcohol exposure. A 1-hour increase in movie exposure predicted a significant 16% increased probability of cannabis initiation in models adjusted for demographic variables and a significant 14% increase in models adjusted for demographic, behavioral, and social variables. No differences were observed across sex.
Conclusions
Greater adolescent exposure to alcohol content in the media was associated with earlier cannabis initiation above and beyond other etiologically relevant demographic, behavioral, and social variables. The influence of cross-substance media exposures warrants further exploration and should be taken into consideration in the development of preventive interventions for youth substance use.
... Both types of media content are rife with positive alcohol depictions (Erevik et al., 2017;Hendriks et al., 2020;Keller-Hamilton et al., 2018), frequently displaying alcohol in fun, social settings and less commonly resulting in negative outcomes (Dal Cin et al., 2009;El-Khoury et al., 2019). Studies of Instagram and TikTok content also revealed mostly positive alcohol depictions, commonly associated with humor, camaraderie, and positive experiences (Hendriks et al., 2018;Russell et al., 2021). While Instagram most commonly depicts alcohol in a positive light, Snapchat more commonly depicts negative consequences of alcohol use, at least among college students (Boyle et al., 2017). ...
... Adolescents reported that much of the content they observe in both entertainment and social media is promotive of drinking. This aligns with prior work specific to both social (Hendriks et al., 2018;MacArthur et al., 2020;Russell et al., 2021) and entertainment media (Stern, 2005;Stern & Morr, 2013). A novel observation was that some consequences of drinking that are typically thought of as negative (e.g., vomiting) can be portrayed positively or downplayed (e.g., "no big deal") in the media. ...
Objective: Exposure to alcohol in the media is pervasive and may influence adolescents’ perceptions and use of alcohol. The purpose of this study was to better understand how adolescents perceive alcohol-related content in both entertainment and social media, with a focus on the valence of portrayals (i.e., positive, negative) and impacts on cognitions and behaviors. Method: Participants were 40 high school students (60% female). Nine focus groups were conducted via videoconferencing, stratified by grade (9th/10th, 11th/12th) and gender. Transcripts were analyzed via template-style thematic analyses to identify themes. Results: Six themes were developed, including (a) some portrayals of alcohol may increase likelihood of using alcohol, (b) some portrayals of alcohol in the media can discourage drinking, (c) sometimes truly negative consequences of alcohol are portrayed positively or downplayed, (d) media portrayals of alcohol are perceived to be based in reality but are at times exaggerated, (e) adolescent and adult alcohol use is portrayed differently in entertainment media, and (f) the extent to which adolescents are influenced by the media may depend on their preexisting attitudes, beliefs, and education. Conclusions: Adolescents have awareness of media portrayals of alcohol, both positive and negative, and their associated impacts. Findings highlight the need for much more work to understand the conditions under which, and for whom, exposure to different types of positive portrayals of alcohol in the media translate into positive expectancies about alcohol or drinking motives. Such work may ultimately inform intervention targets to reduce early initiation and/or risky drinking among adolescents.
... Although some tweets in this cluster referenced successful Dry January experiences and positive associations with these experiences, a large number of these tweets used humor and sarcasm to make light of Dry January participation and voiced an overall lack of desire to participate in the temporary abstinence initiative. This finding is in line with prior work examining alcohol-related content on social media platforms, such as Twitter and TikTok [25,26,59]; the vast majority of alcohol-related posts on these social media platforms portray drinking in a positive manner and often depict hazardous drinking behaviors, such as intoxication and blacking out, in a favorable manner. Similarly, alcohol-related negative consequences are rarely portrayed in alcohol-related social media posts, and when such portrayals are present, they are often depicted in a humorous manner that serves to downplay the severity of alcohol-related problems [25,59]. ...
... This finding is in line with prior work examining alcohol-related content on social media platforms, such as Twitter and TikTok [25,26,59]; the vast majority of alcohol-related posts on these social media platforms portray drinking in a positive manner and often depict hazardous drinking behaviors, such as intoxication and blacking out, in a favorable manner. Similarly, alcohol-related negative consequences are rarely portrayed in alcohol-related social media posts, and when such portrayals are present, they are often depicted in a humorous manner that serves to downplay the severity of alcohol-related problems [25,59]. ...
Background:
Dry January, a temporary alcohol abstinence campaign, encourages individuals to reflect on their relationship with alcohol by temporarily abstaining from consumption during the month of January. Though Dry January has become a global phenomenon, there has been limited investigation into Dry January participants' experiences. One means through which to gain insights into individuals' Dry January-related experiences is by leveraging large-scale social media data (e.g., Twitter chatter) to explore and characterize public discourse concerning Dry January.
Objective:
We sought to answer the following questions: (1) What themes are present within a corpus of tweets about Dry January, and is there consistency in the language used to discuss Dry January across multiple years of tweets (2020-2022)? (2) Do unique themes or patterns emerge in Dry January 2021 tweets after the onset of the COVID-19 pandemic? and (3) What is the association with tweet composition (i.e., sentiment and human-authored vs. bot-authored) and engagement with Dry January tweets?
Methods:
We applied natural language processing techniques to a large sample of tweets (N = 222,917) containing the term "dry january" or "dryjanuary" posted from December 15 to February 15 across three separate years of participation (2020-2022). Term frequency inverse document frequency, k-means clustering, and principal component analysis were used for data visualization to identify the optimal number of clusters per year. Once data were visualized, we ran interpretation models to afford within-year (or within-cluster) comparisons. Latent Dirichlet Allocation topic modeling was used to examine content within each cluster per given year. Valence Aware Dictionary and sEntiment [sic] Reasoner sentiment analysis was used to examine affect per cluster per year. Botometer automated account check was employed to determine average bot score per cluster per year. Lastly, to assess user engagement with Dry January content, we took the average number of likes and retweets per cluster and ran correlations with other outcome variables of interest.
Results:
We observed several similar topics per year (e.g., Dry January resources, Dry January health benefits, updates related to Dry January progress), suggesting relative consistency in Dry January content over time. While there was overlap in themes across multiple years of tweets, unique themes related to individuals' experiences with alcohol during the midst of the COVID-19 global pandemic were detected in the corpus of tweets from 2021. Also, tweet composition was associated with engagement, including number of likes, retweets, and quote-tweets per post. Bot-dominant clusters had fewer likes, retweets, or quote tweets compared with human-authored clusters.
Conclusions:
Findings underscore the utility for using large-scale social media, such as discussions on Twitter, to study drinking reduction attempts and to monitor the ongoing dynamic needs of persons contemplating, preparing for, or actively pursuing attempts to quit or cut down on their drinking.
Clinicaltrial:
... The latter include numerous posts by hosts sharing negative experiences, illustrating how their guests have left the apartments after use, which could evoke feelings of fear and surprise. This reflects the diverse reactions and experiences of Airbnb users on TikTok, ranging from positive moments to problematic situations (Russell et al., 2021). ...
This study delves into Airbnb’s brand presence on TikTok by analyzing textual content in posts, and human audio in videos. This approach aims to decipher the brand narrative and gauge user engagement. In the dynamic realm of social media marketing, TikTok has emerged as a key platform in shaping brand perception. This research specifically concentrates on Airbnb’s content, distinguishing between official narratives and user-generated content (UGC). Notably, themes of “Travel” dominate official posts, contrasting with “Real Estate” and “Business” in UGC. The methodology employed involves advanced data collection techniques, including web scraping for textual data and artificial intelligence for transcribing human audio to text. The findings reveal that UGC commands greater engagement and volume compared to Airbnb’s own brand content, underscoring the increasing significance of user involvement in brand storytelling. An analysis of the study results is conducted using linguistic natural processing (LNP) for the sentiment base, and the vector space model for emotion analysis. Sentiment analysis reveals a predominance of the emotion “happiness” and a significant presence of “surprise” in the posts, both of which are critical for audience engagement. Moreover, the study indicates a high approval rate for Airbnb-related content, reflecting a positive reception of the brand. Additionally, the research observes that influencers, particularly nano influencers, have higher engagement rates, indicating that their authenticity and relatability appeal especially to Generation Z audiences. This study not only sheds light on the intricate relationship between brand narrative, user engagement, and sentiment on TikTok but also offers valuable insights into effective brand image construction and propagation in the digital era, highlighting the importance of diverse emotions in enhancing audience engagement.
... In another study (Moreno et al., 2012), college students with Facebook profiles that included past-year posts about intoxication/problem drinking had increased likelihood of past-year hazardous drinking (positive AUDIT scores) and alcohol-related injury. Whereas few studies have explored associations between alcohol-related posting on TikTok and "real-life" alcohol outcomes, a content-analysis study of the top 100 TikTok videos with the hashtag "#alcohol" demonstrated that alcohol-related TikTok videos often depict users consuming multiple drinks quickly (61%) or making alcoholic drinks (41%), and are vastly proalcohol in sentiment (98%; Russell et al., 2021). ...
Objective: Research among young adults (YA), in samples of majority White college students, indicates links between posting about alcohol on social media and self-reported drinking behavior. We sought to extend this work by examining unique associations between public versus private posting about alcohol and the high-risk outcome of alcohol-related blackouts among a sample of racially/ethnically diverse YA not in 4-year college. Method: A sample of 499 participants (ages 18–29; 52.5% female; 37.5% Black/African American, 26.9% White, 25.3% Hispanic/Latinx) completed an online survey about social media use and drinking behavior. Results: Across three platforms (Instagram, TikTok, Twitter [now known as “X”]), public posting on Instagram was most common. Adjusting for covariates, a higher frequency of private posting about alcohol was associated with a higher frequency of past-month blackouts. Tests of simple effects of posting on blackouts within racial/ethnic subgroups indicated that private posting about alcohol was significantly associated with past-month blackouts only among those who most strongly identified as Black/African American or White but not among those who most strongly identified as Hispanic/Latinx. Further, public posting was significantly associated with past-month blackouts, though the association was specific to White participants. Conclusions: Whether posting about alcohol may be useful in identifying risky drinking behavior may depend on racial/ethnic identification as well as whether private or public posting is being considered. Results have implications for eventual online interventions, which can identify individuals potentially at risk for hazardous drinking based on their social media posting behavior.
... Other platforms such as TikTok, SnapChat, Twitch and Discord may illuminate other ways in which alcohol companies represent gender and engage with users given the ages and markets targeted by these apps. There has been some emerging research on TikTok but without commentary of differences between genders [91,92]. Future research could also usefully focus on the experiences of social media users who engage with online marketing content, given its ability to engage with consumers in multiple and ephemeral ways, leveraging processes of gendered identity creation [93]. ...
Issues
Alcohol marketing on social media platforms is pervasive and effective, reaching wide audiences and allowing interaction with users. We know little about the gendered nature of digital alcohol marketing, including how women and men are portrayed, how different genders respond and implications for gender relations. This review aimed to identify how males, females and other genders are targeted and represented in digital alcohol marketing, and how they are encouraged to engage with digital alcohol marketing content.
Approach
A narrative synthesis approach was employed. Academic literature and research reports were searched for studies on digital alcohol marketing published within the previous 10 years with a range of methods and designs. We reviewed the studies, extracted data relevant to gender and synthesised findings thematically.
Key Findings
The review included 17 articles and 7 reports with a range of designs and methods, including content analyses of digital material, interviews, focus groups and surveys. Our analysis identified three conceptual themes that captured many of the gendered results, namely: (i) leveraging a diversity of idealised femininities; (ii) amplifying hegemonic masculinity; and (iii) infiltrating everyday gendered life.
Implications and Conclusion
Alcohol marketing on social media is highly gendered and is designed to embed itself into everyday life in agile ways that reinforce traditional and evolving gendered stereotypes, activities, lifestyles and roles. Gendered engagement strategies are widely used to link alcohol to everyday gendered activities and identities to encourage alcohol purchase and consumption. This marketing normalises alcohol consumption and reproduces harmful gender norms and stereotypes.
... In addition, they reported a higher level of "likes" in videos that portray alcohol use using humor. Similarly, Russell et al. (2021) examined the 100 most popular videos on TikTok which included the #alcohol hashtag using a mixed methods design. The researchers found most posts depicted alcohol consumption in a positive light with more than half of the videos illustrating rapid consumption of multiple drinks, humorous alcohol use, and bonding with others through drinking. ...
... Mass media campaigns can also play an important role in sparking public discussions about alcohol J o u r n a l P r e -p r o o f use and contribute to changing attitudes, which are aspects that have been emphasized as important to for improving public health (McCambridge 2021). This is especially important as the vast majority of alcohol related content on social media is pro-alcohol use, and also pro-heavy drinking (Russell, Davis et al. 2021). Moreover, mass media campaigns can contribute to widening the perspectives of AUD and decrease stigma, which especially is important as mass media attention around AUD has been shown to reinforce stigmatizing views (Ghosh, Naskar et al. 2022). ...
Introduction: A minority of individuals with alcohol use disorder (AUD) seek treatment. In Denmark, a mass media campaign, “RESPEKT”, aiming to increase treatment seeking, has been broadcasted nationwide since 2015. The campaign is unique from an international perspective. Similar interventions have, up until now, not been scientifically evaluated.
Aim: To investigate whether there was an association between campaign periods and treatment seeking for AUD. A secondary aim was to investigate possible gender differences. The hypotheses were that treatment seeking would increase during the campaign periods, and that men would increase their treatment seeking more compared to women.
Method: Study design: Interrupted time-series analysis. Participants: Adults aged 18 years and above in the Danish population seeking AUD treatment. Exposure: Campaign periods year 2015 to 2018.Outcome: Changes in treatment seeking defined as treatment entry respectively filled prescription of AUD pharmacotherapy.
Data: National Alcohol Treatment Register on treatment entries for specialist addiction care and National Prescription Registry for filled prescriptions on AUD pharmacotherapies 2013 to 2018.
Analysis: Segmented negative binomial regression, including the full cohort and stratified by sex.
Results: The results show no association between campaign periods and treatment seeking. Nor were there any gender differences in treatment seeking. The hypotheses were not confirmed.
Conclusion: The campaign periods showed no association with treatment seeking. Eventual future campaigns should possibly focus on earlier steps of the treatment seeking process, as problem recognition, to increase treatment seeking. There is a great need to develop other ways to narrow the treatment gap for AUD
... In a recent study, which was published too late to be retrieved for our review, by Jongenelis et al. [49], 94% of the 628 analyzed Australian alcohol ads were found violating at least one AARB Code provision, indicating ineffectiveness of the ABAC self-regulatory codes. Another study by Russell et al. [50], analyzing top 100 popular videos on TikTok with the hashtag #alcohol, found 98% expressed pro-alcohol sentiment and 69% conveyed positive experiences of alcohol, thus demonstrating a propensity to promote rapid consumption of alcohol drinks, likely going against the platform's alcohol advertising policies. After our systematic review was already finished, a relevant Lithuanian case study was published in the second half of 2022 [51], which assessed the effectiveness of their comprehensive statutory alcohol advertising ban (including digital alcohol advertising restrictions). ...
Background
The rapid growth of social networking sites and video sharing platforms has created an opportunity for the alcohol industry to employ advanced advertising and marketing approaches to target their audiences, increasingly blurring the lines between commercial marketing and user-generated content, which poses a challenge for effective regulation.
Methods
We conducted a systematic search through three peer-reviewed journal databases (WoS, PubMed, Scopus). Studies were included if published in English, after 2004, and assessed statutory regulation or voluntary industry codes, enacted by an EU or nation’s governmental agency or private entity, and with the intent to restrict digital alcohol advertising. In addition, we conducted a manual search of gray literature.
Results
A total of 4690 records were identified. After duplicate removal and full-text assessment, 14 articles were examined. Our findings indicate that children and adolescents may often be exposed to alcohol advertisements on social media and websites due to industry’s self-regulatory age-affirmation systems being largely ineffective at preventing under-aged access. Cases of self-regulatory violations by the alcohol industry, and increasingly innovative ‘gray-area’ advertising approaches have also been noted. Additionally, research illustrates a lack of developed statutory restrictions of digital alcohol advertising and instead continued reliance on voluntary industry self-regulation.
Conclusions
There is a substantial need for further research to examine the effectiveness of digital alcohol advertising restrictions in social media, websites and image/video sharing platforms. Moreover, there is a necessity for countries to develop comprehensive statutory frameworks, which would effectively restrict and monitor rapidly advancing digital alcohol advertising practices on new digital media.
... Los resultados de esta investigación señalan que la imagen del consumo de alcohol proyectada en Instagram no es neutra, ya que las personas participantes eliminan las imágenes de los efectos secundarios adversos o no deseados y sólo muestran el consumo de alcohol asociado a la "fiesta", amistad o emoción positiva, a la fase de desinhibición de los efectos del alcohol, nunca de las subsiguientes fases que provoca el consumo de esta sustancia. Coincidimos con otros estudios en otras redes sociales, como el de Russell et al. (2021) cuando analizan el contenido sobre consumo de alcohol en vídeos de TikTok y coinciden también en mostrar el consumo de alcohol con asociaciones positivas, como el humor y la camaradería, mientras que rara vez muestran efectos adversos negativos asociados con el consumo de riesgo de bebidas alcohólicas. En las investigaciones sobre Instagram se la ha señalado como un medio fundamental y especial para publicar contenido relacionado con el consumo de alcohol de manera atractiva y glamurosa, ya que las características que tiene esta red social permiten el uso de filtros atractivos en las fotografías, el foco en las imágenes bellas o los efectos dramáticos, siendo fácil hacer glamuroso cualquier comportamiento, entre los que aparece el consumo de alcohol (Boyle et al., 2017). ...
Introducción: Compartir “eventos de la bebida” se ha convertido en una práctica habitual entre las personas jóvenes en redes como Instagram. La pandemia por el Covid-19 ha reestructurado tanto sus pautas de consumo de alcohol, como los usos que hacen de las redes sociales. Objetivos y Métodos: Describir en profundidad las pautas de consu- mo de alcohol y los efectos de este consumo que se muestran en Instagram en una muestra de 118 jóvenes y ado- lescentes en España a través de la etnografía digital. Resultados y Conclusiones: Instagram es parte de la fiesta, parte imbricada en la vida cotidiana de las personas jóvenes, en la que se comparten regularmente imágenes deseables de las pautas de consumo de alcohol y sus efectos. Adolescentes y jóvenes construyen un modelo online idealizado de pautas de consumo de alcohol en el que sólo son visibles los efectos de la fase de desinhibición tras el consumo y se obvian el resto de las fases de los efectos del alcohol en el organismo. Es fundamental incluir estas nuevas formas de transmisión de las pautas de consumo de alcohol en la normativa española que regula la venta y uso de alcohol.
... Exposure to alcohol-related content on SM is common, and the majority of alcohol-related posts portray drinking positively, often normalizing hazardous drinking behaviors [3][4][5]. Moreover, engagement with pro-drinking SM content (posting, liking, commenting, and viewing) is associated with increased alcohol consumption [2]. ...
... Global corporations' advertising expenditure is immense and widespread, and public health responses have struggled to keep up with industry innovations in digital and social marketing [164]. This point is emphasised in an international study looking at the top 100 videos on the social media platform TikTok using the hashtag "#alcohol" [165]. The study found that the vast majority (98%) of the videos portrayed alcohol in a positive light. ...
Alcohol and other drug use among young people
... Expectedly, the same challenges regarding the online safety, content moderation, data regulation and the ethics of targeted advertising of CYP are applicable to TikTok (De Leyn et al., 2021). For example, a recent content analysis found that alcohol-related content on TikTok showed a propensity to promote rapid consumption of multiple drinks and to align alcohol consumption with positive associations (i.e., humour), while rarely communicating the known negative outcomes (Russell et al., 2021). ...
Globally, TikTok is now the fastest growing social media platform among children and young people; but it remains surprisingly under-researched in psychology and psychiatry. This is despite the fact that social media platforms have been subject to intense academic and societal scrutiny regarding their potentially adverse effects on youth mental health and wellbeing, notwithstanding the inconsistent findings across the literature. In this two part study, we conducted a systematic review concerning studies that have examined TikTok for any public health or mental health purpose; and a follow-up content analysis of TikTok within an Irish context. For study 1, a predetermined search strategy covering representative public and mental health terminology was applied to six databases - PSYCINFO, Google Scholar, PUBMED, Wiley, Journal of Medical Internet Research, ACM - within the period 2016 to 2021. Included studies were limited to English-speaking publications of any design where TikTok was the primary focus of the study. The quality appraisal tool by Dunne et al., (2018) was applied to all included studies. For study 2, we replicated our search strategy from study 1, and converted this terminology to TikTok hashtags to search within TikTok in combination with Irish-specific hashtags. As quantified by the app, the top two "most liked" videos were selected for inclusion across the following three targeted groups: official public health accounts; registered Irish charities; and personal TikTok creators. A full descriptive analysis was applied in both studies. Study 1 found 24 studies that covered a range of public and mental health issues: COVID-19 (n = 10), dermatology (n = 7), eating disorders (n = 1), cancer (n = 1), tics (n = 1), radiology (n = 1), sexual health (n = 1), DNA (n = 1), and public health promotion (n = 1). Studies were predominately from the USA, applied a content analysis design, and were of acceptable quality overall. In study 2, 29 Irish TikTok accounts were analysed, including the accounts of public health authorities (n = 2), charity or non-profit (n = 5), and personal TikTok creators (n = 22). The overall engagement data from these accounts represented a significant outreach to younger populations: total likes n = 2,588,181; total comments n = 13,775; and total shares n = 21,254. TikTok has been utilised for a range of public health purposes, but remains poorly engaged by institutional accounts. The various mechanisms for connecting with younger audiences presents a unique opportunity for youth mental health practitioners to consider, yet there were distinct differences in how TikTok accounts used platform features to interact. Overall, there is an absence of high quality mixed methodological evaluations of TikTok content for public and mental health, despite it being the most used platform for children and young people.
... Research has shown that social media experiences may influence health behaviors, including alcohol use (Curtis et al., 2018;Lobstein et al., 2017;Moreno & Whitehill, 2014;Morgan et al., 2010;Noel et al., 2020;Sudhinaraset et al., 2016). Alcohol-related social media posts tend to portray drinking in a positive manner, often glamorizing and normalizing heavy drinking behaviors (e.g., intoxication, blacking out), while rarely depicting any alcohol-related negative consequences (Cavazos-Rehg et al., 2015;Curtis et al., 2018;Litt et al., 2018;Lobstein et al., 2017;Moreno & Whitehill, 2014;Morgan et al., 2010;Noel et al., 2020;Riordan et al., 2019;Russell, Davis, et al., 2021;Sudhinaraset et al., 2016). Increased exposure to this alcohol-related social media content among adolescents and young adults, in particular, is associated with increased alcohol consumption and alcohol-related problems (Curtis et al., 2018;Lobstein et al., 2017;Moreno & Whitehill, 2014;Noel et al., 2020;Sudhinaraset et al., 2016). ...
Objective
Social media use among American adults is ubiquitous. Alcohol-related social media posts often glamorize heavy drinking, with increased exposure to such content associated with greater alcohol use. Comparatively less is known, however, about how social media promotes alcohol-related health behavior change. Greater scientific knowledge in this area may enhance our understanding of the relationship between social media and alcohol behaviors, helping to inform clinical and public health recommendations. We examined the relationship between exposure to peer alcohol-related social media posts (pro-drinking, negative consequences, and pro-treatment/recovery) and treatment-seeking intentions among heavy drinkers, as well as potential mediators of the relationship (e.g., attitudes toward treatment effectiveness). Method: Hazardous drinking adults (aged 18-55 years) who use social media (N = 499) completed an online questionnaire. Linear regression analysis examined the association between alcohol-related social media exposures and treatment-seeking intentions. Mediation was tested using structural equation modeling. Results: Exposure to peer pro-drinking posts was negatively associated with intentions to seek treatment (β=-0.67, p<0.01), whereas exposures to peer alcohol-related negative consequences posts and peer posts about positive experiences with treatment/recovery were positively associated with treatment-seeking intentions (β=0.69, p<0.01; β=1.23, p<0.001, respectively). Mediation analysis concluded the effect of exposures on intentions was explained partially by attitudes toward treatment effectiveness (25.5%) and alcohol treatment stigma (6.1%). Conclusions: Findings suggest peers’ alcohol-related social media posts may both promote and hinder health behavior change depending on the nature of the post. Future research that develops and tests social media-delivered interventions to promote treatment and recovery seeking is warranted.
... An overwhelming majority of alcohol content shared across a variety of platforms features positive experiences (e.g., drinking with friends at a party) related to drinking and is shared widely (TikTok, Russell, Davis, et al., 2021;Twitter, Cavazos-Rehg et al., 2015;Facebook, and Instagram;Hendriks et al., 2018;YouTube, Primack et al., 2015). In fact, only 0.5%-7% of content features negative experiences (e.g., passing out on the street) related to drinking. ...
Peer social influence is a robust predictor of problematic drinking among young adults and adolescents; it is typically assessed by collecting nonspecific social network information (i.e., behaviors of peers globally) or specific social network information (i.e., behaviors of named friends). Socialization happens both in-person and online through social media. Exposure to alcohol-related social media content is consistently related to alcohol consumption in cross-sectional and longitudinal studies alike. Previous research has often not focused on who specifically is sharing the alcohol-related social media content with most examining effects of exposure to content posted by nonspecific network members (e.g., peers, friends) and individual alcohol consumption. The purpose of the current critical review is to describe how exposure to alcohol-related social media content is commonly measured and how including a specific social network assessment may explain more variance in alcohol use. The review found inconsistencies in the reference groups used when assessing frequency of exposure and found that specific modalities of content exposure were often not assessed. Of the 30 published studies reviewed, 15 used cross-sectional designs, which is regrettable considering that the composition of adolescent and young adult peer groups have been found to change over time possibly affecting the content viewed. Understanding factors which affect the relationship between exposure to alcohol-related social media content and individual alcohol use has implications for tailoring drinking interventions to address the unique social influence of social media content. Gaps in the literature are summarized and future directions for research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... With the introduction of SoMe, young people now have additional arenas for social learning. Research suggests that young people are particularly likely to share alcohol content such as positive depictions and stories on SoMe, thereby exposing other adolescents to content that potentially promotes alcohol use (Boers, Afzali, & Conrod, 2020;Erevik, Pallesen, Andreassen, Vedaa, & Torsheim, 2018;Russell et al., 2021). Praise in the form of comments and "likes" to alcohol posts on SoMe can also be observed, and this can facilitate alcohol initiation and increase over time because the viewer learns that the consequences of drinking can be positive. ...
Background and aims
Research into the association between use of social media (SoMe) and alcohol use among adolescents is still in its infancy. The aim of the current longitudinal study was to examine if time spent on SoMe was prospectively associated with alcohol use among adolescents, and whether these associations differed for boys and girls.
Design
Prospective cohort study among Norwegian adolescents who completed e-questionnaires in the autumn of 2017 (t1), 2018 (t2), 2019 (t3) and 2020 (t4).
Setting
Norway.
Participants
A nation-wide sample of N = 3096 adolescents (mean age at t1: 14.3 years (SD = 0.85), 43% boys).
Measurements
Self-report data were collected on adolescents’ alcohol use, time spent on SoMe, parental monitoring, sensation-seeking, and positive and negative urgency, gender, and age.
Findings
Latent growth modelling adjusted for time invariant covariates (i.e., parental monitoring, sensation-seeking, and positive and negative urgency at t1) showed a positive association between time spent on SoMe and alcohol use at the start of the study; standardized b (β) = .17 (95% CI: .09, .26). Time spent on SoMe at t1 was a strong positive predictor of increase in alcohol use β = .31 (95% CI: .23, .40). There was also an association between degree of increase in alcohol use and increase in time on SoMe, β = .14 (95% CI: .05, .24). Subsequent multigroup analysis found little evidence for gender differences (p > 0.05).
Conclusion
The more time Norwegian adolescents aged 13-15 years spend on SoMe, the greater is their subsequent increase in alcohol use over time.
... Previous studies have used similar sample sizes to analyze health-related videos on social media platforms such as TikTok and YouTube. 10,[13][14][15] Videos meeting the inclusion criteria were then included for extraction of video characteristics and further analysis. ...
Objectives
Social media platforms are increasingly being used to disseminate mental health information online. User-generated content about attention-deficit/hyperactivity disorder (ADHD) is one of the most popular health topics on the video-sharing social media platform TikTok. We sought to investigate the quality of TikTok videos about ADHD.
Method
The top 100 most popular videos about ADHD uploaded by TikTok video creators were classified as misleading, useful, or personal experience. Descriptive and quantitative characteristics of the videos were obtained. The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) and Journal of American Medical Association (JAMA) benchmark criteria were used to assess the overall quality, understandability, and actionability of the videos.
Results
Of the 100 videos meeting inclusion criteria, 52% ( n = 52) were classified as misleading, 27% ( n = 27) as personal experience, and 21% ( n = 21) as useful. Classification agreement between clinician ratings was 86% (kappa statistic of 0.7766). Videos on the platform were highly understandable by viewers but had low actionability. Non-healthcare providers uploaded the majority of misleading videos. Healthcare providers uploaded higher quality and more useful videos, compared to non-healthcare providers.
Conclusions
Approximately half of the analyzed TikTok videos about ADHD were misleading. Clinicians should be aware of the widespread dissemination of health misinformation on social media platforms and its potential impact on clinical care.
El uso de las redes sociales es una situación preocupante en el área de salud pública
debido a que en forma negativa puede dirigir al adolescente al aumento de consumo de alcohol o inicio temprano de consumo de alcohol, siendo dos fenómenos presentes en los adolescentes que por sí solos afectan la salud física, mental y emocional. Por lo tanto, durante el desarrollo de este ensayo científico se revisará el papel de las redes sociales en el consumo de alcohol de los adolescentes como fenómenos conjuntos y qué estrategias existen para contenerlos que puedan dar
pauta a la prevención.
Background: Social influences from peers, such as the perceptions of how much one's peers drink (i.e., descriptive drinking norms) are robust predictors of college drinking. In the digital age, these influences can happen on social media through viewing posts shared by peers depicting drinking (alcohol-related content). Social media influencers also post alcohol-related content and are popular among students. However, less is known about whether influencer drinking norms potentially mediate the association between viewing influencer alcohol-related content and drinking. Methods: College students who drink alcohol (N = 528) completed an online survey which assessed if they followed influencers who posted alcohol-related content, how often they perceived the influencer shared the content, influencer norms, and personal alcohol consumption and consequences. Results: Findings from two cross-sectional mediation models revealed that influencer norms mediated associations between following more influencers who shared alcohol-related content or frequency of influencer content and participant drinking. Conclusions: These findings suggest that influencer norms are uniquely linked to students' drinking habits. Further, it extends prior research in the influencer domain by examining how perceptions of how much influencers drink (i.e., descriptive norms) may impact college drinking.
Objective: The federal Australian government has introduced legislation to require social media platforms to restrict access to their platforms for young people under 16 years of age. Amongst the conversations about protecting the health and wellbeing of young people, we have yet to see discussion on the impact of alcohol imagery as a pervasive ‘unhealthy’ industry on social media. This is problematic because young people consume a large amount of social media content and are exposed to glamorised alcohol depictions and targeted advertising.
Conclusions: According to current regulations, the sponsoring of social media posts by alcohol companies should be declared, but enforcement of these requirements is challenging and most alcohol posts (whether sponsored or not) tend to glorify alcohol use. Better regulation, but not necessarily a social media ban, is needed to protect young viewers from pervasive alcohol exposure on social media.
In this study, a mixed methods approach was deployed to investigate how personality traits predispose Generation Z in Ireland to the influence of social media influencers (SMIs). In the context of this research, Generation Z is assumed to include people born from 1995 to 2012. This case study outlines the integration of quantitative and qualitative data to explore the influence of SMIs on the researcher’s sample population. The study used a convergent parallel mixed method design, collecting data simultaneously. The newly developed SUSIS questionnaire (SUSceptibility to being influenced by social media influencers) and the HEXACO-PI-R 60-items personality inventory (honesty-humility [H], emotionality [E], extraversion [X], agreeableness [A], conscientiousness [C], and openness to experience [O]) assessed participants’ susceptibility to SMIs and their personality traits. This revealed significant correlations through structural equation modeling (SEM), particularly showing that traits like honesty-humility and conscientiousness are linked to lower susceptibility. A qualitative thematic analysis of SUSIS’ open-ended questions responses provided deeper insights into motivations for following SMIs, enriching the quantitative findings. The research rigorously applied structural equation modeling for quantitative analysis and thematic analysis for qualitative data, confirming the SUSIS Questionnaire’s reliability. This dual-phase approach highlighted the role of personality in SMIs’ influence and enriched the understanding of how young people interact with SMIs’ content. Addressing ethical considerations ensured the integrity of the findings. My study demonstrates the value and complexity of mixed methods research in uncovering nuanced digital social dynamics, offering insights for future digital education, marketing communication strategies, and policy-making.
Purpose: The consumption of alcoholic beverages and their exposure on social media is becoming more common among teenagers. From an exhibition of youngsters showing alcoholic beverages in social media, we analyzed the social, familiar, and attitudinal contexts related to the use of the said social media and the desire to consume alcoholic beverages. Method: Based on a sample of Brazilian teenagers, a survey was developed, in which part of the data collection was made from an almost-experimental model. Results: Results revealed that teenagers’ exposure to alcoholic beverages on social media stimulates the desire to drink in those who see those posts, and this desire can increase when positive attitudes are depicted and injunctive norms are high. Theoretical contributions: This research aims to support the literature to confirm that social media tends to have an influence on earlier alcoholism. Furthermore, the study advances by revealing that injunctive norms influence more on the desire to consume alcoholic beverages by young people than extreme peer orientation. Originality: Unlike previous studies, this research provides evidence that injunctive norms significantly influence the behavior of adolescents, especially when the topic is alcohol consumption and self-display on social media. Management or social implications: The study provides several transformative proposals regarding media education relevant to public and private organizations.
Background
TikTok is a social media mobile application that is widely used by adolescents, and has the potential to serve as a revolutionary platform for public and mental health discourse, education, and intervention.
Objective
Our study aimed to describe the content and engagement metrics of the hashtag #teenmentalhealth on TikTok.
Methods
In this study, we: (a) conducted a directed content analysis of the Top 100 TikTok videos tagged with #teenmentalhealth, and (b) collected data on video engagements (views, likes, saves, and shares) and computed view-based engagement rates.
Results
The videos collectively garnered 144,320,591 views; 28,289,655 likes; 219,780 comments; 1,971,492 saves; and 478,696 shares. Most of the generated content were from teens and therapists. Engagement metrics revealed strong user engagement rates across user types. The most prevalent content categories represented across videos were personal experience, coping techniques or treatment, humor, interpersonal relationships, and health campaign. The content categories with the highest engagement rates were relatable media representation, health campaign, social isolation, and humor. Only a single video incorporated evidence-based treatment content.
Conclusion
TikTok facilitates communication and information dissemination on teen mental health. Future research should focus on improving the quality and credibility of digital content while maintaining engagement through creativity, self-expression, and relatability. Use of popular social media platforms and community-engaged research to disseminate evidence-based content may help bridge the translational research gap.
Objectives. To assess the exposure of Chinese adolescents to proalcohol advertising and explore its association with alcohol consumption.
Methods. A nationally and regionally representative school-based survey was conducted in mainland China in 2021 among students in grades 7 through 12, aged 13 to 18 years. We assessed adolescent exposure to proalcohol advertising and its association with alcohol consumption.
Results. A total of 57 336 students participated in the survey, and the exposure percentage of proalcohol advertising was 66.8%, with no difference between boys and girls or between urban and rural areas. The top 3 exposure channels were television (51.8%), the Internet (43.6%), and outdoor billboards (42.0%). The exposure was higher among students who had consumed alcohol in the past 30 days (80.1% vs 65.1%; adjusted odds ratio [AOR] = 1.29) and in the past 12 months (77.3% vs 61.7%; AOR = 1.30). However, no significant correlation was observed between advertising exposure and drunkenness.
Conclusions. Approximately two thirds of Chinese adolescents have been exposed to proalcohol advertising in the past 30 days, with television, the Internet, and outdoor billboards being the most prevalent channels. Exposure to proalcohol advertising exhibits a positive correlation with drinking. ( Am J Public Health. Published online ahead of print June 13, 2024:e1–e10. https://doi.org/10.2105/AJPH.2024.307680 )
Issue addressed:
A 'Black Out Rage Gallon' (borg) is a customised, individual alcoholic beverage popularised on TikTok, whereby half the water in a gallon jug is replaced with alcohol (usually spirits), flavourings, electrolytes and caffeine. We investigated the characteristics and portrayal of the emerging alcohol trend associated with the hashtag descriptor #borg on TikTok.
Methods:
We identified highly viewed TikTok videos with the #borg hashtag (n = 103) and conducted a content analysis, capturing viewer engagement ('likes', shares, comments), techniques used, characteristics of featured individuals, and the portrayal of alcohol and risky drinking behaviours.
Results:
Alcohol was visible in three quarters of the videos analysed (n = 78, average amount of alcohol present 865 mL per borg) and consumed in one third of the videos (n = 34). One quarter of videos (n = 25) promoted alleged benefits of borg consumption compared to other alcohol products or approaches to drinking, yet only nine videos included a warning about potential harms.
Conclusions:
The borg trend on TikTok may encourage risky drinking, by portraying it in a style that younger viewers are likely to see as fun and entertaining. SO WHAT?: We were able to gain a better understanding of how this potentially health harming activity is represented on a social media platform that is popular with young people. The speedy dissemination of this trend highlights the need to monitor, investigate and counter emerging trends. Concurrently, there is an urgent need for content restrictions to limit the visibility and promotion of risky alcohol consumption on TikTok.
A ‘Blackout Rage Gallon’ (borg) is a dangerous new alcohol consumption trend popular with young people. It involves creating a customised, individual alcoholic beverage by replacing half the water in a four litre (gallon) jug with alcohol (usually spirits), flavourings, electrolytes and caffeinated energy drinks or caffeine supplements. The most prevalent ‘recipe’ calls for the addition of 750ml of alcohol. The ‘blackout’ part of the name refers to the intent of one person to consume the borg in one session, thereby encouraging risky alcohol use. Indeed, there have been reports in popular media of multiple hospitalisations attributed to consumption of borgs at college events in the United States. Part of the attraction of the trend is to label the borg with a clever name, usually incorporating the term ‘borg’. The trend has gained traction recently on TikTok, which has become an important, yet unregulated, source of information for the public including young people(1). We investigated TikTok videos associated with the hashtag #borg to better understand this dangerous new phenomenon. We identified and analysed highly viewed TikTok videos (n = 105) for engagement, techniques, characteristics of featured individuals, and the portrayal of alcohol and risky drinking behaviours. Alcohol was visible in three quarters of the videos analysed (n = 78), and consumed in one third (n = 34). The average amount of alcohol present was well in excess of safe drinking guidelines (865ml) One quarter of videos (n = 25) promoted alleged benefits such as control of volume of consumption, protection from drink spiking, and mitigation of side effects due to addition of electrolytes and water. Alarmingly, only 9 videos included a warning about potential harms of the borg or alcohol in general. Indeed, videos discussing potential harms and benefits tended to encourage the use of borg, for example ‘I’m on board with the borg’. Our study found the borg TikTok trend encourages risky drinking in a fun and entertaining way, supporting previous studies where the majority of content was positively portraying a product or behaviour(2). As there is an association between viewing alcohol-related content on social media and alcohol use(3), there is an urgent need for social media content restrictions to limit the visibility of risky alcohol consumption, particularly to underage users.
Introduction
TikTok is often the first source teens and young adult patients turn to for medical information, a short-form social media video application known to promote videos with inaccurate information. The primary goal of this study was to characterize popular endometriosis misinformation found on TikTok, with the secondary goal of describing attitudes surrounding endometriosis on TikTok so that physicians can be knowledgeable about the content available on the internet, and be prepared when patients talk about endometriosis misinformation.
Methods
The top 100 videos under the three most popular endometriosis search terms were assessed for misinformation in four categories: incorrect causes, incorrect symptoms, incorrect treatment, and other incorrect information. Non-English, inaudible, duplicated, or irrelevant videos were excluded from analysis. Videos were analyzed until 100 valid videos were identified in each search term. Metadata was collected, including whether the video was created by a physician or non-physician and attitudes toward endometriosis. Chi squares, Fisher’s Exact Tests, and Mann–Whitney U tests were performed as appropriate.
Results
Of total, 298 videos met the eligibility criteria for review. Fifty videos were created by individual physicians and 248 were created by non-physicians. Overall, out of 298 videos, 69 videos (23%) had incorrect or misleading information about causes, treatment, symptoms, or information about endometriosis. Only 1% of the analyzed videos discussed medication management other than COCPs. Nonphysician sources were associated with negative attitudes ( p < 0.003). Nonphysician videos were more likely to contain misinformation in at least one category, compared to physician videos ( p < 0.0008). Despite the greater volume of non-physician videos, those created by physicians were more likely to be shared. Misinformation from non-physician sources was associated with positive/neutral attitudes toward endometriosis and treatment ( p < 0.00002).
Discussion
This study reveals that TikTok hosts a high volume of endometriosis misinformation, especially about endometrosis treatments. Popular TikTok misinformation tends not to reflect traditional misconceptions, but rather modern misinformation trends of holistic health and “wellness.” Physicians should be prepared to have respectful discussions about endometriosis treatments found on TikTok without invalidating the emotions that led patients to seek information on the internet.
Black out rage gallons (BORGs) are a troublesome drinking pattern emerging on social media platforms. The prevalence of BORGs has been increasing on college campuses and is demonstrating significant consequences. There is no known research on BORGs in addiction treatment settings. We suggest that future research will be necessary to understand their implication. Troublesome binge drinking is not a new problem among colleges. However, social media has seemed to ignite such trends.
Introduction:
Adolescent exposure to alcohol-related content on social media is common and associated with alcohol use and perceived norms; however, little is known about how exposure differs by the source of the content (e.g., peer or 'influencer'). The purpose of this study was to utilise qualitative methods to compare adolescent perspectives on peer- versus influencer-generated alcohol content on social media.
Methods:
Nine virtual semi-structured focus groups were conducted with adolescents (aged 15-19 years), following a general script aimed at ascertaining adolescent comparative perspectives on peer and influencer alcohol-related media content and the contexts in which it occurs.
Results:
Five main themes emerged: (i) although both influencers and peers post predominantly positively-valenced alcohol content online, adolescents perceived some differences between these posts; (ii) adolescents perceived their peers to be more cautious and strategic when posting about alcohol than influencers are; (iii) the decision to engage with peer or influencer alcohol-related posts is influenced by a number of factors; (iv) both peer and influencer posts were perceived to send the message that drinking is acceptable, normal or cool; and (v) adolescents believed they are more likely to be influenced by peers' alcohol posts than influencers' alcohol posts, with some exceptions.
Discussion and conclusions:
Future studies should aim to further understand the unique attributes and circumstances in which exposure to peer and influencer alcohol-related posts impact adolescent alcohol-related cognitions and behaviours. This knowledge will inform prevention and intervention efforts, such as media literacy training and media-specific parenting practices.
Eating-related content is common on TikTok, a popular video-based social media platform, but studies of eating-related content on TikTok are limited. Given the documented association between social media use and disordered eating, investigation of eating-related content on TikTok is needed. One subset of popular eating-related content is "What I Eat in a Day" (#WhatIEatInADay), in which a creator documents the food they eat over the assumed span of a single day. We sought to evaluate the content of TikTok #WhatIEatInADay videos (N = 100) using reflexive thematic analysis. Two primary types of videos emerged. First, Lifestyle videos (N = 60), which included aesthetic elements, presentations of clean eating, stylized meals, promotion of weight loss and the thin ideal, normalization of eating as a fat woman, and disordered eating content. Second, Eating Only videos (N = 40), which were primarily focused on food, and included upbeat music, an emphasis on highly palatable foods, displays of irony, emojis, and excessive consumption of food. Because viewing eating-related social media content has been associated with disordered eating, both types of TikTok #WhatIEatInADay videos may be harmful to vulnerable youth. Given the popularity of TikTok and #WhatIEatinADay, clinicians and researchers should consider the potential impact of this trend. Future research should examine the impact of viewing TikTok #WhatIEatInADay videos on disordered eating risk factors and behaviors.
Introduction:
Exposure to media with alcohol-related content is a known risk for alcohol use and related harms among young people. The present study used longitudinal self-report data on exposure to media with alcohol-related content to examine age trajectories across young adulthood and to estimate associations with heavy episodic drinking (HED) and negative consequences.
Method:
Participants were 201 high-risk young adults enrolled in 2- and 4-year colleges (ages 18-25 at screening; 63.7% female). Repeated assessments occurred at four timepoints across a 12-month period.
Results:
Self-reported exposure to both positively and negatively portrayed alcohol-related media content decreased with age. Between-persons, controlling for alcohol use frequency, exposure to positive alcohol-related media content was positively associated with HED, and exposure to negative alcohol-related media content was inversely associated with HED; no within-person effects on HED were significant. For negative consequences, controlling for alcohol quantity, exposure to positive media content was associated with more negative consequences both between- and within-persons. Unexpectedly, exposure to negatively portrayed media content was positively associated with negative consequences at the within-person level.
Discussion and conclusions:
Trajectories in exposure to media with alcohol-related content showed that relatively younger participants reported greater exposure, highlighting the need for policy and prevention efforts to protect this vulnerable demographic. Findings generally indicated that positive portrayals of alcohol use increase alcohol-related risks. Moreover, increased exposure to negative portrayals in a given assessment was associated with more negative consequences-potentially by normalising or glorifying high-risk drinking and consequences, though mechanistic/causal research is needed.
Background
Online information on mpox (monkeypox) is not well studied. We have analysed the video content, information quality, and audience engagement of mpox-related videos on TikTok.
Methods
Using a hashtag-based searching strategy, we identified 2462 mpox-related videos on TikTok from 1 January to 11 August 2022; 85 were included after exclusion criteria screening. Videos were evaluated for content on features and treatment of mpox. Video and information quality was assessed using the DISCERN instrument and the Journal of the American Medical Association (JAMA) criteria. We recorded video source, evaluation scores, and viewer engagement metrics. The Kruskal-Wallis test was used for statistical analysis and multiple linear regression for factor-association studies.
Results
Of the 85 videos, two assessed all content topics and highlighted 33% of all content items in clinical guidelines. The overall average score for the videos was 39.56 of 80 on the DISCERN instrument and 1.93 of 4 on the JAMA criteria. No video met all JAMA criteria. Subgroup analysis based on author identity suggested the variance in video scores by source (p<0.05 for all). Overall scores were higher for videos produced by doctors and science communicators than for those made by institutional users, nurses, and the general public. Multiple linear regression analysis showed that having people in the video (69.20, p=0.0001) and including information on treatment choices (1.15, p=0.045) were significant, independent determinants of audience engagement.
Conclusion
Public-directed TikTok videos on mpox frequently provide incomplete, inaccurate information, highlighting the potential risks of using TikTok as a health information source.
The normalisation of gambling for young people is a growing public health challenge. Despite initiatives aimed at reducing young people's exposure to unhealthy products, there is still little understanding of how they may be exposed to gambling. Using social exposure theory, this study aimed to explore young people's observations of gambling products and promotions within their everyday environments. In-depth interviews were conducted with 54 young people (n = 25 girls, n = 29 boys, aged 11–17 years) in Australia. Convenience and then snowball and purposive recruitment strategies were used to ensure a range of gambling attitudes and experiences were represented. Data were interpreted using reflexive thematic analysis. Young people described seeing gambling in varied social environments such as their own homes; physical environments in their local communities – including at local shopping centres, post offices, and sporting matches; and through symbolic environments such as marketing in community settings, on traditional and social media platforms, and depictions of gambling in movies and television shows. This exposure contributed to the perception that gambling was a normal activity, often placed alongside non-gambling activities in everyday settings. Comprehensive evidence-based public health strategies are needed to protect young people from exposure to gambling activities and promotions. These should include legislation to restrict the marketing and availability of gambling products, and research-based public education designed to counter normalising messages about gambling.
This comprehensive report details the full extent of the way that alcohol is being marketed across national borders – often by digital means – and often regardless of the social, economic or cultural environment in receiving countries. It highlights how increasingly sophisticated advertising and promotion techniques, including linking alcohol brands to sports and cultural activities, sponsorships and use of e-mails, SMS and social media, are being used to increase customer loyalty and gain new customers. It shows that young people and heavy drinkers are increasingly targeted by alcohol advertising, often to the detriment of their health, and highlights the need for more effective national regulations and better international collaboration
Der vorliegende Praxisbeitrag befasst sich mit der Kurzvideoplattform TikTok. Er beschreibt die Funktionsweise der Plattform und geht auf den bisherigen Stand der TikTok-Forschung ein. Im Fokus stehen dann Sexualaufklärung, LGBTIQ + sowie Beziehungs- und Datingberatung auf TikTok. // This practice-oriented article deals with the short video platform TikTok. It describes the functionality of the platform and summarizes the current state of TikTok research. It then focuses on sexuality education and LGBTIQ+ as well as relationship and dating counseling on TikTok.
Introduction
TikTok has over one billion monthly users and is particularly popular among children. We examined the (1) use of owned media by major unhealthy food and non-alcoholic beverage brands on TikTok and (2) nature of branded hashtag challenges instigated by such brands and the user-generated content created in response.
Methods
We assessed the (1) content of all videos posted on the accounts of 16 top food and non-alcoholic beverage brands (based on global brand share) as at 30 June 2021, and (2) content and sentiment of a sample of brand-relevant user-generated content created in response to branded hashtag challenges instigated by these brands.
Results
Of 539 videos posted by brands, 60% were posted in the first half of 2021. The most common marketing strategies were branding (87% of videos), product images (85%), engagement (31%) and celebrities/influencers (25%). Engagement included instigation of branded hashtag challenges that encouraged creation of user-generated content featuring brands’ products, brands’ videos and/or branded effects. The total collective views of user-generated content from single challenges ranged from 12.7 million to 107.9 billion. Of a sample of 626 brand-relevant videos generated in response to these challenges, 96% featured branding, 68% product images and 41% branded effects. Most portrayed a positive (73%) or neutral/unclear (25%) sentiment, with few negative (3%).
Conclusion
Unhealthy food and non-alcoholic beverage brands are using TikTok to market brands and products via their own accounts and to encourage users to create and share their own content that features branding and product images. Given TikTok’s popularity among children, this study supports the need for policies that protect children from the harmful impact of food marketing on social networking platforms.
Background
College‐aged young adults (e.g., 18 to 29‐year‐olds) use social media more than any other age group. An emerging body of literature shows that higher exposure to alcohol‐related social media content is associated with greater alcohol consumption among college students. However, most studies assess exposure to peer drinking on social media using global measures, rather than measuring the exposure to alcohol‐related posts of identified specific close peers. We examined whether having a higher proportion of important peers (i.e., social network members) who post alcohol‐related social media content is associated with greater alcohol consumption and alcohol‐related consequences. We also investigated the extent to which the qualities of network members who share alcohol‐related content are associated with participants' alcohol outcomes.
Methods
Participants were 130 college students (86.2% female, 56.9% White) with an average age of 23.39 years (SD = 5.63) who had consumed at least one alcoholic drink in the past week. Participants completed measures of their social media use, alcohol consumption, alcohol‐related consequences, and characteristics of important peers in their social network, including their alcohol‐related social media posting.
Results
Having a higher proportion of social network members who post alcohol‐related social media content was positively related to participants' drinks per week and peak number of drinks. Higher network proportions of drinking buddies posting alcohol‐related content were also associated with a greater frequency of alcohol use. Having a higher proportion of friends who post alcohol content and from whom the participants seek advice was linked to more alcohol‐related consequences.
Conclusions
Having more important peers who post alcohol‐related content on social media is associated with alcohol outcomes among college students. Harm‐reduction focused alcohol interventions delivered on college campuses that incorporate information about the influence of viewing and sharing alcohol‐related content could help to reduce alcohol consumption and alcohol‐related consequences among students.
Many ethical questions have been raised regarding the use of social media and the internet, mainly related to the protection of young people in the digital environment. In order to critically address the research question "who is responsible for ethically protecting minors in the digital environment?", this paper will review the main literature available to understand the role of parents, the government, and companies in protecting young people within the digital environment. We employed a holistic process that covers a state-of-the-art review and desk research. The article is divided into four sessions; (1) Government Policies from the European Union (EU) Perspective; (2) Parental Control; (3) An Overview of Companies and the Private and Self-Regulation Sectors; and (4) the Ethical Dilemma. Throughout, we reviewed specific topics regarding the potentially harmful content for young people within the digital environment, questioned how ethical concerns shape content and interactions online and discussed how internet parenting styles impact risks and opportunities for young people in the digital world. Finally, we analysed the research question contrasting it with the main findings in this review and offered recommendations.
Background: Young adults are prolific media users and tend to use substances, such as alcohol, more than people of other ages. Despite much research on young adults' exposure to alcohol advertisements and portrayals of alcohol use in the media, much is still unknown about the nuances of young adults' exposure to and engagement with alcohol-related media content. The present paper examined how college students' media exposure differed for messages portraying positive and negative alcohol effects, how exposure to alcohol-related content differed across media sources, which themes of alcoholrelated content were seen most, and whether exposure to alcohol-related content was associated with hazardous/harmful drinking. Method: Participants (N=500) were two- and four-year college students (Mage=20.90, SDage=1.70, 63.2% female) recruited for a longitudinal study examining the efficacy of a mobile app intervention for high-risk drinking college students. The data used here comes from the baseline survey. Results: Participants reported the greatest exposure to alcohol-related messages in movies/TV/on-demand streaming shows followed by in social media, and they reported greater exposure to messages portraying positive than negative effects of alcohol. Findings from linear regressions indicated that exposure to messages portraying positive or negative effects of alcohol generally did not predict hazardous/harmful drinking. Conclusion: This sample of high-risk college student drinkers reported seeing alcohol-related content through a variety of media sources, with most content portraying alcohol in a positive light. Future research should assess the effects that messages of different types and from different sources have on use, expectancies, norms, and other outcomes.
Underage drinking is a serious public health problem in the United States, and youth exposure to alcohol advertising has been indicated as a possible contributing factor. Although a number of studies have identified advertising content features that youth find appealing, a key limitation of this research is the absence of a broader tool to examine those features, especially those used by alcohol brands that are popular with underage drinkers. We created an index of content elements found in the research literature to be appealing to youth, and then used this index in a content analysis to identify the degree to which youth-appealing content appeared in a sample of alcohol ads that aired on television shows popular among youth. Finally, using bivariate analysis, we tested the relationship between alcohol brands' use of this content and the popularity of those brands among youth. We found that many of the ads featured youth-appealing content, and that the ads for the alcohol brands most popular among youth had more youth-appealing content than the less popular brands.
Aims:
Assess whether alcohol companies restrict youth/adolescent access, interaction, and exposure to their marketing on Twitter and Instagram.
Methods:
Employed five fictitious male and female Twitter (n = 10) and Instagram (n = 10) user profiles aged 13, 15, 17, 19 and/or 21. Using cellular smartphones, we determined whether profiles could (a) interact with advertising content-e.g. retweet, view video or picture content, comment, share URL; and/or (b) follow and directly receive advertising material updates from the official Instagram and Twitter pages of 22 alcohol brands for 30 days.
Results:
All user profiles could fully access, view, and interact with alcohol industry content posted on Instagram and Twitter. Twitter's age-gate, which restricts access for those under 21, successfully prevented underage profiles from following and subsequently receiving promotional material/updates. The two 21+ profiles collectively received 1836 alcohol-related tweets within 30 days. All Instagram profiles, however, were able to follow all alcohol brand pages and received an average of 362 advertisements within 30 days. The quantity of promotional updates increased throughout the week, reaching their peak on Thursday and Friday. Representatives/controllers of alcohol brand Instagram pages would respond directly to our underage user's comments.
Conclusion:
The alcohol industry is in violation of their proposed self-regulation guidelines for digital marketing communications on Instagram. While Twitter's age-gate effectively blocked direct to phone updates, unhindered access to post was possible. Everyday our fictitious profiles, even those as young as 13, were bombarded with alcohol industry messages and promotional material directly to their smartphones.
Background
We aimed to characterize the content of leading YouTube videos related to alcohol intoxication and to examine factors associated with alcohol intoxication in videos that were assessed positively by viewers.Methods
We systematically captured the 70 most relevant and popular videos on YouTube related to alcohol intoxication. We employed an iterative process to codebook development which resulted in 42 codes in 6 categories: video characteristics, character socio demographics, alcohol depiction, degree of alcohol use, characteristics associated with alcohol, and consequences of alcohol.ResultsThere were a total of 333,246,875 views for all videos combined. While 89% of videos involved males, only 49% involved females. The videos had a median of 1,646 (interquartile range [IQR] 300 to 22,969) “like” designations and 33 (IQR 14 to 1,261) “dislike” designations each. Liquor was most frequently represented, followed by beer and then wine/champagne. Nearly one-half (44%) of videos contained a brand reference. Humor was juxtaposed with alcohol use in 79% of videos, and motor vehicle use was present in 24%. There were significantly more likes per dislike, indicating more positive sentiment, when there was representation of liquor (29.1 vs. 11.4, p = 0.008), brand references (32.1 vs. 19.2, p = 0.04), and/or physical attractiveness (67.5 vs. 17.8, p < 0.001).Conclusions
Internet videos depicting alcohol intoxication are heavily viewed. Nearly, half of these videos involve a brand-name reference. While these videos commonly juxtapose alcohol intoxication with characteristics such as humor and attractiveness, they infrequently depict negative clinical outcomes. The popularity of this site may provide an opportunity for public health intervention.
Aims:
Examine and evaluate the overall effectiveness of age gates preventing access of underage users to alcohol websites.
Methods:
Assess the characteristics of digital age gates among the top 25 alcohol brands among American adolescents, including type of age gate employed and resulting actions of repeated access requests indicating the user was under the legal drinking age.
Results:
All official alcohol brand websites examined included an age gate, requiring either entering one's date of birth (DOB, 91%) or clicking a yes/no box indicating they were of legal drinking age (9%). Only one out of every five alcohol websites blocked futures attempts to gain access after entering a response indicating the user was under the legal drinking age. Users were allowed indefinite attempts to enter a DOB that was of legal drinking age, with the majority of websites subsequently granting access even after multiple underage entries.
Conclusions:
Alcohol website visitors with minimal arithmetic abilities, such as very young youth, are able to employ 'trial and error' to eventually enter an acceptable legal drinking DOB and gain access. Alcohol brand age gates are weak, at best, and likely an inconsequential barrier that someone with limited math abilities can easily overcome.
Introduction and Aims
This study has, for the first time, mapped the extent to which alcoholic beverage brands operating on the Swedish market follow national advertising regulations and industry self‐regulating codes in their postings on social media.
Design and Methods
All social media content posted on YouTube, Twitter, Facebook and Instagram by 52 brands operating in the Swedish market was gathered from three sample months in 2014, 2016 and 2017. A content analysis was performed.
Results
An audit of the 1204 posts shows that the brands’ social media content conforms rather well with the industry's own self‐regulation codes. However, the studied beverage brands had alarmingly inadequate age‐gates to social media accounts. Advertisements for alcoholic beverages must be clearly distinguishable from advertisements for non‐alcoholic beverages, according to the Swedish Alcohol Act criteria. These criteria are fulfilled to a varying degree among the posts in the analysed data. Advertisements for non‐alcoholic beverages give companies a greater leeway in terms of shape and content of the post through logotypes, settings and connotations. However, advertisements of non‐alcoholic beverages continue to convey the brand connotations and image to consumers.
Discussion and Conclusions
Regulating alcohol advertising in online milieus can be very difficult because of the complex mixture between quickly evolving techniques and the diverse nature of communication messages targeting consumers. Many countries, including Sweden, are now focusing on how to enforce effective policies. This short report strives to shed some light on the scope and content of commercial messages on Swedish social media platforms.
Objective:
The purpose of this study was to document exposure to alcohol advertising by sex, age, and the level and type of alcohol people consume.
Method:
We use unique marketing survey data that link the media individuals consume and advertising appearing in those media. Our sample of 306,451 men and women represents the population age 18 and older living in the 48 contiguous United States between 1996 and 2009. We measure advertising exposure not with the standard expenditure data but with counts of actual advertisements people likely saw. We relate advertising exposure across groups defined by age, gender, and the amount of beer, wine, and spirits consumed.
Results:
We found that drinkers, particularly young male drinkers, see much more alcohol advertising. Men, especially younger men, see more advertisements for alcohol of all types than do women. Their higher exposure is largely explained by sex differences in the propensity to read sports and adult magazines and to watch sports and gambling television programs.
Conclusions:
The evidence highlights the need to recognize, and when possible, control for the fact that a selected group of individuals is more likely to see alcohol advertising. Firms successfully place advertising on programs and in magazines viewed by youth and drinkers. To estimate whether seeing advertising causes people to drink (more), researchers need to develop clever identification strategies.
Background: Exposure to alcohol-related advertising is consistently linked to adolescent drinking initiation and alcohol-related consequences. Since the advent of social networking sites, the alcohol industry has adapted its advertising efforts and allocated large portions of advertising budgets and efforts on digital and online media. Purpose: This investigation employed a novel, objective content analysis to examine the advertising practices of leading alcohol brands on Twitter. Methods: Latent Dirichlet allocation (LDA) was utilized to examine the entire Twitter post history for 13 alcohol brands. Results: Very distinct, clear themes emerged for each brand. Each brand had a unique approach to marketing that was representative of the brand itself. Insufficient alcohol brand messaging on Twitter focused on moderation (ie, drink responsibly). Discussion: Our analysis of tweets from 2010 to 2017 by 13 distinct alcohol brands echoes previous documenting utilization of content appealing to youth and violation of the alcohol industry’s self-developed marketing code. Translation to Health Education Practice: Public health practitioners and policymakers should utilize these findings and those of previous peer-reviewed studies to advocate for clear externally monitored advertising regulations and guidelines protecting adolescents from alcohol advertising exposure.
Background:
There is considerable evidence that exposure to alcohol marketing increases the likelihood of adolescents initiating and engaging in alcohol consumption. There is a paucity of research, however, specifically examining industry generated alcohol marketing occurring on social media/networking platforms.
Objective:
The purpose of this investigation was to analyze the content of promotional advertisements by alcohol brands on Instagram.
Methods:
For a 30-day period, Instagram profiles of 15 distinct alcohol brands were examined. Pictorial posts/updates from each profile were screen captured and individually documented. Approximately 184 distinct posts constituted our final sample. The Content Appealing to Youth Index was independently employed by two raters to assess each post. For each characteristic, Cohen's Kappa measures, and associated 95% confidence intervals, were calculated. Descriptive statistics were performed.
Results:
Posts increased throughout the week and peaked on Thursday and Friday. The production value of the posts examined was generally high, frequently featuring color, texture, shine, contrast, faces, and action. Character appeals and use of youth-oriented genres were uncommon. Many of the posts used product appeals and physical benefits to consumption. The posts also emphasized the following rewarding appeal characteristics: positive emotional experiences, achievement, individuality, and camaraderie. The most commonly coded risk-related feature was inappropriate use. Conclusions/Importance: This investigation represents an initial attempt to provide insights into the content alcohol brands are including in their promotional materials on social networking sites.
Background and aims:
Youth alcohol consumption is a major global public health concern. Previous reviews have concluded that exposure to alcohol marketing was associated with earlier drinking initiation and higher alcohol consumption among youth. This review examined longitudinal studies published since those earlier reviews.
Methods:
Peer-reviewed papers were identified in medical, scientific and social science databases, supplemented by examination of reference lists. Non-peer-reviewed papers were included if they were published by organizations deemed to be authoritative, were fully referenced and contained primary data not available elsewhere. Papers were restricted to those that included measures of marketing exposure and alcohol consumption for at least 500 underage people. Multiple authors reviewed studies for inclusion and assessed their quality using the National Heart, Lung and Blood Institute's Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies.
Results:
Twelve studies (ranging in duration from 9 months to 8 years), following nine unique cohorts not reported on previously involving 35 219 participants from Europe, Asia and North America, met inclusion criteria. All 12 found evidence of a positive association between level of marketing exposure and level of youth alcohol consumption. Some found significant associations between youth exposure to alcohol marketing and initiation of alcohol use (odds ratios ranging from 1.00 to 1.69), and there were clear associations between exposure and subsequent binge or hazardous drinking (odds ratios ranging from 1.38 to 2.15). Mediators included marketing receptivity, brand recognition and alcohol expectancies. Levels of marketing exposure among younger adolescents were similar to those found among older adolescents and young adults.
Conclusions:
Young people who have greater exposure to alcohol marketing appear to be more likely subsequently to initiate alcohol use and engage in binge and hazardous drinking.
Background and aims:
The rising use of digital media in the last decade, including social networking media and downloadable apps, has created new opportunities for marketing a wide range of goods and services, including alcohol products. This paper aims to review the evidence in order to answer a series of policy-relevant questions: Does alcohol marketing through digital media influence drinking behaviour or increases consumption? What methods of promotional marketing are used, and to what extent? What is the evidence of marketing code violations and especially of marketing to children?
Method and findings:
A search of scientific, medical and social journals and authoritative grey literature identified 47 relevant papers (including 14 grey literature documents). The evidence indicated (i) that exposure to marketing through digital media was associated with higher levels of drinking behaviour; (ii) that the marketing activities make use of materials and approaches that are attractive to young people and encourage interactive engagement with branded messaging; and (iii) there is evidence that current alcohol marketing codes are being undermined by alcohol producers using digital media.
Conclusions:
There is evidence to support public health interventions to restrict the commercial promotion of alcohol in digital media, especially measures to protect children and youth.
The promotion of drinking behaviors correlates with increased drinking behaviors and intent to drink, especially when peers are the promotion source. Similarly, online displays of peer drinking behaviors have been described as a potential type of peer pressure that might lead to alcohol misuse when the peers to whom individuals feel attached value such behaviors. Social media messages about drinking behaviors on Twitter (a popular social media platform among young people) are common but understudied. In response, and given that drinking alcohol is a widespread activity among young people, we examined Twitter chatter about drinking.
Tweets containing alcohol- or drinking-related keywords were collected from March 13 to April 11, 2014. We assessed a random sample (n = 5,000) of the most influential Tweets for sentiment, theme, and source.
Most alcohol-related Tweets reflected a positive sentiment toward alcohol use, with pro-alcohol Tweets outnumbering anti-alcohol Tweets by a factor of more than 10. The most common themes of pro-drinking Tweets included references to frequent or heavy drinking behaviors and wanting/needing/planning to drink alcohol. The most common sources of pro-alcohol Tweets were organic (i.e., noncommercial).
Our findings highlight the need for online prevention messages about drinking to counter the strong pro-alcohol presence on Twitter. However, to enhance the impact of anti-drinking messages on Twitter, it may be prudent for such Tweets to be sent by individuals who are widely followed on Twitter and during times when heavy drinking is more likely to occur (i.e., weekends, holidays).
Here, we review the research we have conducted on social contagion. We describe the methods we have employed (and the assumptions they have entailed) to examine several datasets with complementary strengths and weaknesses, including the Framingham Heart Study, the National Longitudinal Study of Adolescent Health, and other observational and experimental datasets that we and others have collected. We describe the regularities that led us to propose that human social networks may exhibit a 'three degrees of influence' property, and we review statistical approaches we have used to characterize interpersonal influence with respect to phenomena as diverse as obesity, smoking, cooperation, and happiness. We do not claim that this work is the final word, but we do believe that it provides some novel, informative, and stimulating evidence regarding social contagion in longitudinally followed networks. Along with other scholars, we are working to develop new methods for identifying causal effects using social network data, and we believe that this area is ripe for statistical development as current methods have known and often unavoidable limitations. Copyright © 2012 John Wiley & Sons, Ltd.
The Media Ready Program was designed as a middle school, media literacy education, preventive intervention program to improve adolescents' media literacy skills and reduce their intention to use alcohol or tobacco products. In a short-term efficacy trial, schools in North Carolina were randomly assigned to conditions (Media Ready: n = 214; control: n = 198). Boys in the Media Ready group reported significantly less intention to use alcohol in the future than did boys in the control group. Also, students in the Media Ready group who had used tobacco in the past reported significantly less intention to use tobacco in the future than did students in the control group who had previously used tobacco. Multilevel multiple mediation analyses suggest that the set of logical analysis Message Interpretation Processing variables mediated the program's effect on students' intentions to use alcohol or tobacco in the future.
Alcohol consumption has important health-related consequences and numerous biological and social determinants.
To explore quantitatively whether alcohol consumption behavior spreads from person to person in a large social network of friends, coworkers, siblings, spouses, and neighbors, followed for 32 years.
Longitudinal network cohort study.
The Framingham Heart Study.
12 067 persons assessed at several time points between 1971 and 2003.
Self-reported alcohol consumption (number of drinks per week on average over the past year and number of days drinking within the past week) and social network ties, measured at each time point.
Clusters of drinkers and abstainers were present in the network at all time points, and the clusters extended to 3 degrees of separation. These clusters were not only due to selective formation of social ties among drinkers but also seem to reflect interpersonal influence. Changes in the alcohol consumption behavior of a person's social network had a statistically significant effect on that person's subsequent alcohol consumption behavior. The behaviors of immediate neighbors and coworkers were not significantly associated with a person's drinking behavior, but the behavior of relatives and friends was.
A nonclinical measure of alcohol consumption was used. Also, it is unclear whether the effects on long-term health are positive or negative, because alcohol has been shown to be both harmful and protective. Finally, not all network ties were observed.
Network phenomena seem to influence alcohol consumption behavior. This has implications for clinical and public health interventions and further supports group-level interventions to reduce problematic drinking.
To assess the impact of alcohol advertising and media exposure on future adolescent alcohol use.
We searched MEDLINE, the Cochrane Library, Sociological Abstracts, and PsycLIT, from 1990 to September 2008, supplemented with searches of Google scholar, hand searches of key journals and reference lists of identified papers and key publications for more recent publications. We selected longitudinal studies that assessed individuals' exposure to commercial communications and media and alcohol drinking behaviour at baseline, and assessed alcohol drinking behaviour at follow-up. Participants were adolescents aged 18 years or younger or below the legal drinking age of the country of origin of the study, whichever was the higher.
Thirteen longitudinal studies that followed up a total of over 38,000 young people met inclusion criteria. The studies measured exposure to advertising and promotion in a variety of ways, including estimates of the volume of media and advertising exposure, ownership of branded merchandise, recall and receptivity, and one study on expenditure on advertisements. Follow-up ranged from 8 to 96 months. One study reported outcomes at multiple time-points, 3, 5, and 8 years. Seven studies provided data on initiation of alcohol use amongst non-drinkers, three studies on maintenance and frequency of drinking amongst baseline drinkers, and seven studies on alcohol use of the total sample of non-drinkers and drinkers at baseline. Twelve of the thirteen studies concluded an impact of exposure on subsequent alcohol use, including initiation of drinking and heavier drinking amongst existing drinkers, with a dose response relationship in all studies that reported such exposure and analysis. There was variation in the strength of association, and the degree to which potential confounders were controlled for. The thirteenth study, which tested the impact of outdoor advertising placed near schools failed to detect an impact on alcohol use, but found an impact on intentions to use.
Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.
To describe alcohol use and alcohol brand appearances in popular movies and estimate adolescents' exposure to this alcohol-related content.
Nationally representative, random-digit dialed survey in the United States and content analysis of alcohol depictions in the top 100 US box office hits each year from 1998 to 2002 and 34 top movies from early 2003.
A total of 6522 US adolescents aged 10-14 years.
Frequency of alcohol use and brand appearances in movies by Motion Picture Association of America (MPAA) rating. Estimated exposure to minutes of movie alcohol use and brand appearances among US adolescents in this age group.
Most movies (83%, including 56.6% of G/PG-rated movies) depicted alcohol use and 52% (including 19.2% of G/PG movies) contained at least one alcohol brand appearance, which consisted of branded use by an actor 30.3% of the time. These movies exposed the average US adolescent 10-14 years of age to 5.6 [95% confidence interval (CI) 5.4, 5.7] hours of movie alcohol use and 243.8 (95% CI 238, 250) alcohol brand appearances (5 billion in total), mainly from youth-rated movies. Exposure to movie alcohol content was significantly higher among African American youth than youth of other races.
Alcohol use and brand appearances are portrayed frequently in popular US movies (which are distributed world-wide). Children and adolescents in the United States are exposed to hours of alcohol use depictions and numerous brand appearances in movies and most of this exposure is from movies rated for this segment of the population.
Four related theories about the personal and social resources that shield individuals from developing substance use disorders and foster the process of remission from these disorders are described. These theories are social control theory, behavioral economics and behavioral choice theory, social learning theory, and stress and coping theory. Next, the social processes specified by these theories are highlighted, including the provision of support, goal direction, and monitoring; engagement in rewarding activities other than substance use, exposure to abstinence-oriented norms and models, and attempts to build self-efficacy and coping skills. Then, a review of the literature considers evidence about the association between the personal and social resources specified by the four theories and remission from substance use disorders. The discussion highlights several issues that need to be addressed to enhance our understanding of the protective resources involved in stable remission, such as how to develop integrated measures of the key resources and specify their associations with substance use outcomes, the extent to which the resources amplify or compensate for the influence of treatment, and how treatment and continuing care can be tailored to strengthen the protective resources that promote remission.
Teens, social media & technology 2018
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Belief, attitude, intention, and behavior
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New TikTok challenge kicks off national truth® campaign underscoring young people's desire to ditch Juul and quit vaping
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What is this is quitting?
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