According to the review of the Cochrane Drugs and Alcohol Group, there is no robust evidence for or against recommending the implementation of alcohol advertising restrictions.
The misuse of alcoholic beverages is a significant risk factor for ill health, injury (e.g. through violent behaviour or road traffic collisions), death and social problems around the world. Advertising to promote the drinking of alcoholic beverages is very common and some parties among health groups, governments and scientists reportedly believe that restricting the advertising of alcohol in any form would lead to adults drinking less alcohol and prevent young people from starting drinking at an early age. Types of restrictions for alcohol advertisement include alcohol advertisements on television, the internet, billboards or magazines. But no systematic review had ever evaluated the effectiveness, possible harms and cost-effectiveness of this endeavour.
A systematic review was published by the Cochrane Drugs and Alcohol Group* to evaluate the benefits, harms and costs of restricting or banning advertising of alcohol, of any format, compared with having no restrictions or counter-advertising, on alcohol consumption in adults and adolescents. They also tried to assess the harm that banning advertisements may cause, such as reducing profits in the alcohol beverage and advertising industries, and whether governments would lose taxes, if purchases of alcoholic beverages went down after a ban. None of the studies reported on any harms arising from the bans.
The Cochrane researchers only found four studies that evaluated the restriction or banning of alcohol advertising via any format. One was a small randomised controlled trial (RCT) that evaluated drinking behaviour in 80 young men in the Netherlands exposed to movies with either a high or low alcohol content combined with a commercial with either a neutral (interpreted as a ban on alcohol advertising) or a high alcohol content. The other three studies were interrupted time series (ITS) studies. ITS studies are studies in which changes, usually in the general public, are measured at various points before, during and after an intervention such as a change in policy.
The results of these studies could not show a clear effect either for or against the banning or restricting of advertising of alcoholic beverages. In the small RCT performed in the Netherlands, young men who watched movies with low-alcohol content drank less than men who watched movies with high-alcohol content. Young men exposed to commercials with a neutral content compared to those exposed to commercials for alcohol drank less. However, as the Cochrane Group stresses, the trial was only one and a half hour long, so it is hardly known how long beyond the trial such effects would last.
Since the results from the other three ITS studies were inconsistent, the Cochrane Group statistically combined the results of the two studies that assessed what happened after the introduction of a ban. As a fact, an overall increase in beer consumption was observed among the general population following the introduction of the ban. But the Cochrane researchers emphasize that the results were uncertain and could also be consistent with no difference or an overall decrease in the consumption of alcoholic beverages. The results of the third ITS study, which evaluated the lifting of a total ban on all forms of alcohol advertising to a ban on spirits advertising only, were also uncertain.
The Cochrane reviewers were thus unable to recommend for or against banning alcohol advertising. Their advice to governments that are considering implementing alcohol advertising bans is to implement the ban in a research environment and monitor the effects over time to build the evidence base.
* Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. It is a not-for-profit organisation with collaborators from over 120 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest.
Siegfried N, Pienaar DC, Ataguba JE, Volmink J, Kredo T, JereM, Parry CDH. Restricting or banning alcohol advertising to reduce alcohol consumption in adults and adolescents. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD010704.
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