Local community and the broader environment
The broader environment, mass media campaigns and the local community can have a role to play in preventing, or delaying, the uptake of alcohol and other drugs by young people.
Initiatives to do so may seek to address risk factors in a community, such as the high availability of alcohol, by increasing awareness of AOD-related harms and reducing accessibility and promotion.
Mass media campaigns aimed at young people
Public health efforts sometimes include mass media campaigns to share information and encourage behaviour change.44
Depending on the campaign and the target audience, this may be done through channels ranging from television and social media to print and outdoor advertising. Various campaigns have been run in Australia by state and federal governments to prevent illicit drug use.
Some campaign approaches, such as those which use alleged ‘before and after’ photos of so-called drug use-related transformations can stigmatise people who use drugs and reinforce negative stereotypes.
There is insufficient evidence on the effectiveness of mass media campaigns in preventing the use of illicit drugs by young people to draw conclusions.45
This is due largely to ineffective or poorly designed evaluation of campaigns. 46
Research into alcohol-focussed media campaigns, demonstrated high recall of the campaigns and a positive impact on knowledge, attitudes and beliefs about alcohol consumption – although their impact on young people was not specifically examined.
The campaigns did not appear to be effective in reducing alcohol consumption; although they did not claim to be designed to target consumption. 47
The Australian ‘Alcohol, Think Again’ campaign demonstrates promise as an effective method to increase awareness, decrease parental supply of alcohol and improve knowledge of guidelines and evidence. 48
Long term harm reduction mass media campaigns have shown some success in areas such as the reduction of alcohol-impaired driving and the reduction of tobacco uptake among young people.
These campaigns were accompanied by a range of policy interventions, such as reducing accessibility to tobacco for minors.
The successes of these campaigns demonstrate that for mass media to be effective, a long-term investment is required, and they must be accompanied by other policy measures. 46
Mass media campaigns should be undertaken with caution, as there are concerns that some campaigns are ineffective and may inadvertently produce a backfire effect.45, 49
Availability of alcohol
The availability of alcohol refers to how easy it is to get alcohol in an area.
The availability of alcohol is affected by factors such as how many venues sell alcohol in an area (outlet density), the opening hours of those venues, and the age for legal purchase of alcohol.50
Liquor outlet density refers to the number of licensed liquor vendors in a given area, including bars, pubs, clubs, etc., as well as packaged liquor outlets (i.e. bottle shops).
The evidence for the impact of liquor outlet density on underage drinking is mixed.51
Some international studies have found a significant relationship between outlet density and drinking or heavy drinking among young people, whereas other studies have found no relationship. 51
Australian research has found a higher density of outlets selling alcohol in a community – specifically take-away liquor outlets – is linked to a higher risk of alcohol consumption for adolescents between 12–14 years of age.52
These findings suggest that minimising the density of alcohol outlets in a community may be a protective factor to reduce young people’s alcohol consumption. As such, communities and regulators should be given the ability to have meaningful input and control over the density, and type, of liquor outlets licenced in their local area.
Online sales are being increasingly used to access packaged liquor.
Given the rapid transformation of the market, little is known about the risks of online alcohol sales to young people; however, increased access to alcohol via online alcohol sales to minors is an area of growing concern.
One US study of young people showed one in ten 17-18 year-olds in the US have consumed home-delivered alcohol, with home-delivered alcohol also associated with high-risk drinking (more than five drinks on one occasion).53
Studies examining adherence to regulations around alcohol identify that home-delivered alcohol sales are not well monitored in relation to underage drinking.
A Dutch study revealed that all orders placed by underage children were fulfilled, and there were no requests for proof of age on delivery.54
In the US, half of the orders placed by underage drinkers were fulfilled.55
To date there has been limited research in Australia to understand how an online sales model can comply with alcohol sales regulations.
A report published in 2019 found that more than one-third of people aged under 25 who purchased alcohol online did not have their identification checked upon delivery.56 Further research is needed to understand if an online alcohol sales model is increasing access for minors.
Enforcing purchase laws of 18 years of age50 and secondary supply laws (provision of alcohol to those under 18 years) is an important aspect of reducing the availability of alcohol to young people.
Communities That Care, in partnership with Deakin University, is undertaking the testing and evaluation of a ‘secret shopper’-style intervention to check retailer compliance with identification laws.57
One study conducted in the USA found that compliance checks increased compliance with retailers who were issued with citations for noncompliance as well as retailers who were only exposed to media coverage about the issuing of the citations.58
Price of alcohol
Controls on the price of alcohol have been identified by the World Health Organization as some of the most effective measures to reduce the harms caused by alcohol.59, 60
Cheaper alcohol tends to encourage underage drinking and higher levels of alcohol consumption, including short-term risky drinking.61, 62
Young people appear sensitive to changes in the price of alcohol. When the cost of alcohol increases they are likely to consume less, which reduces the likelihood of experiencing alcohol-related harms.63, 64
There are two mechanisms to influence the price of alcohol - a minimum unit price (MUP) for alcohol beverages (also known as a floor price, which establishes a minimum price per standard drink) or taxation.
Promotion of alcohol
Australians are exposed to an extensive volume of alcohol promotions through a myriad of channels – traditional media, digital media, outdoor media, promotional activities and sponsorships. Alcohol advertising and marketing is governed by a mix of quasi-regulatory and self-regulatory regimes with limited or no involvement of government.
Young people are exposed to alcohol advertising through television, radio, print media, alcohol branded merchandise, and outdoor billboards.
Exposure to alcohol advertising is one factor that shapes young people’s attitudes to, and consumption of, alcohol.65-67
A systematic review examining the relationship between alcohol marketing and youth consumption of alcohol identified 12 studies involving 35,219 participants.
All studies showed a positive relationship between the level of alcohol marketing and the level of youth consumption. A clear association between level of exposure and hazardous drinking was also found.65
Exposure to alcohol advertising is also associated with normalising alcohol consumption,68 young people’s expectation of consuming alcohol, reduced age of initiation and is associated with more harmful drinking practices, such as excessive consumption.69
Alcohol brands are innovators in the use of social media and they are using it to target young people.
Social media allows brands to target young people in a host of ways that may be difficult to regulate, be ’self-regulated’ by the industry, or not yet covered by current regulations. It can also go unnoticed by many adults, including parents.
One example of this below-the-line marketing is an alcohol brand that leveraged its sponsorship of a music festival by having a photographer take pictures of people at the event for posting on the alcohol brand’s Facebook page. People in the photos then tagged themselves and shared them with their friends, enabling the alcohol company to collect more data on the young person so they could continue to target them with things like competitions and discussions around appealing cultural topics.
Social media has become an environment where alcohol consumption has been normalised and, to an extent, glamourised among young people. Studies have shown that 89% of males and 91% of female adolescents and young adults were exposed to alcohol marketing on social media.70 The authors concluded that exposure to alcohol content in social media may increase the likelihood that young people will initiate alcohol consumption.
Advertising of alcohol brands via social media platforms and via online gaming has created a new avenue for exposure to alcohol advertising by young people.
Online gaming has become a popular recreational activity. Many games are now competitive (referred to as ‘esports’) and attract many viewers and opportunities for sponsorship.
Research in 2016 showed that major brands, including fast food, betting, energy drink and alcohol companies, are sponsoring players and thus exposing viewers to their products. Analysis of advertisements found 15% of online esports sponsorship is from alcohol companies.71
As alcohol marketing becomes more targeted, it’s hard for anyone to know, or measure, how much alcohol advertising young people are seeing. Some young people under 18 years of age may use social media often – they can set up a Facebook account at 13.
This makes it increasingly important for young people to have media literacy and critical thinking skills to apply to how they understand social media advertising and brand engagement.
The sponsorship of sport provides a platform for brands to reach large segments of the population - including children and adolescents - with sponsors providing support for individual athletes, national sports teams, and national, state, regional and local sporting competitions.
Due to the prevalence of alcohol sponsorship in Australia, anyone playing or watching sport is exposed to the message that the consumption of alcohol is a natural accompaniment to that sporting activity.72
In Australia, although alcohol advertising on television is prohibited during children’s viewing hours, it is still currently permitted in this time slot during the broadcast of sporting events.
At many sporting venues, advertising is also present on the field, billboards around stadiums, broadcast on the stadium TV screens, featured on some jerseys or players’ attire, and in the names of various on-site bars or licenced venues.
Research has shown that children who wear clothes or own merchandise that carries alcohol branding are attracted to alcohol, have higher expectations of drinking, are more likely to start drinking early, and drink more often during adolescence.73
Popular support exists for protecting children from alcohol advertisements.
According to the Foundation for Alcohol Research and Education, results from the Annual Alcohol Poll 2018 show 62% of respondents believe alcohol advertising should be phased out from television during sporting broadcasts.74