Exposure to alcohol advertisements and alcohol consumption: Implications of findings of the South Africa International Alcohol Control (IAC) study for a total ban on alcohol advertising Neo K. Morojele 1,2,3 Nadine Harker Burnhams 1,3 Qinisile i il Sibanda 1 Petal Petersen 1 Elmarie Nel 1 Charles D.H. Parry 1,4 1 Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council 2 School of Public Health, University of the Witwatersrand 3 School of Public Health and Family Medicine, University of Cape Town 4 Department of Psychiatry, University of Stellenbosch
Background South Africans have amongst the highest rates of alcohol consumption worldwide (WHO, 2014) To address the harms associated with alcohol consumption, the South African government approved the Control of Marketing of Alcoholic li Beverages Bill in 2013 which h seeks to ban alcohol advertisements (Parry et al., 2014) However, there have been numerous delays in releasing the bill to Parliament
Background There has been limited research that can be used to inform the government s proposed ban onalcoholadvertisements advertisements in SA This study uses data from the SA arm of the International Alcohol Control (IAC) study to examine the associations between exposure to alcohol advertisements and alcohol consumption Previous analyses of IAC study data revealed that: Adolescents have high rates of exposure to alcohol brand marketing Adolescents with high levels of exposure to alcohol brand marketing were 2.25 times more likely to have initiated drinking than those with low levels of exposure (Morojele et al., 2015)
Aims To examine: 1. The extent of exposure to alcohol marketing amongadultadult menand women in Tshwane, South Africa 2. The association between exposure to alcohol brands/products being marketed and frequency of alcohol consumption at different drinking locations amongadult adult menand women intshwane Tshwane, South Africa
Methods South African arm of the International Alcohol Control (IAC) study (Caswell et al., 2012). Conducted in Tshwane Metropolitan Municipality (north eastern part of South Africa) population of 2.3 million Household survey: Multi-stage stratified cluster random sampling design Data for this paper relate to 1975 adults aged 18-65 years Males = 1265 (64.1%) Females = 710 (35.9%) All adults reported alcohol consumption in the past six months
Questionnaire measures Demographic factors: Age, gender, educational status, educational level, socio-economic status Exposure to alcohol brand marketing (16 items): In the last 6 months have you noticed any (alcohol) brands or products being advertised? Traditional (e.g. television, billboards, signs at shops, merchandise, radio, magazines, newspapers) Sponsorships (sports, music events, TV programmes/films, celebrities) Special price offers (on TV/radio/newspapers, free offers when buying alcohol) Electronic media (e.g. websites, SMS, S FB, emails) Response options: Yes, No, Don t know (responses No and Don t know were combined) Frequency of alcohol consumption: How often do you usually drink alcohol o at (Options comprise 16 different locations home, shebeens, pubs, special events such as festivals, music events, dance parties, etc.)
Percentage of women and men reporting exposure to alcohol brands/products via various methods and media (Traditional) Women Men 86.286.8 86.2 81.2 85 81.5 79.3 78.7 75.6 70 47.77 54.5
Percentage of women and men reporting exposure to alcohol brands/products via various methods and media (Sponsorships) Women Men 80.8 60.9 56.3 63.2 52 66.4 49.4 53.5 Sports sponsorship Famous people Music events sponsorship TV/movie sponsorship
Percentage of women and men reporting exposure to alcohol brands/products via various methods and media (Special Price Offers) Women Men 76.6 81.2 61.1 52.8 Special price offers Free offers
Percentage of women and men reporting exposure to alcohol brands/products via various methods and media (Social Media) Women Men 26.9 24.7 fijop 14 15.8 14.8 11.1 9.2 8.6 Social media Website In sms Email
At which locations do men and women drink alcohol? 100 90 80 75.8 78.7 Women Men 70 60 50 44.7 40 40.4 40.2 30 20 25 23.4 21.3 17.7 14.6 15.2 15.9 14.7 23.1 14.4 10 10.3 10.3 5.6 0 Home Someone else Special events Bars, pubs, Restaurants Outdoor Night clubs Other clubs Shebeen home taverns places
Exposure to alcohol adverts and frequency of drinking at home (p = 0.185) 100% Weekly Weekly monthly Less than monthly Never 90% 22.2 19.4 23.6 80% 70% 17.2 15.2 13.3 60% 50% 26.2 25 27.3 40% 30% 20% 34.4 40.4 35.8 10% 0% Low exposure (0 5 adverts) Medium exposure (6 11 adverts) High exposure (12 16 adverts)
Exposure to alcohol adverts and frequency of drinking at others home (p = 0.301) 100% Weekly Weekly monthly Less than monthly Never 90% 80% 70% 60.2 57.9 52.7 60% 50% 40% 30% 20% 10.4 11.9 15.1 15.6 12.5 15.5 10% 0% 14.3 14.9 Low exposure (0 5 adverts) Medium exposure (6 11 adverts) 19.3 High exposure (12 16 adverts)
Exposure to alcohol adverts and frequency of drinking in shebeens (p = 0.082) 100% Weekly Weekly monthly Less than monthly Never 90% 80% 70% 60% 50% 91 89.2 84.9 40% 30% 20% 10% 0% 4.1 1.8 2.4 4.1 36 3.6 4.2 3.6 4.3 6.8 Low exposure (0 5 adverts) Medium exposure (6 11 adverts) High exposure (12 16 adverts)
100% Exposure to alcohol adverts and frequency of drinking in pubs/bars/taverns (p <. 001) 90% 80% 70% 60% 74.6 68.1 55.2 50% 40% 10 30% 20% 10% 0% 5.4 9 6.7 12.4 11.1 12.7 Low exposure (0 5 adverts) Medium exposure (6 11 adverts) High exposure (12 16 16 adverts) 15.3 19.4 Weekly Weekly monthly Less than monthly Never
Exposure to alcohol adverts and frequency of drinking at special events (p = 0.013) 100% Weekly monthly Less than monthly Never 90% 80% 70% 60% 50% 83.9 75.5 73.1 40% 30% 20% 10% 11.8 17.1 19.9 0% 4.3 74 7.4 7 Low exposure (0 5 adverts) Medium exposure (6 11 adverts) High exposure (12 16 adverts)
Discussion Adult participants had very high levels of exposure to alcohol adverts Men s exposure significantly higher than women s in terms of all forms of advertisements except via TV/Movies, Posters/billboards, social media, email Degree of exposure was associated with frequency of consumption: In bars/pubs/taverns / At special events In shebeens (trend) Degree of exposure not associated with frequency of consumption: At home At other people s homes
Limitations Cross-sectional data Self-reporting of alcohol consumption (e.g. possible under-reporting reporting of frequency of alcohol consumption) Study does not address quantity of alcohol consumed
Final Comment The high levels of exposure to multiple modes of alcohol advertisements in South Africa is cause of concern Limiting exposure to advertisements may be associated with less frequent alcohol consumption, particularly outside of the home The results provide some support for the SA government s plans to ban advertisements Future analyses of the IAC data set will examine associations between exposure to alcohol advertisements t and other alcohol l consumption variables
Acknowledgements International Development Research Centre (IDRC). Professor Sally Caswell, DT DrTasia Huckle, Dr Thomas Graydon-Guy and Dr Lanuola Asiaga (SHORE and Whariki Research Centre, Massey University) Colleagues from international network of IAC studies Research staff from South African Medical Research Council (MRC) Study yparticipants p from the Tshwane community study site