Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University.
Environ Health Prev Med. 2023;28:58. doi: 10.1265/ehpm.23-00127.
Underage drinking is a public health concern. However, few studies have examined the association between alcoholic beverage advertising and underage drinking, particularly in countries with low underage drinking rates, such as Japan. Therefore, we aimed to investigate the relationship between exposure to advertising in various media and alcohol drinking among Japanese adolescents.
We conducted a cross-sectional study involving 15,683 adolescents (51% girls) using data from a nationwide lifestyle survey in 2021 among junior and senior high schools across Japan. Media types were websites, stores, and public transportation. We defined current drinking as alcohol consumption of ≥1 day in the 30 days preceding the survey. Multivariable logistic regression was used to examine the association between exposure to alcohol advertisements and current drinking, adjusting for sex, grades, school area, lifestyle (bedtime and having fun at school), and addictive behaviors (smoking status and parents' alcohol consumption).
The prevalence of current drinking was 2.2% (2.3% of boys and 2.0% of girls). Students who were exposed to any alcohol advertising media had higher odds of current drinking compared with those who were not (odds ratio, 1.48; 95% confidence interval [CI], 1.18-1.87). Students who were exposed to web, in-store, and public transportation advertisements had odds ratios of 1.44 (95% CI, 1.14-1.81), 1.62 (1.28-2.05), and 1.45 (1.06-1.98) of current drinking, respectively, compared with those who were not. The association of exposure to alcohol advertising media with the prevalence of current drinking was similar among boys and girls (all p for sex interaction >0.1), except for that of exposure to web advertisements; its association with current drinking was more pronounced in girls (p for sex interaction = 0.046). Exposure to a larger cumulative number of different alcohol advertising media was independently associated with a higher prevalence of current drinking among all students, boys, and girls (p-values for trend <0.001, 0.031, and <0.001, respectively; p for sex interaction = 0.085).
We found an association with a dose-response relationship between exposure to alcohol advertisements and current drinking among adolescents in junior and senior high schools across Japan. Our findings highlight the need for further advertising regulations to prevent underage drinking.
未成年人饮酒是一个公共卫生问题。然而，很少有研究调查酒精饮料广告与未成年人饮酒之间的关系，尤其是在未成年人饮酒率较低的国家，如日本。因此，我们旨在研究日本青少年接触各种媒体广告与饮酒之间的关系。
我们使用了 2021 年在日本全国各地的初中和高中进行的一项生活方式调查的数据，对 15683 名青少年（51%为女孩）进行了一项横断面研究。媒体类型包括网站、商店和公共交通工具。我们将当前饮酒定义为在调查前 30 天内至少有 1 天饮酒。多变量逻辑回归用于检验接触酒精广告与当前饮酒之间的关联，调整因素包括性别、年级、学校区域、生活方式（就寝时间和在学校的娱乐活动）和成瘾行为（吸烟状况和父母饮酒状况）。
当前饮酒的患病率为 2.2%（男生为 2.3%，女生为 2.0%）。与未接触任何酒精广告媒体的学生相比，接触任何酒精广告媒体的学生更有可能饮酒（比值比，1.48；95%置信区间[CI]，1.18-1.87）。接触网络、店内和公共交通广告的学生当前饮酒的比值比分别为 1.44（95%CI，1.14-1.81）、1.62（1.28-2.05）和 1.45（1.06-1.98）。在男孩和女孩中，接触酒精广告媒体与当前饮酒的患病率之间的关联相似（所有性别交互作用的 p 值均大于 0.1），但接触网络广告的情况除外；在女孩中，这种关联更为显著（性别交互作用的 p 值=0.046）。所有学生、男孩和女孩中，接触更多不同的酒精广告媒体数量与当前饮酒的患病率呈正相关（趋势检验的 p 值均<0.001，0.031 和<0.001；性别交互作用的 p 值=0.085）。
我们发现，在日本初中和高中青少年中，接触酒精广告与当前饮酒之间存在关联，且存在剂量-反应关系。我们的研究结果强调需要进一步规范广告，以防止未成年人饮酒。
