Social Norms Regarding Alcohol Use, Perceptions of Alcohol Advertisement and Intent to Drink Alcohol among Youth in Uganda.

The objective of this paper is to address the scarcity of research on alcohol marketing exposure and underage drinking in sub-Saharan Africa. This study examines perceptions of alcohol advertisements and perceived peer, adult, and parental attitudes regarding alcohol use and intentions to drink among vulnerable youth. The Kampala Youth Survey is a cross-sectional study conducted in 2014 with service-seeking youth (ages 12-18 years) living in the slums of Kampala (n=1,134) who were participating in Uganda Youth Development Link drop-in centers. Survey measures assessed perceptions of alcohol ads, social norms regarding alcohol use, and intentions to drink alcohol. Chi-square tests and structural equation modeling analyses were computed. Among participants, 32% reported intentions to drink alcohol. In fully adjusted multivariable models, current drinking status (AdjOR=5.13; 95%CI:3.93, 6.72) and perceived attractive alcohol ads (AdjOR=3.71; 95%CI:2.88, 4.78) were most strongly associated with the intention to drink. Analyses examining social norms as a moderator between perceptions of alcohol ads and intention to drink found that peer networks that disapproved of drinking were protective against intent to drink. Perceived alcohol advertisement effectiveness and peer networks supportive of alcohol use are associated with intentions to drink among both boys and girls in Kampala and are not buffered by parental disapproval of drinking. Reducing exposure to alcohol marketing and developing prevention programs that strengthen peer networks disapproving of underage alcohol use and reduce exposure to alcohol marketing may be promising strategies among these vulnerable youth.