The Effect of Exposure to Alcohol Media Content on Young People's Alcohol Use: A Qualitative Systematic Review and Meta-Synthesis.

Alcohol harm continues to present a public health priority. Whilst we know that a relationship exists between exposure to content and alcohol initiation and use in young people, the mechanism behind this effect is not well understood. Using the social identity approach as a meaning-making lens, a systematic review of the qualitative literature and meta-synthesis was conducted using Medline (all years), Embase (all years), and PsycINFO (all years). The inclusion criteria included studies which qualitatively explored the effect of exposure to content or marketing in young people (aged < 26). Twenty-two articles were identified and included in the synthesis and assessed for bias using the Downe and Walsh checklist. Four themes were identified: normalisation of alcohol use, branding and identity, marketing strategies, and acting in identity congruence. A line of argument was constructed arguing that alcohol content and marketing are often targeted at and work through social identities and cultural norms to normalise alcohol use and lead to increased consumption through embedding content and marketing in culture. These findings have implications for stricter regulations around alcohol marketing and the protection of young people from alcohol content.