In our society, we are constantly subjected to advertisements throughout our day; through traditional media forms, like radio, TV and print, as well as through newer avenues, like social media.  Many of us have become de-sensitized to this assault on our senses so it seems harmless enough.  But what about when it comes to advertising products that are known to be harmful to our health?  And what about when they are directed at some of our most vulnerable populations like youth?  We’re not talking about tobacco use here, because Canada has very strict regulations around tobacco advertising.  We’re actually talking about a product that 80% of Canadians report using in the past year, one that is associated with socializing and having fun.  We’re talking about alcohol.
 
Alcohol, as we were recently reminded by the Chief Public Health Officer of Canada (Taylor 2016), is a mind-altering drug and its use is a leading risk factor for global disease burden (Lim. et. al, 2010). For youth alcohol can have other detrimental effects.  The human brain continues to develop until the mid-20’s, putting youth at risk for lifelong damage to parts of the brain involved in problem solving, decision making and emotional regulation.  Second-hand effects of alcohol use include legal problems, violence, injuries, and abuse of other drugs, unplanned sexual activity and hindered academic performance.
 
Despite these well documented harms, alcohol is heavily marketed and promoted. The alcohol industry uses targeted advertising to influence social norms around youth drinking. They know very well how to secure new, lifelong clients. Before graduating high school, students will spend about 18,000 hours in front of the television – more time than they will spend in school; this results in youth watching about 2,000 alcohol commercials on television each year (American Academy of Family Physicians [AAFP], 2010).  Alcohol advertisements reach youth not only through television, but also through other varied media, such as billboards, magazines, sports stadium signs, and on mass transit such as subway systems. In all, youth view 45% more beer ads and 27% more liquor ads in magazines than people of legal drinking age (AAFP, 2010).
 
Promotion of alcohol contributes to the normalization of alcohol consumption; evidence shows that exposure to alcohol marketing lowers the age that youth start drinking, as well as increases the amount they drink once they start (OPHA, 2015).  Furthermore, the earlier youth start drinking alcohol, the greater the risk of becoming dependent on alcohol later in life (OPHA, 2015).  Alcohol marketing tactics create favourable attitudes in youth towards drinking by using attractive people who seem to be having the time of their life drinking alcohol, while completely risk-free (Heung, Rempel & Krank, 2012).  But for youth, drinking alcohol is anything but risk-free.  Alcohol advertising plays on the fact that youth tend to be more impulsive, and focus more on the things that make them happy in the moment, rather than on future consequences. . 
 
Alcohol is the most widely used substance by Ontario youth. The Ontario Student Drug Use & Health Survey reports just under half of Ontario students in grades 7-12 drank alcohol in the past year (Boak et al, 2015); this represents about 400,000 students.  Drinking increases significantly by grade; from a low of 9% in grade 7 to a high of 72% in grade 12 (Boak et al., 2015).  While trends in alcohol use over time show that drinking rates are decreasing, binge drinking remains high among youth, with 1 in 6 youth in Ontario reporting drinking five or more drinks on the same occasion in the past month (Boak et al, 2015).  Approximately 20% of youth also reported that they could not remember what happened when they were drinking and 9% reported that they were injured, or injured someone else, while drinking (Boak et al., 2015).
 
Lessons learned from tobacco have paved the way for us to advocate for tighter controls on alcohol advertising and sponsorship.  Currently, there are no restrictions on the quantity of advertising, there are no regulations around alcohol sponsorship, and the guidelines/standards that alcohol advertisements are expected to adhere to are often ignored. Ads that are found to be inappropriate are pulled only if there is a consumer complaint, and after the ad has already been released and widely viewed. Clearly, self-regulation is not working.
 
In summary, youth alcohol use has both short and long-term impacts on health and wellbeing.  Adolescence is a critical time in life where important areas of the brain that are responsible for problem solving, decision making and emotional-regulation are under development. Alcohol marketing targets and influences youth in a negative way.  As seen with tobacco, restriction on alcohol advertisements may be effective in delaying youth from drinking alcohol and reducing binge drinking rates and related harm.
 
References
 
American Academy of Family Physicians.  (2010). Alcohol Advertising and Youth (Position paper).  Retrieved on March 21, 2016 @ http://www.aafp.org/about/policies/all/alcohol-advertising.html
 
Boak, A., Hamilton, H. A., Adlaf, E. M., & Mann, R. E., (2015). Drug use among Ontario students, 1977-2015: Detailed OSDUHS findings (CAMH Research Document Series No. 41). Toronto, ON: Centre for Addiction and Mental Health.
 
Heung, C., Rempel, B. & Krank, M.  (2012). Strengthening the Canadian Alcohol Advertising Regulatory System.  Canadian Journal of Public Health; 103(4):e263-e266.
 
Lim S., Vos T., Flaxman A. D., Danaei G., Shibuya K., Adair-Rohani H., et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet; 380: 2224–60.
 
Ontario Public Health Association. (2015). Alcohol marketing and advertising: strategies to reduce alcohol-related harms and costs in Ontario. OPHA Issue Series. Retrieved from:
http://opha.on.ca/wp-content/uploads/2021/06/Marketing-Advertising-Alcohol-OPHA-Issue-Series-2015.pdfext.pdf     
 
Taylor, G.  (2016). The Chief Public Health Officer’s Report on the State of Public Health in Canada, 2015: Alcohol Consumption in Canada.  Retrieved on March 2, 2016 @ http://healthycanadians.gc.ca/publications/department-ministere/state-public-health-alcohol-2015-etat-sante-publique-alcool/index-eng.php