The DRAM, Vol. 17(9) – Does television exposure to alcohol influence youth drinking behaviors?


Teens and young adults use and abuse alcohol more than any other substance. Adolescent alcohol use harms brain development and can lead to future problem drinking and alcohol dependence. Many popular youth television shows include mentions or depictions of alcohol and the average teenager watches television for almost two hours per day. Understanding the impact of television alcohol appearances on youth perceptions and behaviors is important to reduce adolescent risk for alcohol use disorder. This week, The DRAM reviews a study by Joy Gabrielli and colleagues that examined alcohol product placement within television series and its relationship to youth brand affiliation and drinking behaviors.

What were the research questions?
Does seeing alcohol brands on television series influence which brands youth drink or want to drink? Does seeing alcohol brands on television series influence youth drinking behavior?

What did the researchers do?
The researchers analyzed secondary data from a 2012 national sample of youth ages 15-20 years. They selected ten popular television series from the 2009-2010 distribution season based on high viewership and popularity from the preceding season.1 The researchers intentionally chose series to represent a range of rating categories (TV-PG, TV-14, TV-MA) and included series with mature content. Two researchers watched all episodes from the selected series and seasons, noting every alcohol brand appearance. Participants reported any drinking and hazardous drinking, aspirational brand and usual brand to drink, and frequency with which they watched each of the ten television series.

The researchers combined the frequencies of watching each series with the frequency of alcohol brand appearances to create a brand exposure score. They counted the number of series that contained any appearance of a given brand to calculate a sum score. The researchers also assigned salience scores to each brand appearance to represent its notability. They then defined a brand’s prominence score as its average salience score times its sum score. The researchers used regression analyses, including logistic regression, to evaluate the associations between brand exposure, brand affiliation, brand prominence, and drinking outcomes.

What did they find?
Series that aired on cable television, such as Burn Notice and True Blood, had significantly more alcohol brand appearances compared to series on broadcast network television, such as 30 Rock and Friday Night Lights (3.38 vs. 0.16 appearances per episode). Alcohol brands more frequently shown across television series were more likely to be named by youth as brands they usually drink or aspire to drink. For example, Budweiser had the highest number of brand appearances overall (41), appeared in the most series (6), and was the most popular among youth (selected by 9% as aspirational and 5% as usual brand to drink).

Adolescents who viewed television series with alcohol appearances were more likely to initiate drinking or progress to hazardous drinking, compared to adolescents who had not seen them. Youth who had moderate brand exposure were 1.5 times more likely to do any drinking or hazardous drinking while youth who had high exposure were over 2 times more likely (see Figure). Television series with more frequent alcohol appearances and more frequent viewings of these television series generally had a larger effect on youth drinking behavior.

Aug 17. DRAM 17(9) FigureFigure. Odds ratios for the associations between television alcohol brand exposure and drinking behaviors among youth. The cross-sectional model identifies how brand exposure and drinking behaviors are associated at the time of data collection (2012). The longitudinal model predicts how drinking behaviors will change over one year based on brand exposure. Circles represent odds ratios for a moderate level of television brand exposure. Stars represent odds ratios for a high level of television brand exposure. Orange indicates statistically significant associations. (An odds ratio of 1.0 means no increased risk among people exposed, in this case to brand exposure.) Adapted from Gabrielli et al., 2021. Click image to enlarge.

Why do these findings matter?
Youth are exposed to alcohol brands on television shows and this exposure is associated with brand affiliation and drinking behavior. Previous research found that youth are also highly exposed to alcohol in movies, Super Bowl advertisements, and digital media such as social networking sites. The lack of independent surveillance of alcohol marketing and product placement in entertainment media is concerning given the evidence for its relationship with youth drinking behavior. Through external regulations on alcohol marketing as well as parental monitoring and restricting of media content, reducing youth exposure to media depictions of alcohol can help mitigate the development and progression of youth drinking.

Every study has limitations. What are the limitations in this study?
Because the study analyzed cross-sectional data, it cannot be determined whether brand exposure caused the drinking behavior, simply that there is a relationship between the two. Researchers selected the television series by hand and only chose ten for this study, so the range of television shows watched by youth may not be fully represented. For example, the list contained no animated series. The selected television programs also aired over a decade ago. Although they are currently still accessible via streaming platforms, the current relevance of past television content is unclear.

For more information:
Parents, guardians, and other adults who want to have conversations with youth about alcohol, tobacco, and substance use can find information at TalkSooner. They provide drug facts, age-specific talking tips, and a glossary of drug-related terms.

The National Institute on Alcohol Abuse and Alcoholism also has tips and resources for people struggling with problem drinking. For additional drinking self-help tools, please visit our Addiction Resources page.

— Caitlyn Fong, MPH

What do you think? Please use the comment link below to provide feedback on this article.


[1] The following television series were selected: Friday Night Lights, The Hills, Burn Notice, 30 Rock, Desperate Housewives, Madmen, Californication, Entourage, True Blood, and Weeds. The researchers excluded reality television from the study.


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