Break needed from alcohol ads

Alcohol advertising is one of the primary culprits in the normalization of youth drinking. Addressing it is an important part of the effort to curb underage alcohol use.

Editorial. Feb. 24, 2003.

Just a month ago, people across the country observed what has become a national tradition -- Super Bowl Sunday. But its celebration highlights one of the nation's most difficult public health challenges: The attraction of young people to alcohol.

The hype of the big game goes beyond the playing field, and well into partying and product promotion. A key focal point has become the commercials, designed to be hip and to create a buzz. Advertising experts gave the highest accolades this time to a beer maker, a company that also happened to claim the biggest tab of all the advertisers that day -- $20 million for 11 spots.

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Considered in a vacuum, maybe it is possible to weigh these ads in terms of art and style. But it is their aggregate effect on young television viewers -- not just on Super Bowl Sunday, but on the other 364 days of the year, too -- that is a serious concern for the American Medical Association and physicians everywhere.

The AMA long has focused on how alcohol advertising affects young people, who, studies show, typically will see 100,000 beer commercials before reaching age 18. These ads are a major contributor to the "normalization" of alcohol use by children and youth -- a phenomenon that has reached epidemic proportions. About 11 million Americans younger than 21 drink, and nearly half of them drink to excess. Boys usually try alcohol for the first time at just 11 years old, while the average first-drink age for American girls is 13.

Still, there seems to be a persistent temptation to consider young people's interest in drinking to be a rite of passage. But in this regard, the concept of youthful resilience does not hold true. Underage drinking is a factor in nearly half of all teen automobile crashes, the leading cause of death among teenagers. Alcohol is linked to as many as two-thirds of all sexual assaults and date rapes of teens and college students. Alcohol is also a major factor in unprotected sex among youth, increasing the risk of contracting HIV or other sexually transmitted diseases. And recently, scientific evidence concluded that this "rite of passage" may actually cause changes in the brain that impair learning.

At its Interim Meeting in December 2002, the AMA released a report, "Harmful Consequences of Alcohol Use on the Brains of Children, Adolescents and College Students." It's a compilation of two decades of research concluding that teen alcohol use damages both the hippocampus region of the brain, which handles many types of memory and learning, and the prefrontal area, which undergoes the most change during adolescence and plays a role in forming adult personality and behavior.

These findings, combined with the alarming statistics, add newfound imperative to the AMA's challenge to network and cable TV stations to pledge not to run alcohol ads targeted at underage youth -- no alcohol ads before 10 p.m.; none during television shows with 15% or more underage viewers; and no commercials with cartoons, mascots or other youth-focused images.

The findings are also a reminder about the urgent need to reverse the tide of the underage drinking epidemic in general. For instance, the AMA advocates policies to reduce sales of alcohol to youth, increase underage drinking law enforcement, and provide more education about alcohol's harmful effects.

Physicians who want to find out more about what they can do in their practices and their communities can turn to the AMA. Its Office of Alcohol and Other Drug Abuse, a national program office of the Robert Wood Johnson Foundation, runs initiatives targeting alcohol use among college students and other young people. In addition, the AMA is a partner organization in the upcoming National Alcohol Screening Day. Taking place on April 10, this effort will provide physicians with screening tools to help identify those at risk, with special emphasis placed on reaching out to teens and college-aged patients.

If doctors can help young people tune out the tempting messages about alcohol, it will be more than just the best kind of commercial break, it will be an important public health accomplishment.