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Craig F. Garfield, MD, MA; Paul J. Chung, MD, MS; Paul J. Rathouz, PhD

JAMA. 2003;289:2424-2429.

Context  Adolescent drinking is a major public health concern. The federal government does not restrict alcohol advertising to adolescents, but relies on the alcohol industry for self-regulation.

Objectives  To investigate recent alcohol advertising in magazines and to determine whether advertising frequency is associated with adolescent readership.

Design, Setting, and Subjects  All alcohol advertisements were counted that appeared from 1997-2001 in 35 of 48 major US magazines, which tracked their adolescent readership (3 refused all alcohol advertisements; and advertisement counts were unavailable for 10). Variation was assessed in the advertisement placement frequency for each major category of alcohol (beer, wine and wine coolers, and distilled liquor) by a magazine's adolescent readership (age 12-19 years), young adult readership (age 20-24 years), and older adult readership (age 25 years); readership demographics (sex, race, and income); year; frequency of publication; and cost per advertisement.

Main Outcome Measure  Variation in alcohol advertising frequency by adolescent readership.

Results  Adolescent readership ranged from 1.0 to 7.1 million. The alcohol industry placed 9148 advertisements at a cost of $696 million. Of the 9148 advertisements, 1201 (13%) were for beer, 443 (5%) for wine, and 7504 (82%) for liquor. After adjustment for other magazine characteristics, the advertisement rate ratio was 1.6 times more for beer (95% confidence interval [CI], 1.0-2.6; P = .05) and liquor (95% CI, 1.1-2.3; P = .01) for every additional million adolescent readers. Wine industry advertising was not associated with adolescent readership.

Conclusions  Magazine advertising by the beer and liquor industries is associated with adolescent readership. Industry and federal policymakers should examine ways to regulate advertising that reaches large numbers of adolescents.

Author Affiliations: Department of Pediatrics, Evanston Northwestern Healthcare Research Institute, Evanston, Ill, and Feinberg School of Medicine, Northwestern University, Chicago, Ill (Dr Garfield); Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (Dr Chung); and Department of Health Studies, University of Chicago, Chicago, Ill (Dr Rathouz).

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