Alcohol Advertising: Next Steps for New Mexico I. Background A. Alcohol Use Among New Mexico Youth New Mexico, like most states, has a significant underage drinking problem. In 2005, more than a third of New Mexico 9 th graders and roughly half of 11 th and 12 th graders reported drinking alcohol in the past month. Dangerous binge drinking -- drinking five or more drinks on a single occasion -- was the norm among these drinkers: 60% of 9 th grade drinkers and more than 70% of 11 th and 12 th grade drinkers reported binge drinking in the past month. Underage drinking cuts across all demographic categories. Among New Mexico high school students there are no significant differences in drinking behavior between boys and girls or among different race/ethnic groups (2005 New Mexico Youth Risk and Resiliency Survey, New Mexico Department of Health). New Mexico ranks near the middle among states for current underage alcohol use. o Past 30-day alcohol use prevalence 23 rd (of 40 responding states) among high-school students, per the 2005 Youth Risk Behavior Survey (YRBS) (CDC, 2006) New Mexico 42.3% vs. United States 43.4% 31 st (of 50 states) among 12-20 year-olds, per the 2004-2005 National Survey on Drug Use and Health (NSDUH) (Wright et al, 2007) New Mexico 27.9% vs. United States 28.5% o Past 30-day binge drinking prevalence 14 th (of 40 responding states) among high-school students, per the 2005 YRBS (CDC, 2006) New Mexico 28.6% vs. United States 25.5% 27 th (of 50 states) among 12-20 year-olds, per the 2004-2005 NSDUH (Wright et al, 2007) New Mexico 19.4% vs. United States 19.2% A recent study by epidemiologists from the Centers for Disease Control and the New Mexico Department of Health (CDC, 2007), based on the 2005 Youth Risk Behavior Survey, reported that distilled spirits were the number one beverage of choice among high school drinkers in New Mexico and the three other states surveyed (see Figure 1).
Figure 1. Prevalence of type of alcoholic beverages usually consumed by 9 th -12 th graders who reported current alcohol use. These findings are consistent with national trends based on the Monitoring the Future survey (Johnston et al, 2006), which over the past decade has been reporting the increasing prevalence of liquor use and the decreasing prevalence of beer use among 12 graders in the United States (see Figure 2). 80 70 60 Prevalence (%) 50 40 30 Alcohol Beer Liquor Wine Wine Coolers Flavored Alcoholic Beverages 20 10 0 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Year Figure 2. Prevalence of Past 30-day Alcohol Use by Beverage Type, 12 th Graders, United States, 1976-2005
B. Problems Related to Alcohol Use Among New Mexico Youth According to a recent report by the US Surgeon General, underage drinking poses grave immediate threats to the health of our young people (US DHHS, 2007). Alcohol consumption is a major contributor to the three leading causes of death among young people and is strongly associated with many other life-altering risk behaviors such as unplanned pregnancy, academic failure, and DWI. Binge drinking is especially strongly associated with other risky behaviors. In the U.S. binge-drinking high school students are five times as likely as non-drinkers to have been pregnant or have gotten someone pregnant; four times as likely to have attempted suicide; and almost eleven times as likely to have ridden with a drinking driver (Miller et al, 2007). In New Mexico, binge drinking high school students are six times as likely as nonbinge drinkers to have driven after drinking (2003 New Mexico Youth Risk and Resiliency Survey, New Mexico Department of Health). Clearly, prevention of binge drinking should be a primary focus of our efforts to reduce harms associated with underage drinking. Based on the most recent available data (2002-2004) from the Centers for Disease Control (CDC Wonder, 2007b), New Mexico has among the worst (top quintile) rates (deaths per 100,000 population) for each of the three leading causes of death among young people; a significant proportion of each of these causes of death is attributable to alcohol. o Motor vehicle traffic crash death rate 6 th (of 50 states) among 10-19 year-olds New Mexico 23.8 vs. United States 14.8 o Suicide rate 3 rd (of 50 states) among 10-19 year-olds New Mexico 11.0 vs. United States 4.4 o Homicide rate 9 th (of 50 states) among 10-19 year-olds New Mexico 6.5 vs. United States 5.1 Underage drinking also increases the risk of chronic alcohol problems in adulthood. Research tells us that youth who begin to drink before the age of 15 are five times as likely to develop alcohol dependence or abuse as adults (OAS, 2004). In 2005, New Mexico had one of the highest rates of early underage drinking in the United States: 30% of New Mexico high school students reported having had their first drink before age 13 (CDC, 2006). High rates of early initiation may help explain New Mexico s persistently high rates of adult alcohol dependence, abuse, and alcohol-related chronic disease. Prevention of early underage drinking is another important focus of our state s alcohol-related prevention efforts.
New Mexico ranks near the top (worst) for early underage alcohol use. o Drank alcohol before age 13 years 5 th (of 40 responding states) among high-school students, per the 2005 YRBS (CDC, 2006) New Mexico 30.0% vs. United States 25.6% New Mexico has among the highest rates of alcohol-related chronic disease death (New Mexico Department of Health, Substance Abuse Epidemiology Unit). o Alcohol-related chronic disease death rate (deaths per 100,000 population) Highest average rate (of 50 states) during the period 1981-2004 Ranked 1 st, 2 nd, or 3 rd throughout and 1 st (worst) each year since 1999 New Mexico 26.8 vs. United States 15.0 (2002-2004) C. Alcohol Advertising and Youth The Center on Alcohol Marketing and Youth (CAMY) has compiled a very useful fact sheet reviewing the research on the impact of alcohol advertising on youth (CAMY, 2007). This research, conducted at the national, state, and local level, supports the link between exposure to alcohol advertising (including alcoholbranded merchandise), early initiation of drinking, and higher alcohol consumption among advertising-exposed youth. Aditional research reviewed by CAMY suggests that policy interventions such as a total ban on alcohol advertising could result in significant reductions in alcohol consumption and alcohol-related death and disability among youth. CAMY has also reviewed the research on how advertising influences young people; on what teens and others think about alcohol advertising; and on how much alcohol advertising reaches youth. On the latter topic, CAMY reports: Between 2001 and 2005, youth exposure to alcohol advertising on television in the U.S. increased by 41%. Much of this increase resulted from the rise in distilled spirits advertising on television from 1,973 ads in 2001 to 46,854 ads in 2005. This finding is particularly alarming in light of the recent study, mentioned earlier, which showed that distilled spirits are now the most consumed beverage among New Mexico high school students. In studies monitoring youth exposure to alcohol advertising conducted over the past decade, CAMY has documented improvements in youth exposure to magazine advertising (CAMY, 2007b, CDC, 2007c). Unfortunately, it has also documented the increase in youth exposure to TV advertising mentioned above (CAMY, 2006), as well as ongoing youth exposure to radio advertising (CAMY, 2007c). CAMY has also documented the
relative exposure of youth to alcohol advertising as compared to industrysponsored responsibility advertising (e.g., industry-paid ads promoting responsible alcohol consumption). According to a recent CAMY report (CAMY, 2007d): From 2001 to 2005 youth were 28 times more likely to see an alcohol product advertisement than an industry-sponsored responsibility advertisement. They were 239 times more likely to see an alcohol product advertisement than an alcohol company advertisement about underage drinking, and 32 times more likely to see the industry s advertisements promoting its products than to view industry sponsored messages about driving after drinking and other alcohol-related safety issues. Finally, in another line of research, CAMY has documented higher exposure to alcohol advertising among specific youth subpopulations such as African American youth (CAMY, 2006b). Here in New Mexico, a 2007 study of outdoor alcohol advertising conducted by the Albuquerque Partnership (Lopez, 2007) suggests there may be differences in the prevalence of outdoor alcohol advertising by neighborhood socioeconomic level, with a higher prevalence of outdoor alcohol advertising in some of Albuquerque s poorer neighborhoods. II. Potential Interventions Related to Alcohol Advertising and Youth The HJM 64 task force discussed a number of types of interventions to reduce the impact of alcohol advertising on youth in New Mexico. These included policy approaches such as alcohol advertising legislation; educational approaches such as media literacy and counter-drinking curricula; and efforts to increase parental and personal responsibility. In trying to determine which strategies to pursue, the task force consulted a number of expert reviews of alcohol-related prevention strategies that have been conducted over the past several years by organizations such as the World Health Organization (Babor et al, 2003), the Institute of Medicine (NRC and IOM, 2004), and Join Together (Rosenbloom et al, 2006). Expert groups convened by these organizations have systematically reviewed the prevention literature and made recommendations on which alcohol-related strategies are best-supported by scientific evidence as effective in reducing alcohol-related risk behaviors and alcohol-related harms. Some of the recommendations of these expert reviews are germane to the task force s discussion of strategies: Educational strategies tend to be discouraged by these reviews. According to the most comprehensive of these reviews, alcohol education in schools may increase increase knowledge and change attitudes but [it] has no sustained impact on drinking (Babor et al, 2003). In addition, a recent study of prevention education in schools, conducted by Join Together (Anderson et al, 2007), concluded that:
Schools should not be relied on as the primary element in the country s efforts to prevent the early initiation and consequences of alcohol and drug use. Teachers don t have the time, training or other resources needed to do the job effectively, regardless of what the state-mandated standards say. Further, research shows that a comprehensive approach, encompassing families, schools, and the community as a whole, is the key factor in successful prevention efforts. Social attitudes, especially in the family, are very important. Parents have a large impact on their child s use of alcohol and drugs through their expressed beliefs and modeled behavior. On the community level, environmental policies such as appropriate alcohol taxes, graduated drivers licenses and social host laws have been shown to be effective at reducing adolescent use. The various expert reviews conducted in the past five years have tended instead to recommend environmental strategies such as those mentioned in the previous paragraph. In their report State Alcohol Advertising Laws: Current Status and Model Policies (CAMY, 2003), CAMY provided important guidance to the task force regarding the specific environmental strategy -- legislation to restrict alcohol advertising that was mandated for discussion by the HJM 64 task force. This CAMY report reviewed twelve different types of alcohol advertising legislation and suggested best practice legislation for each type of provision. The report also reviewed the status of alcohol advertising legislation in all 50 states and reported that none of these provisions is currently enacted in New Mexico. CAMY provided consultation to the HJM 64 task force and identified two major categories of legislation related to alcohol advertising: legislation of the content of alcohol advertising and legislation of the placement of alcohol advertising. In its advice to the task force, CAMY encouraged New Mexico to pursue legislative measures to control the placement of alcohol advertising rather than the content. Placement legislation comprises items 6-12 in the previously mentioned CAMY report. These measures include restrictions on outdoor advertising, on alcohol promotion on college campuses, on industry sponsorship of civic events, and on industry giveaways of free goods and services. CAMY discouraged the pursuit of content legislation, citing the difficulty in enforcing this type of legislation. Content legislation comprises items 1-5 in the previously mentioned report, and includes prohibition of alcohol advertising that targets minors, portrays children, associates alcohol with athletic achievement, or encourages intoxication. Further, CAMY provided legal resources outlining important constitutional considerations related to alcohol advertising legislation; and provided model legislation for several types of placement legislation, including:
Constitutionally Defensible Restrictions on Alcohol Advertising and Alcohol Sponsorship in State Publications and on State-Owned or State-Leased Lands (CAMY, 2004) Model State Statute for Regulating Billboard and Other Forms of Outdoor Alcohol Advertising (CAMY, 2004b) Finally, Jim Mosher of the Center for the Study of Law and Enforcement Policy, Pacific Institute for Research and Evaluation (PIRE) conducted a special review of recent state legislation for the task force. He reviewed legislation enacted since the 2003 CAMY report and found that none of the types of legislation recommended by the 2003 CAMY report had been enacted in New Mexico since that report s publication. Mosher s review identified only a single piece of placement-related legislation in New Mexico statute, this prohibiting alcohol advertising on school buses in New Mexico. III. Recommended Next Steps for New Mexico In light of CAMY s recommendations, in the absence of current regulation of alcohol advertising in New Mexico, given the gravity of New Mexico s alcoholrelated problems, and given the documented impact of alcohol advertising on youth, this task force recommends the following steps to protect public health, safety, and welfare by regulating the placement of alcohol advertising in New Mexico: Recommendation 1: Pursue best-practice legislation (per CAMY) to restrict outdoor alcohol advertising in locations where children are likely to be present. Recommendation 2: Pursue best-practice legislation (per CAMY) to prohibit outdoor alcohol advertising near schools, public playgrounds and churches. Recommendation 3: Pursue best-practice legislation (per CAMY) to restrict alcohol advertising on alcohol retail outlet windows and outside areas. Recommendation 4: Pursue best-practice legislation (per CAMY) to prohibit alcohol advertising on college campuses. Recommendation 5: Pursue best-practice legislation (per CAMY) to restrict alcohol industry sponsorship of civic events, particularly events held on state property.
Recommendation 6: Pursue best-practice legislation (per CAMY) to limit giveaways (contest, raffles, etc.).
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