JMIR Publications

ABSTRACT

Background:

Whether exposure to alcohol marketing increases alcohol use and purchase in young adults is unknown.

Objective:

We used ecological momentary assessment (EMA) to examine the effects of alcohol marketing in university students.

Methods:

We conducted an intensive longitudinal observational study via EMA among university students in Hong Kong who reported current drinking. Each particpant completed five fixed-interval signal-contingent EMAs via a smartphone app daily for 14 consecutive days. Each EMA enquired the number and types of alcohol marketing exposure, amount and types of alcohol use, and whether alcohol was purchased within past 3 hours. We used two-part models to examine if number of alcohol marketing exposure was associated with subsequent alcohol use and alcohol purchase.

Results:

Forty-nine students (male 32.7%; mean age 22.6 years, SD 2.6 years) completed 2,360 EMAs (completion rate 68.9%). They reported 140 (5.9%), 145 (6.1%), and 56 (2.4%) episodes of alcohol marketing exposure, alcohol use, and alcohol purchase, respectively. Exposure to more alcohol marketing within a day predicted a higher probability of alcohol use (AOR=3.51, 95% CI 1.29-9.54, P=.014) and purchase (AOR=4.59, 95% CI 1.46-14.49, P=.009) the following day. Exposure to more alcohol marketing within a day did not increase the amount of alcohol use and number of purchase the following day in participants who consumed or purchased alcohol. Daily variations in alcohol marketing exposure were not associated with the initiation of alcohol use or purchase, nor with the amount of alcohol use or number of purchases.

Conclusions:

We provided the first evidence using EMA that exposed the dynamic effect of alcohol marketing exposure on alcohol use and purchase in university students in a real-world environment, supporting the regulation of alcohol marketing for alcohol reduction in young adults. Clinical Trial: The trial was registered on ClinicalTrials.gov (NCT04055402)