Summary of the impact

Almost one in four deaths of young people in England and Wales are attributable to alcohol (Hastings and Sheron, 2011). Critical marketing research by the Institute for Social Marketing at The Open University (ISM-Open) has informed policy by: establishing the link between the marketing practices of drinks manufacturers and young people's attitudes to and consumption of alcohol; providing the material for the seminal report Under the Influence commissioned and published by the BMA Board of Science; guiding the Health Select Committee and underpinning a Private Members Bill on the regulation of alcohol marketing to children.

This research in ISM-Open is a collaboration between the Open University Business School (OUBS) and Stirling University.

Underpinning research

Key researchers based at OUBS are Professor Gerard Hastings OBE, Professor of Social Marketing (at OUBS from 2008 to date — part-time); Dr Fiona Harris, Lecturer in Management (OUBS 1997 to date); Dr Ross Gordon, Research Fellow (OUBS, 2009-2010); and Dr Tom Farrell (PhD at OUBS 2008-2012).

The core research for this case study arose from a project funded by the Medical Research Council (MRC), under its National Prevention Research Initiative (NPRI), entitled `NPR1: Assessing the cumulative impact of alcohol marketing communications on youth drinking' (Jan 06-Dec 09). Both Professor Hastings and Dr Harris were named grant holders. Based on the results of the research, further funding has been awarded to Professor Hastings and Dr Harris (March 12-Sept 15) under the NPRI scheme entitled `NPR4: Alcohol Policy in Scotland and England (APISE)'.

The stream of research is distinctive in that it is undertaken by experienced marketing academics, based in a Business School, who adopt a critical social marketing perspective. To date, the majority of health promotion studies have been undertaken by clinical and public health academics based in medical schools or health faculties, causing them often to overlook, or fail to recognise, the range of marketing activities that firms can employ to target and promote their products to young people. This research thus provides hard evidence of what has been suggested in the popular media — that overt and covert promotion of alcohol results in the excessive consumption of alcohol by young people.

Focus groups revealed that young people (aged 13-15 years) had a sophisticated level of awareness of, and involvement with, alcohol marketing through multiple and varied marketing channels. Significant associations were found between this awareness and involvement at age 13 and drinking behaviour and intentions to drink alcohol. The study suggested a need for alcohol policy to be revised in order to limit youth exposure to seemingly ubiquitous marketing communications. Use of a two-stage cohort design for the research revealed that involvement with alcohol marketing at age 13 predicted both the uptake of drinking and increased frequency of drinking at age 15. The research also included a systematic review of studies of alcohol marketing that provided evidence that increasing exposure to alcohol marketing encourages children to start drinking younger and to drink more.

This research counters much of what is claimed in the alcohol industry literature, that the advertising of alcohol has little effect on the young and their propensity to consume. The research shows that the reverse is true, and that the more covert associations of alcohol with social and sexual success as well as with attractive lifestyles (in alcohol marketing) have a substantial cumulative impact on the likelihood of young people consuming alcohol.

References to the research

A deliberate decision was taken to publish outputs in high-quality journals in the areas of public health and policy to ensure access by practitioners in these fields. The impact factors of all these journals place them as equivalent to ABS 3* and 4* as a guide to their quality. Note: authors shown in bold are Open University Business School staff.

Details of the impact

Research from this study has, and continues to, inform the debate on alcohol marketing to young people by policy makers, the medical profession, interest groups and the wider public. The findings of the NPRI research study led the Board of Science of the British Medical Association (BMA) to commission a report in 2009 from the researchers to assess the impact of alcohol marketing on the drinking habits of young people. This report was titled: Under the Influence: the damaging effect of alcohol marketing on young people (evidence 1 below). The Director of Professional Activities at the BMA described the collaboration:

`The BMA has been privileged to work with Professor Hastings and his colleagues on a number of reports, and also when we are considering new areas of work. The report he wrote for the BMA ... has become a seminal document in the UK struggle to get the alcohol abuse epidemic under control. It is firmly the base of our public health lobbying and we know is heavily referenced by all members of the Alcohol Health Alliance.' (2)

The report Under the Influence, which quoted much of the underpinning research from the MRC NPRI study, prompted the BMA to call for a ban on alcohol advertising and the establishment of minimum price levels for alcohol. The report was covered extensively in the media, including interviews with Professor Hastings on News at Ten and Radio 4's Today programme, prompting considerable public debate about alcohol advertising and pricing (3 and 4).

As part of its 2009 investigation into the conduct of the UK alcohol industry, Professor Hastings was appointed as a Special Advisor to the House of Commons Health Select Committee. The Committee obtained access to internal marketing documents from both producers and their advertising agencies and asked Professor Hastings and other colleagues from The Open University, most prominently Dr Farrell, to undertake an analysis of these documents. The findings were presented to the Select Committee and published as a memorandum entitled They'll Drink Bucket Loads of the Stuff (5). The Health Select Committee minutes state: 'Professor Hastings found that the documents reveal major shortcomings in the current self regulatory codes covering alcohol advertising. Specifically, the codes do not, as they are supposed to, protect young people from alcohol advertising; prevent the promotion of drunkenness and excess; or the linking of alcohol with social and sexual success. Nor do they even attempt to address sponsorship, and the documents show this is being systematically used to undermine rules prohibiting the linking of alcohol with youth culture and sporting prowess.' (6) Under the Influence was also cited in the House of Lords' debate on legislation relating to drinking alcohol in public places. In this debate, Baroness Walmsley made direct reference to the importance and centrality of the BMA report, stating: `It is interesting that during the recess we saw a report from the BMA, Under the Influence, about the damaging effects of alcohol marketing on young people. The solutions are all to do with marketing and not with simply removing the alcohol from the child on the street.' (7)

On 30 March 2011, the Conservative MP for Totnes, introduced a Private Member's Bill to Parliament on the regulation of alcohol marketing to children. The Bill drew directly from the underpinning research and concluded: `that increasing exposure to alcohol marketing encourages children to start drinking younger and to drink more when they do' (8).

The MP for Totnes described the impact of the research undertaken by Professor Hastings and colleagues: `The work of Professor Hastings and his team was of immense value in the preparation of my Private Member's Bill which aimed to tackle the inappropriate marketing of alcohol to young people. Whilst such bills are rarely able to progress beyond second reading due to the shortage of Parliamentary time, this bill was important in raising awareness and influencing the policy debate both within Parliament and nationally. Professor Hastings was also personally very helpful sharing his expertise about the wider issues and further sources of evidence-based information. The opportunity for national politicians to consult experts in this specialist field is of immense value' (9). Professor Hastings was awarded the OBE in 2009 for his work in the field (10).

Sources to corroborate the impact

1. Hastings, G. & Angus, K. (2009). Under the Influence: the damaging effect of alcohol marketing on young people, London: British Medical Association Board of Science, September. ISBN: 978-1-905545-37-7 — report commissioned by the British Medical Research Council.
2. Email from Director of Professional Activities — will be supplied on request.
3. Professor Hasting's appearance on News at Ten (8 Sept 2009) DVD available on request and Radio 4's Today Programme (Sept 8 2009) DVD available on request.
4. Example of newspaper coverage of the BMA report Under the Influence:
   The Daily Telegraph (2009) `Ban advertising of drink, says BMA', 9 September, p. 12; Reid, M. (2009) `Drinking is hidden problem of leafy suburbs, says BMA chief', The Times, 15
   September, p.19; Laurance, J. (2009) `BMA calls time on adverts for alcohol; New campaign has echoes of previous anti-smoking drive — and look what that achieved', The Independent, 9 September, p. 8; Johnstone, A. (2009) `Alcohol advertising is a genie we need to put back in its bottle', The Herald, 10 September, p. 17; Bussey, N. (2009) `How should adland react to the BMA?', Campaign, 18 September, p. 11; Charles, G. (2009) `Digital alcohol guidelines are a large measure of sense', Marketing, 3 November, p. 17.
5. Memorandum by Professor G. Hastings, Institute for Social Marketing, University of Stirling & The Open University (AL 81) (They'll drink bucket loads of the stuff: An Analysis of Internal Alcohol Industry Advertising Documents)
   http://www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/memo/alcohol/al81me mo.pdf
6. Debate in House of Commons Health Committee (2010). Alcohol First Report of Session 2009-10. Volume I, London: The Stationery Office Limited.
   http://www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/151/151i.pdf
7. Debate in House of Lords on drinking in public places — Hansard House of Lords Debates, Tuesday 13 October 2009, Volume No. 713 Part No. 115: Column 120.
   http://www.publications.parliament.uk/pa/ld200809/ldhansrd/text/91013-0002.htm
8. Presentation of the Private Member's Bill on alcohol advertising and young children — Hansard House of Commons Debates, 30 March 2011, Volume No. 526, Part No. 142: Columns 368 —
   http://www.publications.parliament.uk/pa/cm201011/cmhansrd/cm110330/debtext/110330-0002.htm
9. Email from MP — will be supplied on request.
10. HM The Queen's 2009 Birthday Honours List
    http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/documents/digit alasset/dg_178692.pdf