Point-of-purchase alcohol marketing and promotion by store type—United States, 2000-2001

Morbidity and Mortality Weekly Report, April 11, 2003

Alcohol consumption is the third leading preventable cause of death in the United States, accounting for approximately 100,000 deaths annually (1). Efforts to reduce the adverse health and social consequences from alcohol use include policies to restrict access to alcohol among underaged persons (i.e., persons aged <21 years) and to reduce alcohol-impaired driving among persons of all ages (2). Recent studies have focused on alcohol marketing as a potentially important contributor to alcohol consumption, particularly among underage drinkers (3). Point-of-purchase (POP) (i.e., on-site) marketing, including alcohol advertising and placement, can increase alcohol sales and consumption substantially (4), thereby increasing the risk for various alcohol-related health outcomes, including alcohol-impaired driving and interpersonal violence (5-7). To assess the type and frequency of POP alcohol marketing, researchers with the ImpacTeen Project* collected and analyzed store observation data during 2000-2001 from 3,961 alcohol retailers in 329 communities throughout the United States. This report summarizes the results of the study, which indicate that POP alcohol marketing is extensive in certain store types frequented by teenagers and young adults. Public health agencies and policy makers should work with liquor control boards to reduce POP marketing that could promote risky or underage drinking.

Communities with one or more public schools that participated in either the 2000 or 2001 Monitoring the Future surveys (nationally representative surveys of 8th-, 10th-, and 12th-grade students) (8) were eligible to be included in the study. Private and magnet schools (comprising approximately 20% of the original sample) were nor included in this study. Community boundaries were defined by the area from which each school drew [greater than or equal to]80% of its student population. Retailers selling tobacco and alcohol products in each community were selected randomly for observation from lists of all potential alcohol and/or tobacco retailers as identified by their Standard Industrial Classification codes . Of the total 6,031 observed stores, 3,961 (66%) were alcohol retailers and were included in this study.

In each alcohol retail establishment, field staff observed the presence of various POP alcohol marketing characteristics in a standardized manner, including 1) exterior and interior advertisements for alcoholic beverages and the intensity of such advertising, 2) alcohol beverage control signage (e.g., health warnings), 3) alcohol-branded functional objects provided free to retailers (e.g., counter change mats with an alcohol company logo), 4) beer placement (e.g., single cans or bottles chilled in buckets near checkout locations (Figure) or not chilled on shelf), and 5) the presence of low-height advertisements (i.e., advertisements placed within 3.5 feet of the floor, in the sight line of children and adolescents as opposed to adults).

The GENMOD procedure in SAS v.8 was used to determine generalized estimating equations that accounted for community clustering, specifying a binomial distribution and a logit link function. For all analyses, weights were included to account for community sampling procedures and store selection probabilities; supermarkets were the referent category.

The majority of stores (94%) had some form of POP alcohol marketing (i.e., store exterior, store interior, and/or parking lot or other property advertising and/or alcohol-branded functional objects). Exterior alcohol advertisements were observed in 39% of stores (Table 1); 27% of stores had high-intensity exterior advertising ([sections]). Compared with supermarkets, liquor stores (odds ratio [OR] = 176.8), convenience stores (OR = 48.2), convenience/gas stores (OR = 42.3), small grocery stores (OR = 24.5), and drug stores/pharmacies (OR = 15.5) were more likely to have high-intensity exterior alcohol advertising.

Interior alcohol advertisements were observed in 92% of stores, and 37% of stores had high-intensity interior advertising ([paragraph]). Liquor stores (OR = 18.5), convenience/gas stores (OR = 4.8), convenience stores (OR = 3.9), and small grocery stores (OR = 3.5) were more likely than supermarkets to have highintensity interior advertisements. Low-height advertisements were found in 44% of stores. Low-height advertising was more common in liquor stores (OR = 5.1) and in convenience/gas stores (OR = 2.2) than in supermarkets. Less than half (48%) of the stores in the sample had alcohol control or counter-alcohol signage, with no statistically significant differences by store type.

Approximately half (5 1%) of the stores provided at least one alcohol-branded functional object. These objects were more likely to be in liquor stores (OR = 4.2), convenience stores (OR = 1.8), and small grocery stores (OR = 2.0) than in supermarkets (Table 2).

Among all types of stores, beer was located most commonly in coolers (96%), in floor displays (44%), on shelves (23%), and as singles in ice buckets (16%). Single beers in ice buckets, located most often near checkout locations, were most likely to be found in convenience stores (27%), convenience/gas stores (18%), and small grocery stores (27%) (Table 2). Shelf displays of beer were most common in supermarkets (47%) and drug stores (43%); 1% of stores placed beer behind a counter or in a closed or locked cabinet.