Restricting marketing of alcoholic products is purported to be a cost-effective intervention to reduce alcohol consumption. The strength of evidence supporting this claim is contested. This systematic review aimed to assess immediate effects of exposure to alcohol marketing on alcoholic beverage consumption and related cognitions. Electronic searches of nine databases, supplemented with reference list searches and forward citation tracking, were used to identify randomised, experimental studies assessing immediate effects of exposure to alcohol marketing communications on objective alcohol consumption (primary outcome), explicit or implicit alcohol-related cognitions, or selection without purchasing (secondary outcomes). Study limitations were assessed using the Cochrane Risk of Bias tool. Random and fixed effects meta-analyses were conducted to estimate effect sizes. Twenty four studies met the eligibility criteria. A meta-analysis integrating seven studies (758 participants, all students) found that viewing alcohol advertisements increased immediate alcohol consumption relative to viewing non-alcohol advertisements (SMD = 0.20, 95 % CI = 0.05, 0.34). A meta-analysis integrating six studies (631 participants, all students) did not find that viewing alcohol portrayals in television programmes or films increased consumption (SMD = 0.16, 95 % CI = −0.05, 0.37). Meta-analyses of secondary outcome data found that exposure to alcohol portrayals increased explicit alcohol-related cognitions, but did not find that exposure to alcohol advertisements influenced explicit or implicit alcohol-related cognitions. Confidence in results is diminished by underpowered analyses and unclear risk of bias. Viewing alcohol advertisements (but not alcohol portrayals) may increase immediate alcohol consumption by small amounts, equivalent to between 0.39 and 2.67 alcohol units for males and between 0.25 and 1.69 units for females. The generalizability of this finding beyond students and to other marketing channels remains to be established.

Objectives: There is sparse evidence regarding the effect of alcohol‐advertising exposure on alcohol consumption among heavy drinkers. This study aimed to assess the immediate effects of alcohol‐promoting and alcohol‐warning video advertising on objective alcohol consumption in heavy‐drinking young adults, and to examine underlying processes. Design: Between‐participants randomized controlled trial with three conditions. Methods: Two hundred and four young adults (aged 18–25) who self‐reported as heavy drinkers were randomized to view one of three sets of 10 video advertisements that included either (1) alcohol‐promoting, (2) alcohol‐warning, or (3) non‐alcohol advertisements. The primary outcome was the proportion of alcoholic beverages consumed in a sham taste test. Affective responses to advertisements, implicit alcohol approach bias, and alcohol attentional bias were assessed as secondary outcomes and possible mediators. Typical alcohol consumption, Internet use, and television use were measured as covariates. Results: There was no main effect of condition on alcohol consumption. Participants exposed to alcohol‐promoting advertisements showed increased positive affect and an increased approach/reduced avoidance bias towards alcohol relative to those exposed to non‐alcohol advertisements. There was an indirect effect of exposure to alcohol‐warning advertisements on reduced alcohol consumption via negative affect experienced in response to these advertisements. Conclusions: Restricting alcohol‐promoting advertising could remove a potential influence on positive alcohol‐related emotions and cognitions among heavy‐drinking young adults. Producing alcohol‐warning advertising that generates negative emotion may be an effective strategy to reduce alcohol consumption. Statement of contribution: What is already known on this subject? Exposure to alcohol advertising has immediate and distal effects on alcohol consumption. There is some evidence that effects may be larger in heavy drinkers. Alcohol‐warning advertising has been found to have mixed effects on alcohol‐related cognitions. What does this study add? Among heavy‐drinking young adults: Alcohol advertising does not appear to have an immediate impact on alcohol consumption. Alcohol advertising generates positive affect and increases alcohol approach bias. Alcohol‐warning advertising that generates displeasure reduces alcohol consumption.

Executive function, impulsivity, and intelligence are correlated markers of cognitive resource that predict health-related behaviours. It is unknown whether executive function and impulsivity are unique predictors of these behaviours after accounting for intelligence. Data from 6069 participants from the Avon Longitudinal Study of Parents and Children were analysed to investigate whether components of executive function (selective attention, attentional control, working memory, and response inhibition) and impulsivity (parent-rated) measured between ages 8 and 10, predicted having ever drunk alcohol, having ever smoked, fruit and vegetable consumption, physical activity, and overweight at age 13, after accounting for intelligence at age 8 and childhood socioeconomic characteristics. Higher intelligence predicted having drunk alcohol, not smoking, greater fruit and vegetable consumption, and not being overweight. After accounting for intelligence, impulsivity predicted alcohol use (odds ratio = 1.10; 99% confidence interval = 1.02, 1.19) and smoking (1.22; 1.11, 1.34). Working memory predicted not being overweight (0.90; 0.81, 0.99). After accounting for intelligence, executive function predicts overweight status but not health-related behaviours in early adolescence, whilst impulsivity predicts the onset of alcohol and cigarette use, all with small effects. This suggests overlap between executive function and intelligence as predictors of health behaviour in this cohort, with trait impulsivity accounting for additional variance.

To assess the immediate effect of alcohol promoting and alcohol warning advertisements on implicit and explicit attitudes towards alcohol and on alcohol seeking behaviour. We conducted a between-participants online experiment in which participants were randomly assigned to view one of three sets of advertisements: (a) alcohol promoting, (b) alcohol warning, or (c) unrelated to alcohol. A total of 373 participants (59.5% female) aged 18–40 (M = 28.03) living in the UK were recruited online through a research agency. Positive and negative implicit attitudes and explicit attitudes towards alcohol were assessed before and after advertisements were viewed. Alcohol seeking behaviour was measured by participants' choice of either an alcohol-related or non-alcohol-related voucher offered ostensibly as a reward for participation. Self-reported past week alcohol consumption was also recorded. There were no main effects on any of the outcome measures. In heavier drinkers, viewing alcohol promoting advertisements increased positive implicit attitudes (standardized beta = 0.15, P = 0.04) and decreased negative implicit attitudes (standardized beta = −0.17, P = 0.02). In heavier drinkers, viewing alcohol warning advertisements decreased negative implicit attitudes (standardized beta = −0.19, P = 0.01). Viewing alcohol promoting advertisements has a cognitive impact on heavier drinkers, increasing positive and reducing negative implicit attitudes towards alcohol. Viewing alcohol warning advertisements reduces negative implicit attitudes towards alcohol in heavier drinkers, suggestive of a reactance effect.

Negative and positive urgency are facets of trait impulsivity that have been identified as possible risk factors for problematic substance use. Relationships between these traits and substance use measures have not yet been widely investigated in adolescents. In the current study, a sample of 270 adolescent students completed self-report measures of impulsivity-related traits, their alcohol and cannabis use, problematic use, and perceived peer use. Zero-inflated negative binomial regression models indicated that both urgency traits accounted for significant variance in problematic alcohol and cannabis use scores, even after accounting for nonurgency impulsivity traits and typical substance consumption. Furthermore, both urgency traits moderated the positive association between perceived peer alcohol use and individual problematic use. Results indicate that the urgency traits show a direct association with problematic substance use in adolescence, and that high urgency adolescents who believe their peers drink high levels of alcohol may be at increased risk of problematic alcohol use.