Minors who were familiar with television alcohol advertisements were more likely to have tried alcoholic beverages and binge drink than those who could not recall seeing such ads, according to a study to be presented April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

"Underage drinking remains an important health risk in the U.S.," said lead author Susanne E. Tanski, MD, MPH, FAAP, assistant professor in the Department of Pediatrics at Children's Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center. "In this study, we have shown a link between recognition of nationally televised alcohol advertisements and underage drinking initiation and heavier use patterns."

Previous research by Dr. Tanski and her colleagues showed an association between seeing smoking and drinking in movies and adolescents engaging in these risky behaviors. This study expanded on that research by exploring whether there is an association between young people's exposure to television alcohol advertising and substance use.

The researchers surveyed a national sample of 2,541 youths ages 15 to 20 years. Participants were asked about their age, gender, race, if their friends drank, if their parents drank, whether they had a favorite alcohol ad and whether they owned alcohol-branded merchandise. They also were asked questions to assess whether they engaged in "sensation-seeking" behavior.

Participants then were shown 20 still images selected from television ads for the top beer and spirit alcohol brands that aired on national television in the year before the survey as well as 20 ads for fast-food restaurants. The images were digitally edited to remove the brands and logos. Individuals were asked if they remembered seeing the ad, if they liked the ad and if they knew the product or restaurant being advertised.

Results showed that 59 percent of underage youths previously drank alcohol. Of those who drank, 49 percent binge drank (had more than six drinks in a row) at least once in the past year.

Familiarity with TV alcohol advertising was significantly higher for drinkers than for non-drinkers. Other factors linked with drinking alcohol included older age, seeing alcohol in movies, having a favorite alcohol ad, having greater propensity for sensation seeking, having friends who drink alcohol, and having parents who drink alcohol at least weekly.

Among those who drank alcohol, familiarity with TV alcohol advertising was linked with greater alcohol use and binge drinking. Other factors linked with more hazardous drinking included owning alcohol-branded merchandise, having a favorite alcohol ad, older age, male gender, sensation seeking and friend drinking.

Familiarity with fast-food TV advertising was not linked to drinking behavior, suggesting that the relationship between alcohol ad familiarity and drinking is specific and not due to overall familiarity with advertising, Dr. Tanski said.

"At present, the alcohol industry employs voluntary standards to direct their advertising to audiences composed of adults of legal drinking age," Dr. Tanski said. "Our findings of high levels of familiarity with alcohol ads demonstrate that underage youth still frequently see these ads. While this study cannot determine which came first -- the exposure to advertising or the drinking behavior -- it does suggest that alcohol advertising may play a role in underage drinking, and the standards for alcohol ad placement perhaps should be more strict."