Alcohol Advertising Exposure Associated With Youth Drinking

Greater exposure to alcohol marketing was associated with a higher risk of drinking among youths, according to a systematic review and meta-analysis of longitudinal studies published in JAMA Pediatrics.

Researchers identified 19 cohorts reported in 23 publications, encompassing 82,498 participants from 10 high-income countries. Eligible studies followed people younger than 25 years and measured exposure to television and online advertising, entertainment portrayals, promotions, branded merchandise, advertisement liking, or composite marketing measures.

High versus low advertising exposure was associated with a 50% higher risk of youth drinking (pooled relative risk, 1.50; 95% CI, 1.37-1.63). The investigators rated the certainty of that evidence as moderate after considering a dose-response pattern. Across the included estimates, 86% of relative risks were positive, and television advertising had the strongest association in subgroup analyses.

The outcomes included drinking initiation and binge drinking. Narrative evidence suggested that changes in attitudes and alcohol-related beliefs may partly mediate the association between marketing exposure and subsequent behavior.

All studies were considered at risk of bias because drinking outcomes were self-reported. The authors described the findings as associations and did not draw causal conclusions. Evidence also came entirely from high-income countries. The authors called for stronger measures spanning multiple marketing channels and additional research in low- and middle-income settings, while concluding that the accumulated longitudinal evidence consistently links alcohol marketing exposure with youth drinking.

Source: Cukier S, Stoolmiller M, Hartmann-Boyce J, et al. Alcohol marketing exposure and youth drinking: a systematic review and meta-analysis. JAMA Pediatr. Published online August 24, 2026. doi:10.1001/jamapediatrics.2026.3706