The extent and nature of children’s real-time exposure to alcohol marketing using wearable cameras and GPS devices

Abstract

Alcohol places substantial financial, physical, social and psychological burdens on society. There is mounting evidence that childhood exposure to alcohol marketing increases the likelihood children will begin drinking, and current drinkers will increase consumption. However, children’s exposure to alcohol marketing is typically measured using self-report data, television viewing data or street marketing audits, which are subject to bias and often do not provide quantifiable rates of daily exposure. This study uses an innovative methodology to quantify the extent and nature of children’s real-time exposure to alcohol marketing using wearable cameras and GPS devices. Children aged 11-13 years (n=167) were randomly selected from 16 schools in Wellington, New Zealand. The children wore wearable cameras that automatically captured images approximately every seven seconds and GPS devices that captured latitude and longitude coordinates every five seconds for a four-day period between June 2014 and July 2015. Content analysis of images (n = 700,000) was manually undertaken to assess children’s exposure to alcohol marketing. Image data were linked to GPS data to examine the spatial patterning of children’s exposure to alcohol marketing. On average, children were exposed to alcohol marketing 12.4 (95% CI 9.1, 17.1) times per 10 hours, excluding within supermarkets. Children were exposed at home (73%), on-licence alcohol outlets (9%), off-licence shop fronts (5%) and sporting venues (5%). Children were exposed via product packaging (62%), sports sponsorship (11%) and shop front signage (11%). There were stark differences in exposure by sociodemographic characteristics with exposure rates for Māori 5.4 times higher than New Zealand European children and boys 2.0 times higher than girls. In addition, children were exposed to alcohol marketing within supermarkets 3.3 times per week. Children were exposed to alcohol marketing on 85% of their visits to supermarkets for an average of 46 seconds per exposure. In New Zealand, the findings provide strong evidence to support the Law Commission and Ministerial Forum on Alcohol Advertising and Sponsorship recommendations for legislative restrictions on alcohol marketing, in particular, a ban on alcohol sponsorship of sport. These findings highlight the urgent need for strict legislative restrictions on all forms of alcohol marketing as called for in the World Health Organization’s Global Alcohol Strategy. Given the global nature of alcohol marketing, these findings may be applicable in other jurisdictions.