Table 2 Key characteristics of included studies assessing secondary outcomes – explicit and implicit alcohol-related cognitions, and alcohol selection without purchasing
Study | Country | Participants that completed study | Baseline alcohol consumption | Intervention | Comparison | Outcome |
|---|---|---|---|---|---|---|
Alhabash et al. (2015) [45] | USA | 379 undergraduates; mean age = 20.58 (SD = 1.52); 57.1 % female | Not reported | Twelve Facebook screenshots, six of which featured advertisements for a happy hour at a local restaurant | Twelve Facebook screenshots, six of which featured advertisements for a local financial institution | Explicit alcohol-related cognitions – Intentions to consume alcohol, assessed with four items including “seeing this screenshot makes me want to have a drink” with 7 point response scales ranging from strongly disagree to strongly agree. |
Bahk (1997) [46] | USA | 211 undergraduates; mean age = 19.81 (SD = 1.53); 64 % female | Not reported | Film (“A Star Is Born” – a musical) with alcohol portrayals, edited to remove scenes showing negative consequences of alcohol consumption | Same film edited to remove portrayals and negative consequences of alcohol consumption | Explicit alcohol-related cognitions - Attitudes assessed by agreement with 15 statements including “drinking relieves tension” and “drinking is a necessary part of celebration”. |
Brown et al. (2015) [47] | UK | 373 adults from general population; aged 18–40 (M = 28.03, SD = 5.64); 59.5 % female | A mean of 16.02 alcohol units consumed in past week | Eight advertisements, four of which were for alcoholic beverage products | Eight advertisements for non-alcohol products | Explicit alcohol-related cognitions - Attitudes assessed with two items, both preceded “I consider drinking alcohol to be…” with 7 point response scales ranging from very unpleasant to very pleasant, and very bad to very good. |
Implicit alcohol-related cognitions – Positive implicit attitudes assessed with alcohol version of the Implicit Association Test [66]. | ||||||
Alcohol selection without purchasing – Choice of £5 voucher for alcohol-related (pub) or non-alcohol-related (café) outlet. | ||||||
De Graaf (2013) [48] | Netherlands | 108 high school students; Aged 14–17 (M = 15.34, SD = 0.78); 45 % female | Not reported | 20 min of television programme (“Jersey Shore” – a reality show) with alcohol portrayals showing positive consequences of alcohol consumption (bonding, celebrating) | 20 min of same programme presented after outcome measure | Explicit alcohol-related cognitions - Attitudes assessed with 5 items including “I think drinking beer is…” or “I think drinking liquor is…” with responses ranging from unpleasant to pleasant. |
Explicit alcohol-related cognitions - Outcome expectancies assessed with by 5 items including “Drinking alcohol makes you have fun” with responses ranging from completely disagree to completely agree. | ||||||
Dunn & Yniguez (1999) [49] | USA | 551 elementary schoolchildren; Mean age (SD) = 10.27 (1.04); 49 % female | Not reported | Five beer advertisements | Five soft drink advertisements | Explicit alcohol-related cognitions - Adjectives rated for how often they are experienced when consuming alcohol. Preference mapping analysis used to identify the frequency with which positive and arousing expectancies were reported and co-occurred. |
Explicit alcohol-related cognitions - First associate expectancy measure also used. Participants asked to respond open-endedly to the phrase “How do people feel when they drink alcohol?” | ||||||
Goodall & Slater (2010) [50] | USA | 145 undergraduates | Not reported | Four 30 s alcohol advertisements | Four 30 s non-alcohol advertisements | Explicit alcohol-related cognitions – Attitudes toward beer, liquor/mixed drinks, and wine on a scale ranging from 0 (extremely unfavourable) to 10 (extremely favourable). |
Age and gender not reported | ||||||
Implicit alcohol-related cognitions - Implicit attitudes assessed with the Alcohol Affective Misattribution Procedure [67]. | ||||||
Koordeman et al. (2012) [40] | Netherlands | 159 undergraduates; aged 18–29 (M = 21.08, SD = 2.7); 0 % female | A mean of 15.90 alcoholic beverages in past week | 60 min of film (“Planet Earth”) with six alcohol advertisements embedded | 60 min of same film with five non-alcohol advertisements embedded | Explicit alcohol-related cognitions - Positive expectancies, assessed with a 6-item scale. Participants indicated their level of agreement with the statement: “Drinking makes me…”, with items including fun and happy. |
Kotch et al. (1986) [51] | USA | 43 elementary schoolchildren; age not reported (19 5th grade, 24 6th grade); 56 % female | Not reported | 35 min of television programme (not specified) edited to contain 13 scenes in which characters drank an alcoholic beverage in social contexts without negative consequences | 35 min of same television programme edited to show no alcohol portrayals | Explicit alcohol-related cognitions - Outcome expectancies assessed with Subjective Expected Utility Scale [68]. |
Explicit alcohol-related cognitions – Assessed with “How Wrong Is It” scale [69]. Participants reported attitudes towards 24 possible outcomes following alcohol use. | ||||||
Kulick & Rosenberg (2006) [52] | USA | 108 undergraduates; mean age (SD) = 18.42; 70 % female | 6.5 % heavy drinkers, 85 % moderate, and 8.5 % abstinent | 20 min of eight film clips, six of which showed alcohol portrayals with positive outcomes (laughing, singing, dancing, and companionship) and two of which showed no alcohol consumption. Each clip was viewed twice. | 24 min of eight film clips showing no alcohol consumption. Each clip was viewed twice. | Explicit alcohol-related cognitions - Outcome expectancies assessed with the Comprehensive Effects of Alcohol Scale [70]. |
McCarty & Ewing (1983) [53] | USA | 112 adults; age not reported; 57 % female | 40 % heavy drinkers, 36 % moderate, and 24 % light | Eight photographic slides of magazine alcohol advertisements | Ten photographic slides of magazine non-alcohol advertisements | Alcohol selection without purchasing - Amount of alcohol poured into a mixed drink. |
Rychatrik et al. (1983) [54] | USA | 75 children selected from outpatient waiting room of paediatric clinic; aged 8–11; Gender not reported | Not reported | 5.5 min of television programme (“M.A.S.H.” – a comedy drama) with alcohol portrayals showing alcohol consumption in positive contexts (companionship, toasting) | 5.5 min of same programme edited to show no alcohol portrayals | Alcohol selection without purchasing - Hypothetical choice of beverage (alcoholic or non-alcoholic) to serve to photographs of different individuals. |
Slater et al. (1996) [55] | USA | 157 high school students; mean age (SD) = 14.45; 0 % female | Not reported | Beer advertisements with sports content and beer advertisements without sports content | Non-alcohol advertisements | Explicit alcohol-related cognitions - Participants were asked to report their thoughts and feelings towards the advertisements in an open-ended thought-listing procedure. A net score was calculated by subtracting summed negative comments from summed positive comments. |
Van Hoof et al. (2009) [56] | Netherlands | 223 secondary school students; aged 12–18 (M = 14.9); 60 % female | Not reported | Twelve advertisements, six of which were for alcoholic beverages, embedded within 22 min soap opera. Two advertisements each for beer, spirits, and mixed drinks. | Twelve advertisements, six of which were for lemonade, embedded within 22 min soap opera | Explicit alcohol-related cognitions – Positive and negative expectancies, assessed using 11 items. |
Implicit alcohol-related cognitions – Assessed using word completion task where words could be alcohol-related (e.g. “bee…; spi…”). | ||||||
Alcohol selection without purchasing - Hypothetical choice of beverage (from five alcoholic or ten non-alcoholic options). | ||||||
Zwarun et al. (2006) [57] | USA | 215 undergraduates; age not reported; 81 % female | Not reported | 20 min of television programme (“The Real World” – a reality show) with beer advertisements embedded | 20 min of same television programme with non-alcohol advertisements embedded | Explicit alcohol-related cognitions – Expectancies about the social benefits and physical effects of alcohol consumption (e.g. “drinking makes me feel more confident”, “drinking alcohol relaxes me”). |