Alcohol is one of the leading risk factors for global disease burden among the 15–49 years age group [1]. Alcohol use by young people, especially those under 20 years of age, increases the likelihood of risky behaviors such as aggressive incidents and unprotected sex, and adverse outcomes such as learning difficulties, depression, and accidents [2,3,4].
Accessing social networking sites (SNS) has become a common pastime for young people, with these websites considered an integral part of their leisure and friendship networks [5, 6]. This development has provided alcohol companies with an opportunity to utilize SNS as highly effective platforms to reach this group and promote their products [7].
Alcohol companies post content on their official SNS pages, which previous research suggests is deemed pleasurable and socially desirable by SNS users [8, 9]. This process involves initiating conversations between SNS users and brands, and thus facilitates creation of user-generated content. Prompted by brands, users participate in conversations and post content relating to their real-world activities and socio-cultural identities [6]. For example, posting pictures (sometimes with alcohol), tagging their SNS friends in such posts, and checking-in at events on SNS (e.g., music, fashion, sports, and cultural events created by alcohol companies). This is beneficial to brands because such events are deemed socially desirable, increase social capital, and make younger SNS users less critical of these marketing techniques. This process further facilitates the flow of this content into online users’ peer networks and the generation of more content that is favorable to brands [10, 11].
The studies examining the effects of exposure to alcohol marketing on SNS indicate that exposed youth are likely to develop positive attitudes towards alcohol use [5, 12], regularly consume alcohol [13], engage in heavy and risky drinking [14], and experience subsequent alcohol-related problems/disorders [15].
Purpose of the study
India and Australia were chosen for this study based on the contrasting alcohol consumption features – 1) dry (India) versus wet (Australia) drinking cultures, 2) proportion of drinkers and/or per capita consumption increasing (India) versus decreasing (Australia) over the past decade, and 3) substantially different socio-cultural norms towards alcohol consumption. These features are discussed at length in the next section.
Harms related to underage drinking are a major problem in Australia [16] and a growing concern in India [1], and are likely influenced by exposure to alcohol marketing [1]. Most of the research exploring the association between alcohol marketing on SNS and alcohol use among young people has been conducted in the USA [12, 15], the UK [6, 14], and Australia [10, 17,18,19,20,21]. However, these studies explored these associations primarily on Facebook, with work involving other SNS such as Twitter and YouTube is sparse. Further, work in other national contexts such as India appears to be lacking, with a few studies identified [22, 23]. Jones et al. (2016) found significant and positive associations between reported exposure to alcohol advertising and branding on Facebook and reported drinking frequency and volume among 16–24 year old Facebook users [19]. Similarly, another study reported that exposure to Internet advertising was significantly associated with frequency of alcohol consumption among 12–17 year old Australians, with these associations varying across age and gender sub-groups [20].
As stated earlier, alcohol companies use marketing strategies on SNS that are tailored to specific national contexts and users’ responses to such marketing content differ by national settings [22,23,24]. These studies identified common strategies used for alcohol promotion across social media in both countries. These included prompts to engage in time- and event-specific drinking (e.g., “it’s Friday, and it’s beer-o’clock”), alcohol sponsorship of sporting, music, and fashion events, cocktail recipes and food-drink combinations, competitions, brand-related giveaways, and the use of memes. Other strategies were largely country specific, such as posting content relating to inspirational talks, livelihood skills, and sexually suggestive content on Indian social media sites versus references to a brand’s tradition or heritage on Australian sites. Notably, some of the identified strategies (e.g., brand-sponsored events and posts relating to competitions and giveaways) were traditionally more popular amongst younger people. User engagement was assessed through responses to content posted by brands, for example, user-generated messages, images, and videos posted on brands’ social media pages.
However, cross-national comparisons examining the effects of exposure to alcohol marketing on SNS and alcohol use among young people and across different SNS are scant. To extend this work, the present study investigated associations between 13 and 25 year olds’ exposure to and interaction with SNS-based alcohol marketing and alcohol use (assessed as usual consumption) in diverse national contexts (India and Australia), and across varying SNS. The selected SNS were all popular amongst young people, allowed for a variety of comparisons with existing work from the USA [12, 15], the UK [6, 14], and Australia [10, 17,18,19,20,21] and represented SNS not yet examined within the Australian and Indian literature. This information is important to guide the development of regulatory frameworks to minimize any harmful use of alcohol among young people that may result from exposure to alcohol marketing.
Socio-cultural norms and drinking prevalence and patterns
India and Australia have substantially dissimilar socio-cultural contexts and histories, and represent widely contrasting drinking cultures. In India, 11% of males and 1% of females aged 15–19 years and 29% of males and 2% of females aged 20–24 years report consuming alcohol in the past 12 months [25]. In contrast, in Australia 23% of those aged 12–17 years and 62% of those aged 18–24 years consumed alcohol in the past 12 months, with consumption rates being similar for males and females [26]. Similarly, heavy drinking is less prevalent in India than Australia. For example, about 4% of 18–24 year old Indians are classed as ‘heavy drinkers’, defined as consuming at least 50 g of pure alcohol in a single session at least once a month [27]. By comparison, in the same age group, 42% of Australians reported consuming 5 or more standard drinks (equivalent of 50 + g of alcohol) on a single drinking occasion at least once a month [26].
These differences in national consumption rates are likely due to a range of factors. Socio-cultural norms in India are less accepting of alcohol [28], especially in the context of female drinking [29], and religious practices that proscribe alcohol use (14% of the Indian population is Muslim) [28, 30]. The legal drinking age in India ranges from 18 to 25 years, with sales banned to the whole population in certain states [31]. However, with urbanization and industrialization, economic transition, exposure through extensive alcohol marketing, increased availability, and relaxation of overseas trade rules; alcohol use is increasing in India [31, 32]. Hence, both traditions and social change influence drinking culture in modern India [28, 33, 34]. In contrast, although alcohol has been a ubiquitous feature of Australian culture from its colonial era onwards, per capita consumption has been decreasing over the past 10 years [26, 35]. Consequently, although drinking is more prevalent in Australia compared to India, the drinking trajectory is on the rise in India and on decline in Australia [25, 26].
SNS use and regulatory environment
Reflecting the size of the overall populations, the sheer number of social media users varies greatly between India and Australia. Twitter has an estimated 23 million users in India (2% of the population) and 3 million in Australia (13% of the population), YouTube has about 40 million users in India (3% of the population) and 14 million in Australia (58% of the population), while Facebook has about 108 million users in India (9% of the population) and 11 million in Australia (46% of the population) [36,37,38]. Although different SNS vary in terms of user demographics, SNS use overall is more prevalent in the younger age groups. For example, in India about 46% of Facebook users are estimated to be 18–24 years of age and a further 11% are 17 years or younger [39], while 70% of YouTube users are below 35 years of age [40]. Similarly, 36% of Australian Facebook users belong to the 13–24 years age group [38] and about 51% of Australians aged 14–17 years reported using YouTube in 2013 [41]. Among Australian SNS users, Twitter is used by 25% males and 14% females. About 33% of them belong to the 18–29 years age group [42]. Although demographic data on Indian Twitter users are not publically available, it is suggested that about 80% of Twitter users are male [43].
The Advertising Standard Council of India (ASCI) regulates alcohol advertising in India. Although it bans both direct and indirect alcohol advertising in traditional media, it does not cover online alcohol advertising [44]. Therefore, alcohol advertising on SNS remains unfettered and is thus extensive in India [31]. In Australia, alcohol advertising (including on digital media) is self-regulated by the alcohol industry via the Alcohol Beverages Advertising Code [45]. However, the current code only relates to the content of alcohol advertisements, does not consider issues around placement of advertisements on digital media (including where there are no age restrictions), and has very weak enforcement powers [46]. Hence, in both countries SNS are largely unregulated platforms for alcohol companies to promote their products.