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Auden C. McClure, MD, MPH; Mike Stoolmiller, PhD; Susanne E. Tanski, MD; Keilah A. Worth, PhD; James D. Sargent, MD

Arch Pediatr Adolesc Med. 2009;163(3):211-217.

Objective  To describe ownership of alcohol-branded merchandise (ABM) and its association with attitudinal susceptibility, initiation of alcohol use, and binge drinking.

Design  Three-wave longitudinal study.

Setting  Confidential telephone survey.

Participants  Representative US sample of 6522 adolescents aged 10 to 14 years at baseline survey (4309 of whom were never-drinkers at 8 months); subjects were resurveyed at 16 and/or 24 months.

Main Exposures  Ownership of ABM (first assessed at the 8-month survey) and attitudinal susceptibility to alcohol use.

Outcome Measures  Initiation of alcohol use that parents did not know about and binge drinking (5 drinks in a row).

Results  Prevalence of ABM ownership ranged from 11% of adolescents (at 8 months) to 20% (at 24 months), which extrapolates to 2.1 to 3.1 million US adolescents, respectively. Clothing and headwear comprised 88% of ABM. Beer brands accounted for 75% of items; 45% of items bore the Budweiser label. Merchandise was obtained primarily from friends and/or family (71%) but was also purchased by the adolescents themselves (24%) at stores. Among never-drinkers, ABM ownership and susceptibility were reciprocally related, each significantly predicting the other during an 8-month period. In turn, we found that ABM ownership and susceptibility predicted both initiation of alcohol use and binge drinking, while controlling for a broad range of covariates.

Conclusions  Alcohol-branded merchandise is widely distributed among US adolescents, who obtain the items one-quarter of the time through direct purchase at retail outlets. Among never-drinkers, ABM ownership is independently associated with susceptibility to as well as with initiation of drinking and binge drinking.

Author Affiliations: Department of Pediatrics (Drs McClure, Tanski, and Sargent), and Norris Cotton Cancer Center (Drs McClure, Tanski, Worth, and Sargent), Dartmouth Medical School, Hanover, New Hampshire; and Department of Education, University of Oregon, Eugene (Dr Stoolmiller).

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