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The authors comment on a study by J. Manthey and colleagues about the absence of robust evidence for or against statutory restrictions on alcohol advertising. Topics include the need to accompany marketing restrictions by comprehensive evaluation programmes, principal issue about the overall evidence base, and suggestion on jurisdictions planning statutory restrictions.

Minimum unit pricing for alcohol (MUP) came into effect on 1st May 2018 in Scotland, raising the price of the cheapest shop-bought alcohol. Small retailers are a key source of alcohol for communities, often located in areas of high alcohol-related harm. We sought to examine their experiences of MUP implementation and impact. We conducted semi-structured interviews in-store with 20 small retailers in central Scotland at two time points: October – November 2017 (6–7 months pre-implementation); and October – November 2018 (5–6 months post-implementation). Prior to implementation, some retailers did not understand MUP, including how prices would link to product strength, or were concerned about anticipated implementation burden. Several expressed support for reducing 'problem' drinking or suggested that MUP would increase alcohol prices in supermarkets bringing them into line with small retailers. Despite initial concerns, small retailers reported minimal disruption following implementation of MUP, which was generally straightforward. Compliance was taken seriously and price calculations relatively manageable. Few/no negative reactions from customers were reported. Some felt that the measure enabled them to better compete with larger retailers/supermarkets. Concerns about MUP expressed by some trade bodies prior to implementation were largely not borne out in the experiences of small retailers. [ABSTRACT FROM AUTHOR]

Alcohol marketing provides a high-reach opportunity to communicate consumer protection messages (e.g. health warnings), but there are concerns about the efficacy of self-regulatory practice. Through the Public Health (Alcohol) Act, Ireland will mandate the presence of such information. To understand the potential impact of the Act, we examined: (1) the presence of self-regulated consumer protection messages in alcohol marketing on Twitter; and (2) the presence of warnings (about alcohol, drinking when pregnant, and cancers) and signposts to websites with information about alcohol, which will be required under the Act. Data come from a content analysis of Tweets (n = 554) from a purposive non-probabilistic sample of 13 alcohol companies either based in Ireland or, for multinational companies, where marketing was targeted at Ireland. A third of Tweets (36.3%) had a self-regulated message, with 'Get the facts. Be DRINKAWARE' featured most (20.0%). No Tweets signposted independent health websites, 20.6% signposted an industry-funded website (drinkaware.ie), and 6.7% signposted industry-controlled websites. No Tweets featured warnings about the dangers of alcohol or link to cancers. Only one brand (0.5% Tweets) referenced drinking during pregnancy, but only through incidental exposure to warnings on packaging. Ireland's legislation will fundamentally improve communication of warnings in alcohol marketing on Twitter. [ABSTRACT FROM AUTHOR]

Objective: Since November 2019, Ireland has restricted alcohol advertising at the cinema and outdoors (e.g., near schools) and banned alcohol advertising on public transport. Although awareness of such advertising had decreased 1 year after the restrictions, measures to limit COVID-19 transmission complicated interpretation. We examined (a) changes in awareness 2 years after restrictions, when COVID-19 mitigation measures had eased, and (b) how changes in Ireland compared with Northern Ireland, where the restrictions did not apply. Method: Repeat cross-sectional surveys were conducted with adults recruited from nonprobability online panels, with three waves in Ireland (October 2019 [before restrictions] and October 2020/2021 [after restrictions]; n = 3,029) and two in Northern Ireland (October 2020/2021; n = 1,011). Participants self-reported past-month awareness of 13 alcohol marketing activities, including public transport, cinema, and outdoor advertising (coded as any past-month awareness, no awareness, or not sure). Results: In Ireland, the odds of reporting no past-month awareness (vs. any) were higher in both 2021 and 2020 versus 2019 for all restricted advertising activities (e.g., 2021 vs. 2019 for public transport: adjusted OR = 1.88, 95% CI [1.53, 2.32]). Interactions between wave and jurisdiction indicated that in 2021, compared with 2020, the odds of reporting no past-month awareness of public transport and cinema advertising (vs. any) were higher in Ireland than in Northern Ireland, despite increased opportunities for exposure in both jurisdictions through eased pandemic mitigation measures. There was no interaction for outdoor advertising, suggesting between-wave trends did not differ by jurisdiction. Conclusions: Ireland's restrictions have reduced past-month awareness of alcohol advertising at the cinema and on public transport but not outdoors. Continued monitoring is required. [ABSTRACT FROM AUTHOR]

Understanding how the gambling industry generates revenue is of paramount importance. Questions about whether higher volumes of expenditure are concentrated among a small proportion of gamblers, and how this varies by problematic gambling status, underpin policy debate about consumer protection. Analyzing data from two timepoints (T0; T2) from a British longitudinal study of regular sports bettors, we explored both for total (gross) spend and gross spend on individual activities: (a) the concentration of self-reported spend on gambling among individuals; and (b) the extent to which spending was disproportionately generated by those with elevated Problem Gambling Severity Index (PGSI) scores. Results showed that gross gambling expenditure was unequal (GINI-coefficient >0.70 for most activities). At both timepoints, those with a PGSI score of 3+ had an elevated share of spending: at T2, 14.1% of PGSI 3+ gamblers accounted for 43.5% of gross gambling spend. There were differences by activity: lotteries displayed less reliance on those with a PGSI score of 3+ whereas this group contributed over 80% of gross spend on online casinos. Policy attention should focus on reframing the underlying economic model on which some gambling activities are predicated, creating more equal patterns of consumption and less reliance on those harmed. [ABSTRACT FROM AUTHOR]

This commentary about alcohol marketing regulation in the UK draws on a conference held by the Institute of Alcohol Studies, highlighting a need for policy interventions to prevent harm and improve public health. Hazardous and harmful alcohol use is associated with many health conditions, wider social consequences, and harms to others. Following no improvement in alcohol mortality rates in the past decade, 2020 saw alcohol-specific deaths rise to record levels in the UK. Bans or comprehensive restrictions on alcohol advertising across multiple types of media are listed by the World Health Organization (WHO) as one of the 'best buy' policies to reduce alcohol harm. The UK's current complaints-led self-regulatory approach fails to protect consumers and vulnerable groups from being exposed to influential alcohol marketing. There are few meaningful sanctions to deter brands and companies from violating existing codes, processes are retrospective, reactive and slow, and the codes fail in their stated aim of protecting young people. Other important impacts on heavier drinkers and those in recovery, as well as on gender and health equity, are also inadequately addressed. Innovation is also urgently needed to effectively regulate ever-evolving digital alcohol marketing. Addressing these issues through a combination of comprehensive restrictions, content controls, labelling, and replacing self-regulation with an independent body will benefit public health as well as protecting the vulnerable, including heavier drinkers, people in recovery, and children and young people. [ABSTRACT FROM AUTHOR]

Background The Republic of Ireland is introducing new controls on alcohol marketing, starting in November 2019 with restrictions on some outdoor and cinema advertising, and a ban on public transport advertising. We examined changes in marketing awareness one year after initial implementation and during the COVID-19 pandemic. Methods Repeat online cross-sectional surveys with adults in Ireland conducted October 2019 (n  = 1,007) and October 2020 (n  = 1,020). Participants self-reported past-month awareness of alcohol marketing and completed the Alcohol Use Disorders Identification Test-Concise (AUDIT-C). Current drinkers were categorised as those reporting heavy episodic drinking at least monthly and higher-risk drinkers (≥5 AUDIT-C). Results In both waves, most participants recalled some marketing awareness (94.1% vs. 93.8%). For 9/13 activities measured in both waves, there were decreases in the proportion reporting any awareness and frequency of awareness, including for the newly restricted activities. For example, any awareness of public transport advertising decreased between waves (ORAdj  = 0.66, 95%CI: 0.53–0.81). In both waves, higher past-month awareness was associated with at least monthly heavy episodic drinking and higher-risk consumption. Conclusion We recommend a precautionary interpretation. It is plausible that both Ireland's initial controls and COVID-19 restrictions contributed to decreases in awareness, but longer-term evaluation is required to determine relative contribution. [ABSTRACT FROM AUTHOR]

Tobacco companies use brand variant name on cigarette packaging to differentiate, and create interest in, their products. We explored young peoples' reactions to brand variant names on cigarette packs and perceptions of replacing these with numbers, a proposed policy in Turkey. Twelve focus groups, segmented by gender, age (11-12, 13-14, 15-16) and social grade (ABC1, C2DE), were conducted across Britain from May–July 2018 (n = 89). Participants were asked what they thought about brand names in general, and on cigarette packs, and perceptions of replacing the brand variant name on cigarette packs with a number. Brand (variant) name was considered important for products, including cigarettes, and thought to communicate information about the product, image, price, and taste, and encourage purchase. Although replacing brand variant names on cigarette packs with numbers caused confusion, several participants mentioned that it would eliminate any remaining marketing power that the pack may have. They thought that numbered cigarette packs could be off-putting due to the absence of a familiar brand name, although the impact on smokers was considered negligible. Although adolescents were not clear on the rationale for numbered cigarette packs, some suggested that this would reduce one of the few remaining promotional features on standardised packs. [ABSTRACT FROM AUTHOR]