Association between stricter alcohol advertising regulations and lower hazardous drinking across European countries

Aims To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50-64 years in 16 European countries, taking into account both individual and contextual-level factors (alcohol taxation, availability, etc.). Design Cross-sectional study based on SHARE project surveys. Setting and Participants A total of 27773 subjects, aged 50-64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project. Measurements We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi-level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained. Findings The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI=29.3-31.8) in countries with no restrictions, 20.3% (95% CI=19.3-21.2) in countries with some restrictions and 14.4% (95% CI=11.9-16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI=0.90-2.06) for countries with some restrictions and 1.95 (95% CI=1.31-2.91) for those with no advertising restrictions. Conclusions The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50-64 years.