Persistence of Shifts in Beliefs Associated With Exposure to Alcohol Advertising Among Adolescents.

OBJECTIVE The purpose of this study was to quantify the persistence of immediate changes in adolescents' alcohol-related beliefs associated with exposure to alcohol advertising. METHOD Middle school students (N = 606) carried handheld devices for 14 days and logged all of their exposures to alcohol advertisements as they naturally occurred. Perceptions of the typical person one's age who drinks ("prototype perceptions") and perceived norms regarding alcohol use were assessed after each exposure to advertising and at random prompts issued daily throughout the assessment period. Generalized additive modeling was used to determine how long pro-drinking shifts in beliefs persisted after exposure to advertising. RESULTS Following exposure to advertisements, positivity of youth's prototype perceptions immediately increased (β = .07, 95% CI [.06, .09]) and then decreased (β = -.05, 95% CI [-.07, -.03]) over the subsequent 1.5 days, whereas perceived normativeness of alcohol use immediately increased (β = .04, 95% CI [.01, .06]) and then decreased (β = -.03, 95% CI [-.05, -.01]) over the subsequent 2 days. Changes in beliefs occurring after 1.5 days for prototype perceptions and after 2 days for perceived norms were not statistically significant, suggesting that these beliefs were no longer affected by the advertising exposure. CONCLUSIONS Findings are consistent with theories of alcohol advertising effects that presume that repeated exposure results in cumulative, enduring effects on beliefs. Given the rate of decay of alcohol advertising effects, it may be important to limit youth exposures to one every 2 days to avoid cumulative, lasting pro-drinking shifts in beliefs or to devise ways to interrupt cumulative effects with counter-messaging through media, parents, or other influential others at similar intervals.