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Brand Preferences of Underage Drinkers Who Report Alcohol-Related Fights and Injuries

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Background: A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. Objectives: We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. Methods: We recruited 1,031 self-reported drinkers (ages 13–20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Results: Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1–9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3–3.7; AOR: 1.8, 95% CI: 1.1–3.0 and 1.1–3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. Conclusions/Importance: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.


Sarah Roberts, MPH: Sarah Roberts is a Research Manager at Boston University School of Public Health, where she oversees a portfolio of research projects focused on alcohol, tobacco, and opiate use. Her background includes over six years of diverse behavioral health research and project coordination experience with subjects such as reproductive health and substance abuse. Her primary interest is in the utilization of rigorous research methods to improve mental health outcomes among vulnerable populations including women, adolescents, and individuals with substance use disorders.


Michael Siegel, MD, MPH: Dr. Michael Siegel is a Professor in the Department of Community Health Sciences at the Boston University School of Public Health. He has conducted extensive research on the effects of cigarette advertising on youth smoking behavior. Currently, he is using the methods he helped develop in the cigarette advertising field to study the effects of alcohol advertising on youth drinking behavior.


William DeJong, Ph.D.: Dr. William DeJong has spent the bulk of his 37-year career focused on health communications, translational research, knowledge transfer programs, and program and policy evaluation, while working in a variety of content areas, including alcohol prevention, tobacco control, drug treatment, impaired driving prevention, and cancer prevention. He has extensive experience with a wide variety of research methods including randomized control trials, focus groups and one-on-one interviews, intercept interviews, content analysis, psychological scale development, random-sample surveys, and evaluability assessment.

Timothy Naimi MD, MPH: Dr. Timothy Naimi is a physician who is board certified in Internal Medicine, Pediatrics, and Preventive Medicine. He did his epidemiology training with the Centers for Disease Control and Prevention (CDC), and was a Senior Epidemiologist with CDC's Alcohol Team from 2002–2009. He is currently an Associate Professor with the Boston University Schools of Public Health and Medicine, and is a physician at Boston Medical Center. His areas of interest in alcohol include binge drinking, youth drinking, alcohol control policy, and marijuana policy.

David H. Jernigan Ph.D.: Dr. David Jernigan is an Associate Professor in the Department of Health, Behavior and Society and the Director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health, where he teaches courses on media advocacy, alcohol policy, and campaigning and organizing for public health. He has worked as an adviser to the World Health Organization and the World Bank, was principal author of WHOs first Global Status Report on Alcohol and Global Status Report on Alcohol and Youth, and co-authored Media Advocacy and Public Health: Power for Prevention, and Alcohol in the Developing World: A Public Health Perspective.


Alcohol use disorder (AUD): An AUD, categorized as alcohol abuse or dependence (i.e., alcoholism), is a pattern of alcohol consumption that leads to recurrent harmful consequences. Symptoms of an AUD may include inability to fulfill one's role or obligations, dangerous behavior when drinking (e.g., drunken driving), legal or psychosocial problems, an increased physical tolerance to and dependence on alcohol that leads to withdrawal when alcohol consumption ceases, and significant time and/or resources spent on alcohol.

Heavy episodic drinking (or “binge” drinking): This level of drinking is often defined as the consumption of 4 drinks or more (for women) or five drinks or more (for men) in one sitting. In the present study, consistent with the Monitoring the Future studies, we categorized both male and female respondents who reported consuming five or more drinks in a row during the past 30 days as heavy episodic drinkers (Johnston, O'Malley, P.M., Miech, R.A., Bachman, J.G., & Schulenberg, J.E., Citation2014).

Nonresponse bias: A form of selection bias whereby the characteristics of respondents who were sampled and chose to respond to a survey differ significantly from those of individuals who were sampled but did not participate.

Market share: In the context of this study, market share is the proportion of respondents’ alcohol consumption that can be attributed to a specific brand. It is calculated by dividing the total number of drinks for a single brand by the total number of drinks for all brands included in the study.

Standard drink: As defined by the National Institute on Alcohol Abuse and Alcoholism, a standard drink in the United States contains 14 grams of alcohol and is the equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits (hard liquor).

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