Social norms regarding alcohol use, perceptions of alcohol advertisement and intent to drink alcohol among youth in Uganda

Figures & data

Table 1. Perceptions of Alcohol Advertisements by Sex and Intention to Drink among Youth in Kampala, Uganda (N = 1,133)

	Sex		Intent to Drink		Total
	Males n = 497 (43.9%)	Females n = 636 (56.1%)	Yes n = 363 (32.0%)	No n = 771 (68.0%)	N = 1,134 (100%)
Identification
I want to have as many friends as the people in the beer ads do Agree Neither agree or disagree Disagree	201 (40.7%) 47 (9.5%) 246 (49.8%)	246 (38.7%) 66 (10.4%) 323 (50.9%)	246 (67.8%) 47 (13.0%) 70 (19.3%)	201 (26.2%)**** 66 (8.6%) 500 (65.2%)	447 (39.6%) 113 (10.0%) 570 (50.4%)
I want to have as much fun as the people in the beer adverts Agree Neither agree or disagree Disagree	206 (41.6%) 48 (9.7%) 241 (48.7%)	265 (41.7%) 74 (11.7%) 296 (46.6%)	256 (70.5%) 49 (13.5%) 58 (16.0%)	215 (28.0%)**** 73 (9.5%) 480 (62.5%)	471 (41.6%) 122 (10.8%) 538 (47.6%)
I wish I were as good looking as most people in the beer adverts Agree Neither agree or disagree Disagree	196 (39.6%) 67 (13.5%) 232 (46.9%)	260 (40.9%) 61 (9.6%) 314 (49.5%)	221 (61.1%) 58 (16.0%) 83 (22.9%)	235 (30.6%)**** 70 (9.1%) 464 (60.3%)	456 (40.3%) 128 (11.3%) 547 (48.4%)
Desirability
People in alcohol adverts look like they make good decisions while drinking Agree Neither agree or disagree Disagree	150 (30.3%) 114 (23.0%) 231 (46.7%)	177 (27.8%) 137 (21.5%) 322 (50.6%)	163 (44.9%) 95 (26.2%) 105 (28.9%)	164 (21.3%)**** 156 (20.3%) 449 (58.4%)	327 (28.9%) 251 (22.2%) 554 (48.9%)
People drinking beer in adverts seem to have lots of friends Agree Neither agree or disagree Disagree	266 (53.7%) 74 (15.0%) 155 (31.3%)	358 (56.3%) 101 (15.9%) 177 (27.8%)	261 (71.9%) 56 (15.4%) 46 (12.7%)	363 (47.2%)**** 119 (15.5%) 287 (37.3%)	624 (55.1%) 175 (15.5%) 333 (29.4%)
The women in alcohol adverts are always good looking Agree Neither agree or disagree Disagree	302 (61.4%) 58 (11.8%) 132 (26.8%)	389 (61.4%) 64 (10.1%) 181 (28.6%)	296 (81.8%) 26 (7.2%) 40 (11.1%)	395 (51.6%)**** 96 (12.6%) 274 (35.8%)	691 (61.3%) 122 (10.8%) 314 (27.9%)
Skepticism
Alcohol adverts make drinking look like only good things happen while drinking Agree Neither agree or disagree Disagree	285 (57.6%) 78 (15.8%) 132 (26.7%)	370 (58.4%) 105 (16.6%) 159 (25.1%)	261 (72.1%) 58 (16.0%) 43 (11.9%)	395 (51.4%)**** 125 (16.3%) 248 (32.3%)	656 (58.1%) 183 (16.2%) 291 (25.8%)
Alcohol adverts make drinking seem better than it is Agree Neither agree or disagree Disagree	329 (66.6%) 81 (16.4%) 84 (17.0%)	417 (65.6%) 97 (15.3%) 122 (19.2%)	256 (70.5%) 57 (15.7%) 50 (13.8%)	491 (63.9%)* 121 (15.8%) 156 (20.3%)	747 (66.1%) 178 (15.7%) 206 (18.2%)
Companies that make adverts want me to buy things that I really don’t need Agree Neither agree or disagree Disagree	223 (45.1%) 75 (15.2%) 196 (39.7%)	252 (53.1%) 127 (62.9%) 254 (40.1%)	304 (39.7%) 118 (58.4%) 344 (44.9%)	172 (47.5%)**** 84 (23.2%) 106 (29.3%)	476 (42.2%) 202 (17.9%) 450 (39.9%)

Note: * p < 0.05 **p < 0.01 ***p < 0.001 p < 0.0001

Table 2. Measurement models for alcohol advertisement identification, desirability, and skepticism among youth living in the slums of Kampala, Uganda (N = 1,134)

	Estimate (95% CI)	Standardized Estimate (95% CI)	Standard Error	P-value
Identification
‘I want to have as many friends as the people in the beer ads do’	1.00 (1.00, 1.00)	0.95 (0.93, 0.97)	0.00	<0.001
‘I want to have as much fun as the people in the beer adverts’	1.04 (1.00, 1.08)	0.98 (0.96, 1.00)	0.02	<0.001
‘I wish I were as good looking as most people in the beer adverts’	0.81 (0.78, 0.85)	0.77 (0.74, 0.80)	0.02	<0.001
Desirability
‘People in alcohol adverts look like they make good decisions while drinking’	1.00 (1.00, 1.00)	0.70 (0.65, 0.75)	0.00	<0.001
‘People drinking beer in adverts seem to have lots of friends’	1.21 (1.08, 1.33)	0.85 (0.79, 0.90)	0.08	<0.001
‘The women in alcohol adverts are always looking good’	1.04 (0.95, 1.14)	0.73 (0.68, 0.78)	0.06	<0.001
Skepticism
‘Alcohol adverts make drinking look like only good things happen while drinking’	1.00 (1.00, 1.00)	0.70 (0.65, 0.76)	0.00	<0.001
‘Companies that make adverts want me to buy things that I really don’t need’	0.87 (0.79, 0.95)	0.61 (0.56, 0.66)	0.05	<0.001
‘Alcohol adverts make drinking seem better than it is’	1.37 (1.19, 1.55)	0.96 (0.90, 1.03)	0.11	<0.001

Note. Model fit for each latent factor was just-identified. Model fit for all three factors (without any observed variables): Root Mean Square Error of Approximation (RMSEA):0.082; 95% Confidence Interval (CI): 0.070, 0.095. Comparative Fit Index (CFI): 0.988. Tucker-Lewis index (TLI): 0.982. Standardized Root Mean Square Residual (SRMR): 0.046.

Table 3. Measurement models for alcohol advertisement identification, desirability, and skepticism among non-drinking youth living in the slums of Kampala, Uganda (N = 788)

	Estimate (95% CI)	Standardized Estimate (95% CI)	Standard Error	P-value
Identification
‘I want to have as many friends as the people in the beer ads do’	1.00 (1.00, 1.00)	0.94 (0.92, 0.97)	0.00	<0.001
‘I want to have as much fun as the people in the beer adverts’	1.05 (1.01, 1.10)	0.99 (0.97, 1.02)	0.03	<0.001
‘I wish I were as good looking as most people in the beer adverts’	0.82 (0.78, 0.87)	0.78 (0.74, 0.82)	.03	<0.001
Desirability
‘People in alcohol adverts look like they make good decisions while drinking’	1.00 (1.00, 1.00)	0.72 (0.66, 0.78)	0.00	<0.001
‘People drinking beer in adverts seem to have lots of friends’	1.21 (1.06, 1.35)	0.87 (0.81, 0.93)	0.09	<0.001
‘The women in alcohol adverts are always looking good’	1.00 (0.90, 1.11)	0.72 (0.66, 0.78)	0.06	<0.001
Skepticism
‘Alcohol adverts make drinking look like only good things happen while drinking’	1.00 (1.00, 1.00)	0.74 (0.67, 0.80)	0.00	<0.001
‘Companies that make adverts want me to buy things that I really don’t need’	0.80 (071, 0.88)	0.59 (0.53, 0.65)	0.05	<0.001
‘Alcohol adverts make drinking seem better than it is’	1.30 (1.10, 1.51)	0.96 (0.88, 1.04)	0.12	<0.001

Note. Model fit for each latent factor was just-identified. Model fit for all three factors (without any observed variables): Root Mean Square Error of Approximation (RMSEA):0.082; 95% Confidence Interval (CI): 0.070, 0.095. Comparative Fit Index (CFI): 0.988. Tucker-Lewis index (TLI): 0.982. Standardized Root Mean Square Residual (SRMR): 0.046.

Table 4. Adjusted and unadjusted odds ratios for intention to drink among youth living in the slums of Kampala, Uganda, (N = 1,134)

	Intention to drink Model 1 (Demographics + Alcohol Ad Perceptions)		Intention to drink Model 2 (Demographics + Alcohol Ad Perceptions + Friend/Parents Normative Beliefs/Attitudes)
	Unadjusted OR (95% CI)	Adjusted OR (95% CI)	Unadjusted OR (95% CI)	Adjusted OR (95% CI)
School Less than primary Completed primary Secondary or higher	1.00 0.94 (0.67, 1.32) 1.06 (0.80, 1.41)	1.00 0.98 (0.71, 1.36) 1.11 (0.85, 1.43)	1.00 0.94 (0.67, 1.32) 1.06 (0.80, 1.41)	1.00 1.04 (0.74, 1.49) 1.23 (0.93, 1.63)
Age	1.37 (1.27, 1.49)	1.01 (0.93, 1.09)	1.37 (1.27, 1.49)	1.00 (0.91, 1.09)
Gender Male Female	1.00 1.04 (0.81, 1.33)	1.00 1.04 (0.83, 1.30)	1.00 1.04 (0.81, 1.33)	1.00 1.09 (0.86, 1.40)
Alcohol advertisement identification	1.99 (1.87, 2.12)	0.72 (0.24, 2.17)	1.99 (1.87, 2.12)	0.51 (0.13, 1.90)
Alcohol advertisement desirability	2.24 (2.00, 2.52)	0.57 (0.11, 2.89)	2.24 (2.00, 2.52)	4.09 (0.40, 41.87)
Advertisement skepticism	1.48 (1.32, 1.65)	0.99 (0.69, 1.42)	1.48 (1.32, 1.65)	0.66 (0.38, 1.15)
Alcohol advertisement perceived marketing effectiveness ‘If I see a good ad for an alcohol drink, I want to try it’ Agree Neither agree nor disagree Disagree	28.98 (20.40, 41.18) 8.54 (5.08, 14.34) 1.00	3.73 (2.93, 4.74) 2.47 (1.71, 3.58) 1.00	28.98 (20.40, 41.18) 8.54 (5.08, 14.34) 1.00	3.71 (2.88, 4.78) 2.28 (1.54, 3.40) 1.00
Current drinker No Yes	1.00 56.70 (38.71, 83.07)	1.00 6.55 (5.17, 8.31)	1.00 56.70 (38.71, 83.07)	1.00 5.13 (3.93, 6.72)
‘I see alcohol ads every day’ Agree Neither agree nor disagree Disagree	1.34 (0.98, 1.82) 1.01 (0.66, 1.56) 1.00	0.90 (0.68, 1.19) 1.07 (0.76, 1.51) 1.00	1.34 (0.98, 1.82) 1.01 (0.66, 1.56) 1.00	0.87 (0.64, 1.18) 1.07 (0.74, 1.54) 1.00
Normative Friends Agree Neither agree nor disagree Disagree	–	–	1.00 3.79 (2.60, 5.51) 7.37 (5.38, 10.10)	1.00 1.18 (0.79, 1.75) 1.28 (0.93, 1.77)
Attitudes Friends Agree Neither agree nor disagree Disagree	–	–	1.00 5.05 (3.43, 7.46) 9.55 (6.99, 13.05)	1.00 1.75 (1.14, 2.68) 1.83 (1.31, 2.55)
Normative Adults Agree Neither agree nor disagree Disagree	–	–	1.00 3.31 (2.21, 4.96) 7.23 (4.61, 11.34)	1.00 0.79 (0.55, 1.13) 1.18 (0.75, 1.85)
Attitudes Parents Agree Neither agree nor disagree Disagree	–	–	1.00 6.28 (4.03, 9.80) 13.51 (7.80, 23.40)	1.00 1.23 (0.78, 1.93) 1.31 (0.76, 2.25)

Note. Significant findings are bold faced. Normative Friends: ‘Most of my friends do not plan to drink alcohol until they are older’; Attitudes Friends: ‘Most of my friends think I should not drink alcohol’; Normative Adults: ‘Most adults I know discourage people my age from drinking alcohol’; Attitudes Parents: ‘My parents would be upset if they found out that I’m drinking alcohol’.

Figure 1. Path model diagram of predictors for intention to drink among youth participating in the the Kampala Youth Survey (n = 1,134).

Note. Ad = advertisement; id = identification; des = desirability; sk = skepticism. Indicators are as follows: ID1: ‘I want to have as many friends as the people in the beer ads do;’ ID2: ‘I want to have as much fun as the people in the beer adverts;’ I wish I were as good looking as most people in the beer adverts;” DES1: ‘People in alcohol adverts look like they make good decisions while drinking;’ DES2: ‘People drinking beer in adverts seem to have lots of friends;’ DES3: ‘The women in alcohol adverts are always looking good;’ SK1: ‘Alcohol adverts make drinking look like only good things happen while drinking;’ SK2: ‘Companies that make adverts want me to buy things that I really don’t need;’ SK3: ‘Alcohol adverts make drinking seem better than it is’.

Table 5. Adjusted and unadjusted odds ratios for intention to drink among non-drinking youth living in the slums of Kampala, Uganda, (n = 788)

	Intention to drink Model 1 (Demographics + Alcohol Ad Perceptions)		Intention to drink Model 2 (Demographics + Alcohol Ad Perceptions + Friend/Parents Normative Beliefs/Attitudes)
	Unadjusted OR (95% CI)	Adjusted OR (95% CI)	Unadjusted OR (95% CI)	Adjusted OR (95% CI)
School Less than primary Completed primary Secondary or higher	1.00 0.97 (0.68, 1.37) 1.28 (0.96, 1.70)	1.00 0.92 (0.60, 1.42) 1.32 (0.93, 1.86)	1.00 0.97 (0.68, 1.37) 1.28 (0.96, 1.70)	1.00 0.93 (0.58, 1.53) 1.39 (0.96, 1.99)
Age	1.04 (0.96, 1.13)	0.99 (0.64, 1.52)	1.04 (0.96, 1.13)	1.00 (0.89, 1.12)
Gender Male Female	1.00 1.08 (0.84, 1.39)	1.00 1.09 (0.81, 1.48)	1.00 1.08 (0.84, 1.39)	1.00 1.17 (0.85, 1.62)
Alcohol advertisement identification	1.47 (1.22, 1.76)	0.83 (0.33, 2.28)	1.47 (1.22, 1.76)	0.80 (0.29, 2.20)
Alcohol advertisement desirability	1.71 (1.19, 2.46)	1.29 (0.23, 7.26)	1.71 (1.19, 2.46)	1.43 (0.24, 8.44)
Advertisement skepticism	1.22 (0.94, 1.58)	0.88 (0.52, 1.48)	1.22 (0.94, 1.58)	0.88 (0.52, 1.48)
Alcohol advertisement perceived marketing effectiveness ‘If I see a good ad for an alcohol drink, I want to try it’ Agree Neither agree nor disagree Disagree	3.83 (2.83, 5.18) 2.50 (1.59, 3.93) 1.00	3.95 (2.88, 5.41) 2.57 (1.62, 4.09) 1.00	3.83 (2.83, 5.18) 2.50 (1.59, 3.93) 1.00	3.90 (2.80, 5.42) 2.19 (1.30, 3.68) 1.00
‘I see alcohol ads every day’ Agree Neither agree nor disagree Disagree	1.06 (0.91, 1.23) 1.09 (0.95, 1.26) 1.00	1.03 (0.71, 1.49) 1.39 (0.91, 2.13) 1.00	1.06 (0.91, 1.23) 1.09 (0.95, 1.26) 1.00	(0.68, 1.52) 1.30 (0.82, 2.06) 1.00
Normative Friends Agree Neither agree nor disagree Disagree	–	–	1.00 1.54 (1.15, 2.07) 1.72 (1.25, 2.36)	1.00 1.12 (0.66, 1.89) 1.09 (0.72, 1.66)
Attitudes Friends Agree Neither agree nor disagree Disagree	–	–	1.00 1.69 (1.24, 2.31) 2.05 (1.46, 2.90)	1.00 2.13 (1.21, 3.74) 1.36 (0.87, 2.12)
Normative Adults Agree Neither agree nor disagree Disagree	–	–	1.00 1.82 (1.19, 2.76) 1.93 (1.17, 3.20)	1.00 0.95 (0.60, 1.58) 1.79 (0.88, 3.63)
Attitudes Parents Agree Neither agree nor disagree Disagree	–	–	1.00 1.35 (0.59, 3.07) 1.44 (0.84, 2.47)	1.00 0.80 (0.40, 1.59) 0.71 (0.16, 3.21)

Note. Normative Friends: ‘Most of my friends do not plan to drink alcohol until they are older’; Attitudes Friends: ‘Most of my friends think I should not drink alcohol’; Normative Adults: ‘Most adults I know discourage people my age from drinking alcohol’; Attitudes Parents: ‘My parents would be upset if they found out that I’m drinking alcohol’.

Figure 2. Path model diagram of predictors for intention to drink among non-drinking youth participating in the Kampala Youth Survey (n = 746).

Note. Ad = advertisement; id = identification; des = desirability; sk = skepticism. Indicators are as follows: ID1: ‘I want to have as many friends as the people in the beer ads do;’ ID2: ‘I want to have as much fun as the people in the beer adverts;’ I wish I were as good looking as most people in the beer adverts;” DES1: ‘People in alcohol adverts look like they make good decisions while drinking;’ DES2: ‘People drinking beer in adverts seem to have lots of friends;’ DES3: ‘The women in alcohol adverts are always looking good;’ SK1: ‘Alcohol adverts make drinking look like only good things happen while drinking;’ SK2: ‘Companies that make adverts want me to buy things that I really don’t need;’ SK3: ‘Alcohol adverts make drinking seem better than it is’.