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.