Background

Based on recommendations by the World Health Organization (WHO), the Alcohol Framework 2018 in Scotland aims to reduce alcohol-related harm, including restricting alcohol marketing.1,2 A 2022 report by Public Health Scotland sought to examine alcohol marketing restrictions in seven European countries (Estonia, Finland, France, Ireland, Lithuania, Norway, and Sweden) in order to inform consideration of alcohol marketing policy in Scotland.3

Key findings

Justifications for restricting alcohol marketing

The introduction of alcohol marketing restrictions in the seven countries aims to reduce population-level alcohol use and harmful drinking but specifically focused on protecting children from exposure to alcohol advertising. Public support for such measures was common, especially for safeguarding children, although Finland and France identified a need to find a balance between promoting health and supporting local business and the economy.

Controlling the content of alcohol advertising

A total ban on alcohol advertising was noted in Lithuania and Norway, while the remaining countries restrict the content of alcohol advertising (e.g., product name, manufacturer name, country of origin, ethanol content). The report indicated that restrictions to alcohol marketing include the banning of advertising that exhibits alcohol use as ‘healthy, normal, therapeutic or desirable; content that associates alcohol with driving; content that associates alcohol with sexual success; encouragements to buy or consume alcohol; and content that links alcohol with important dates or activities’ (p. 5). The use of children and young people in alcohol marketing is prohibited as is content targeting them. Health warnings are also mandatory in Estonia, France, Ireland, and Sweden.

Alcohol advertising restrictions by medium

Alcohol marketing restrictions varied between the countries investigated, from restrictions on advertising in locations frequented by children and young people to complete bans.

• Under French law, all alcohol advertising is banned, except where permitted under the Évin Law.
• In Finland, alcohol marketing is restricted based on the alcohol by volume (ABV) of the product.
• In Lithuania, Sweden, and Norway, broadcast watersheds are in place. The remaining four countries have legislation for partial broadcast watersheds.
• Only Lithuania has an outright ban on alcohol marketing online and on social media, while there are partial bans in the remaining countries, with the exception of Ireland where no restrictions in alcohol marketing apply online or on social media.
• France, Lithuania, and Norway have a ban on sports and event sponsorship, while Estonia, Finland, and Ireland have partial bans, typically depending on the extent to which the event is attended or performed by children.
• Alcohol advertising in cinemas is prohibited in France, Lithuania, and Norway, while the remaining countries have partial bans, for example, for films certified for viewing by those aged less than 18 years in Ireland or for strong ABV products in Finland.
• All seven countries prohibit outdoor alcohol advertising to some extent, with complete bans in Estonia, Finland, Lithuania, and Norway.
• Only Lithuania has a complete ban on alcohol advertising in print media, while partial bans are in place in the remaining countries. For example, alcohol advertising is allowed in foreign magazines in Norway and only banned in children’s magazines in France. 

Restrictions on product packaging and sales practices

Estonia, France, Ireland, and Sweden have legislation that requires health warning messages to be displayed on alcohol products, including highlighting the association between alcohol use and cancer, the risks of drinking while pregnant, the calorie content, and an independent website providing impartial and factual information about alcohol-related harms. Structural separation is in place in Ireland and Estonia to reduce the visibility of alcohol to children, to discourage buying alcohol as part of regular grocery shopping, and to deter impulse buying of alcohol. In Norway, marketing of no alcohol and low alcohol products of the same brand as alcoholic products is banned and applies to food and clothing also.

Variation by product strength

The ABV of products dictates marketing restrictions in some countries. For example, in Ireland, Lithuania, and Estonia, advertising restrictions apply to products over 0.5% ABV and over 2.5% ABV in Norway and Sweden. In Finland, products over 22% ABV are subject to strict advertising bans, with products below this ABV permitted but with exceptions based on time of broadcast, audience, and content. Products over 15% ABV are governed by stricter restrictions in Sweden, while products with ABV of 2.25% or lower are not included in their legislation, with the exception that marketing of these products must not be able to be mistaken for stronger products.

Monitoring and enforcement

All countries reviewed in the report have statutory bodies monitoring and enforcing compliance with restrictions, with the exception of France and Ireland who have a combination of statutory and non-statutory bodies. In Ireland, the Environmental Health Service is the statutory body while the Advertising Standards Authority for Ireland (ASAI), which is funded by the advertising industry, acts as the non-statutory body.

Those countries with statutory bodies monitoring and enforcing adherence to the legislation involve issuing penalties for illegal marketing, including suspending licences and issuing fines or imprisonment. Non-statutory bodies provide guidance on advertising practices and can demand removal of unacceptable marketing and potentially issue fines or escalate issues to statutory bodies.

International collaboration to monitor and enforce marketing legislation was absent in the review and the authors note that this is relevant to online and broadcast marketing, as it can be accessed beyond the borders of their countries of origin.

Evaluations of restrictions

An absence of comprehensive evaluations of alcohol marketing in the seven countries was noted. As marketing restrictions were often introduced as part of a suite of alcohol legislation measures, it is more often than not difficult to isolate the effects of a particular measure. The authors recommend that monitoring and evaluation plans be incorporated into new alcohol restriction legislation. The report outlines a number of studies that investigated the effects of the marketing restrictions introduced.

• In Norway, the evidence indicates that its legislation banning alcohol advertising resulted in a 7.4% reduction in alcohol sales.4
• In Lithuania, marketing restrictions are deemed responsible for a decline in alcohol-related mortality.5
• Research following the introduction of social media marketing restrictions in Finland found an initial decline in alcohol industry posts; however, user engagement increased, indicating that those advertising alcohol found ways to circumvent restrictions.6
• Awareness of alcohol marketing declined following the introduction of legislation restricting advertising in Ireland.7 

Conclusion

The seven countries included in the review have incorporated alcohol polices restricting alcohol marketing based on WHO recommendations to reduce alcohol use and related harms. Such policies receive public support, particularly to prevent alcohol marketing exposure to children and young people. There is limited evidence demonstrating the effectiveness of such legislation. However, where available, a banning or a reduction in alcohol marketing has resulted in reduced alcohol use, especially harmful and hazardous drinking, and consequently a reduction in alcohol-related harms. 

1  World Health Organization (2010) Global strategy to reduce the harmful use of alcohol. Geneva: World Health Organization. https://www.drugsandalcohol.ie/14845/

2  Scottish Government (2018) Alcohol Framework 2018: Preventing harm – next steps on changing our relationship with alcohol. Edinburgh: Scottish Government. https://www.drugsandalcohol.ie/29983/

3  Scobie G, Patterson C, Rendall G, et al. (2022) Review of alcohol marketing restrictions in seven European countries. Glasgow: Public Health Scotland. https://www.drugsandalcohol.ie/36444/

4  Rossow I (2021) The alcohol advertising ban in Norway: effects on recorded alcohol sales. Drug Alcohol Rev, 40: 1392–1395.

5  Stumbrys D, Telksnys T, Jasilionis D, et al. (2020) Alcohol-related male mortality in the context of changing alcohol control policy in Lithuania 2000–2017. Drug Alcohol Rev, 39(7): 818–826.

6  Katainen A, Kauppila E, Svensson J, et al. (2020) Regulating alcohol marketing on social media: outcomes and limitations of marketing restrictions of Finland’s 2015 Alcohol Act. J Stud Alcohol Drugs, 81(1): 39–46.

7  Critchlow N and Moodie C (2021) Awareness of alcohol marketing one year after initial implementation of Ireland’s Public Health (Alcohol) Act and during the COVID-19 pandemic. J Public Health, Early online. https://www.drugsandalcohol.ie/34954/