INTRODUCTION: Exposure to alcohol advertising is a key influence on adolescent alcohol consumption. Zero-alcohol drinks (< 0.5% alcohol by volume) resemble and often share brands with alcoholic drinks, so may function as surrogate alcohol marketing. We examined whether exposure to zero-alcohol advertising was associated with adolescents' attitudes and consumption intentions towards alcohol.

METHODS: N = 382 Australians aged 15-17 years completed a cross-sectional online survey where they viewed zero-alcohol advertisements from four parent alcohol brands and reported past exposure and liking of each advertisement, attitudes and consumption intentions towards alcohol products from the parent brand, general attitudes and consumption intentions towards alcohol, self-reported location-based exposure to zero-alcohol advertising, prior alcohol and zero-alcohol consumption, and demographics. Associations between exposure and liking, attitudes, and consumption intentions were examined using linear mixed effect models and linear regression.

RESULTS: Adjusting for prior zero-alcohol and alcohol consumption, gender and parent presence during survey completion, attitudes towards and intentions to consume alcohol from the parent brand were associated with previous zero-alcohol advertisement exposure (attitudes: B = 0.22, p = 0.005; intentions: B = 0.20, p = 0.002) and zero-alcohol advertisement liking (attitudes: B = 1.42, p < 0.001; intentions: B = 0.67, p < 0.001). No associations were found between self-reported location-based exposure to zero-alcohol advertising and general attitudes and consumption intentions towards alcohol.

DISCUSSION AND CONCLUSIONS: Findings that adolescents who see and like zero-alcohol advertisements have more favourable attitudes towards and stronger intentions to consume parent alcohol brands suggest that zero-alcohol advertisements may serve as surrogate alcohol marketing, supporting calls to include them within alcohol advertising regulations.