BACKGROUND: Exposure to alcohol portrayals in movies has been associated with increased alcohol use. Several studies have examined the prevalence and frequency of alcohol portrayals in movies, but systematic synthesis of this evidence is lacking. This review aimed to estimate the pooled proportion of movies that portrayed alcohol and the average frequency of such portrayals per movie.

METHODS: Systematic searches were conducted across three major databases (MEDLINE, PsycINFO, and Web of Science). Eligible articles were selected through title and abstract screening, and full-text review. Studies that assessed and reported the prevalence of alcohol portrayals in movies were eligible and included. Pooled prevalence with 95% confidence intervals was computed using a random effects model.

RESULTS: A meta-analysis of 20 studies showed that 84.0% of movies portrayed alcohol at least once (95% CI: 78.0-89.0). We found that 24.0% (95% CI: 16.0-33.0) of 5-minute movie segments portrayed alcohol. The pooled estimate of mean number of alcohol portrayal scenes per movie was 21.3 (95% CI: 3.7-46.4), and alcohol portrayed on screen for 263.1 s per movie (95% CI: 184.5-341.7). Narrative synthesis showed that most studies were conducted in the United States, majority employed cross-sectional content analysis designs, and varied in how alcohol portrayals was operationalised, with most reporting presence and frequency metrics, while additional features such as branding or valence were inconsistently measured.

CONCLUSIONS: Media consumption, especially movies, has proliferated and diversified during the last decades due to the surge of smart devices and online streaming platforms. This study revealed that the vast majority of movies portrayed alcohol and alcohol portrayal appears frequently. Given the well-established link between on-screen alcohol portrayal and subsequent drinking behaviours, policy should aim to target alcohol portrayal in movies (i.e., include alcohol portrayal when classifying movies, ban alcohol product placement).