Have restrictions on alcohol advertising in Ireland affected awareness among adults? A comparative observational study using non-probability repeat cross-sectional surveys

Abstract

Objective: Since November 2019, Ireland has restricted alcohol advertising at the cinema and outdoors (e.g., near schools), and banned alcohol advertising on public transport. Although awareness of such advertising had decreased one year after the restrictions, measures to limit COVID-19 transmission complicated interpretation. We examine: (1) changes in awareness two years post-restrictions, when COVID-19 mitigation measures had eased; and (2) how changes in Ireland compare to Northern Ireland, where the restrictions do not apply. Method: Repeat cross-sectional surveys of adults recruited from non-probability online panels, with three waves in Ireland (October 2019 [pre-restrictions] and October 2020/2021 [post-restrictions]; n=3,029) and two in Northern Ireland (October 2020/2021; n=1,011). Participants self-reported past-month awareness of 13 alcohol marketing activities, including public transport, cinema, and outdoor advertising (coded: Any past-month awareness/No awareness/Not sure). Results: In Ireland, the odds of reporting no past-month awareness (vs. any) were higher in 2021 and 2020 versus 2019 for all restricted advertising activities (e.g., 2021 vs. 2019 for public transport: ORAdj=1.88, 95% CI: 1.53-2.32). Interactions between wave and jurisdiction indicated that in 2021, compared to 2020, the odds of reporting no past-month awareness of public transport and cinema advertising (vs. any) were higher in Ireland than Northern Ireland, despite increased opportunities for exposure in both jurisdictions through eased pandemic mitigation measures. There was no interaction for outdoor advertising, suggesting between-wave trends did not differ by jurisdiction. Conclusions: Ireland’s restrictions have reduced past-month awareness of alcohol advertising at the cinema and on public transport, but not outdoor. Continued monitoring is required.