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Objectives. To update public health surveillance of alcohol advertising to underage populations by assessing alcohol industry compliance with their voluntary guidelines for US magazine advertisements from 2001 to 2011.

Methods. Using advertising industry standard sources The Nielsen Company and MediaMark, we evaluated youth exposure to alcohol advertising, and relative advertising exposure of youths versus adults, in 168 national magazines.

Results. From 2001 to 2011, magazine alcohol advertising seen by youths declined by 62.9%, from 5.4 billion impressions (single person seeing a single advertisement) to 2.0 billion impressions. Most alcohol advertising (65.1% of ads) was for spirits (e.g., vodka, whiskey). Since 2008, alcohol companies achieved 100% compliance with their limited guidelines. However, youths were overexposed to magazine advertising relative to adults on average 73% of the time.

Conclusions. Despite improving compliance with placement guidelines in national editions of the 168 measured magazines, most youth exposure to magazine alcohol advertising exceeded adult exposure, per capita. If alcohol companies adopted stricter guidelines based on public health risk assessments, youths would not be overexposed to alcohol advertising in magazines. (Am J Public Health. 2017;107:136-142. doi:10.2105/ AJPH.2016.303514)

Each year in the United States, excessive alcohol use is responsible for an average of 4350 deaths and 263 500 years of potential life lost among persons under the legal drinking age of 21 years.1 In 2010 alone, underage drinking cost the US economy $24.3 billion.2 Moreover, reducing underage drinking is an important public health goal because it is associated with a wide range of health and social problems, including motor vehicle accidents and other unintentional injuries, violence perpetration, and suicide completions.3

Risk factors for underage drinking initiation identified in previous research include parent drinking,4 peer drinking,5 personality characteristics such as low self-esteem,6 and environmental factors such as availability, pricing, and other alcohol policies.7 Alcohol marketing exposure has been prospectively associated with both increased drinking and negative health consequences as a result of drinking.8 Multiple longitudinal studies link exposure to alcohol marketing to an increased risk that youths will initiate drinking or drink more heavily if already drinking.9

Alcohol advertising in magazines represents a special case ofalcohol media exposure. First, magazines are a highly targeted medium with broad reach, providing an efficient means of reaching segmented audience groups. For example, Sports Illustrated offers...

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