{
  "abstract": "Introduction Alcohol consumption is a leading cause of premature mortality in Europe, with adolescents particularly vulnerable to marketing influences. While alcohol marketing bans are considered a WHO ‘best buy’, evidence of their effectiveness remains limited. Lithuania’s 2018 full national ban on alcohol marketing offers a unique opportunity to assess its impact on adolescent drinking. This study evaluated whether adolescents in Lithuania reported greater declines in alcohol use compared with peers in European Union countries without a full ban.Methods We conducted a difference-in-difference analysis using generalised linear regression models to assess alcohol use among adolescents. We used data from the European School Survey Project on Alcohol and Other Drugs for 15–16 year-olds in Lithuania and five comparator countries (Estonia, France, Italy, Latvia and Poland) across four waves (2007, 2011, 2015 and 2019; n=84 189). The study follows a prespecified and published protocol. The primary outcome was self-reported frequency of intoxication in the past 12 months, assessed by negative binomial regression models adjusted for individual and country-level covariates.Results Compared with statutory control for some alcoholic beverages, a full marketing ban was associated with a 35% reduction in frequency of intoxication (incidence rate ratios (IRR) 0.65 (95% CI 0.56 to 0.77)). Sensitivity analyses confirmed this association. Without the ban, predicted intoxication frequency in 2019 would have been nearly twice as high (1.28 vs 0.73 occasions). Additional analyses showed significant reductions in the odds of any intoxication (OR 0.68 (95% CI 0.60 to 0.78)). Protective associations were also observed for alcohol use (IRR 0.88 (95% CI 0.79 to 0.99)) and binge drinking (IRR 0.82 (95% CI 0.72 to 0.92)).Conclusions The implementation of full alcohol marketing bans was associated with reduced risky drinking behaviours among adolescents in Lithuania. Our findings support full bans as a central component of alcohol control, especially in the digital age, where partial restrictions are easily circumvented.",
  "authors": [
    {
      "affiliations": [
        "Department of Mathematics, Faculty of Sciences, University of Porto, Porto, Portugal",
        "EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal",
        "Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal"
      ],
      "name": "Daniela Correia"
    },
    {
      "affiliations": [
        "Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany",
        "Department of Psychiatry, University of Leipzig Faculty of Medicine, Leipzig, Germany"
      ],
      "name": "Jakob Manthey"
    },
    {
      "affiliations": [
        "Department of Global Public Health, Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Anastasia Månsson"
    },
    {
      "affiliations": [
        "Department of Global Public Health, Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Peter Allebeck"
    },
    {
      "affiliations": [
        "Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany",
        "Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden",
        "Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary"
      ],
      "name": "Ludwig Kraus"
    },
    {
      "affiliations": [
        "Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany",
        "Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada",
        "Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada",
        "Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada",
        "Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Spain",
        "World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada",
        "Institute of Medical Science, Temerty Faculty of Medicine, Toronto, Ontario, Canada"
      ],
      "name": "Jürgen Rehm"
    }
  ],
  "title": "Full alcohol marketing ban and adolescent drinking patterns: a repeated cross-sectional analysis comparing Lithuania with other EU countries",
  "uid": "9faeb283-04b3-53a8-b101-69ce79bdfe1f"
}