DESCRIPTION (provided by applicant): This R01 application is written in response to PA-11-015, Alcohol Marketing and Youth Drinking, which aims to answer whether there is a "direct causal relation between exposure to alcohol marketing and alcohol attitudes/behaviors among youth." The application supports a multi-disciplinary team of epidemiologists, neuroscientists and psychologists that will rapidly accumulate evidence for important causality prerequisites: a) a content analysis will establish whether the themes included in contemporary alcohol advertising could be salient to adolescents and promote hazardous drinking (theoretical plausibility), b) fMRI experiments will assess whether alcohol ad exposure engages brain patterns consistent with a marketing effect (biological plausibility), c) population based survey research will assess whether there is an association between alcohol marketing and adolescent behavior, assessing causal constructs of strength, dose-response, independence, and specificity (epidemiologic plausibility), and d) whether that association is mediated through marketing- specific cognitions (psychological plausibility). The proposal revolves around an innovative heuristic model that the association between alcohol marketing exposure and hazardous/harmful drinking among experimental drinkers is mediated through marketing-specific cognitions-drinker identity and having a favorite alcohol brand-tested using cutting-edge analyses. The content analysis involves a thematic and image-based assessment of over 700 alcohol ads televised nationally over a two-year period, ads that also form the basis for cues presented in the neuroscience and epidemiologic research. Proposed brain imaging studies examine the neural correlates of cue reactivity to dynamic viewing of alcohol brand advertisements among underage undergraduates. Reward activity and activation of drinking-relevant motor planning circuitry is expected in response to viewing the ads, and response levels should predict future drinking behavior. Consistent with our model of marketing effects proposing favorite brand to drink as a key mediating cognition, activity in brain regions associated with self-relevance is expected for favorite vs. other alcohol brand ads-evidence that the brain is processing favorite brand in the context of self. The proposed population-based research builds on ARRA-funded research that recruited 3342 subjects aged 15 to 23 from across the United States in 2010. In this cohort, we have employed an innovative cue-based assessment of alcohol marketing exposures across entertainment media (TV programming, movies and music), advertising on TV and the internet, in which adolescents respond to images randomly drawn from large samples of contemporary media. Our initial findings demonstrate an association between cued responses to alcohol ads and binge drinking and expected mediation paths. A comprehensive review of the published literature will be conducted in year 5. Taken together, the proposed research allows us to rapidly propel the science forward and make significant advances in our understanding of whether the relation between alcohol marketing and drinking behavior is causal.

PUBLIC HEALTH RELEVANCE: This proposal seeks to better understand the extent to which alcohol marketing affects underage drinking. We assess exposure to multiple forms of alcohol marketing and their association with youth drinking in a U.S. sample followed forward in time. We also assess how their brains respond to the imagery depicted in alcohol ads, in order to guide evidence-based policies to limit the impact of alcohol marketing on this age group.