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It is a school day. Morning. Students in varying stages of wakefulness. Dragging themselves to school. Riding in subway cars. Standing on subway platforms. Many listen to music. Some read. Some put eyes on a screen.
The subway cars display advertisements for alcohol. Subway platforms display advertisements for alcohol. Students glance at the advertisements. The advertisements have been crafted to be eye catching and persuasive.
Ads like that are as puzzling as they are troubling to Christopher McKay, Youth Minister at the Church of God of Prophecy in the Bronx. “You wouldn’t allow school buses to have alcohol advertising and, essentially, for young people in New York City the trains are their school buses, and they are seeing ads every single day that are trying to get them to start drinking early,” McKay says. “It’s pretty blatant that young people who really can’t fend for themselves are being targeted.”
McKay adds: “When I was in Riverdale I didn’t see the same type of advertisements.”
He’s right: The distribution of subway alcohol ads is not random. Ads pushing alcohol have been placed significantly more frequently on subway platforms for riders going uptown to the Bronx than for riders heading into midtown, according to a 2016 study in the International Journal of Adolescent Medicine and Health.
Other cities have displayed a similar pattern. “There is clear evidence from our 2011 study of the Boston transit system that alcohol ads are disproportionately targeted toward vulnerable communities,” said Michael Siegel, a professor at the Boston University School of Public Health.
The pattern exists elsewhere A 2009 study from Chicago in Ethnic Health found “Youth attending schools with 20 percent or more Hispanic students were exposed to 6.5 times more alcohol advertising than students attending schools with less than 20 percent Hispanic students.” And “schools with 20 percent or more Hispanic students were also surrounded by more beer advertising and alcohol advertisements on bars and liquor stores.”
In 2012 Boston’s transit system adopted a policy of not accepting alcohol ads. Now, some are calling for New York’s MTA to follow suit.
“In New York City, public transit is the principal mode of transportation for most people, including adolescents. So seeing this kind of advertising on public transit becomes unavoidable,” says David H. Jernigan, PhD, Associate Professor at the Johns Hopkins Bloomberg School of Public Health, and Director of the CDC-supported Center on Alcohol Marketing and Youth. “The bottom line is that this is a public health issue. We want to reduce kids’ exposure to alcohol advertising.”
City Limits contacted the MTA about the subway’s alcohol ads. A spokesperson for the MTA, Kevin Ortiz, responded by sending a copy of the MTA’s current Advertising Policy, effective April of 2015. These guidelines prohibit the advertising of tobacco and tobacco-related products and prohibit advertising promoting or opposing the election of a candidate for federal, state, or local office. Clearly, then, the MTA is willing to prohibit specific categories of advertisements. But current MTA Policy says nothing at all about alcohol.
Ads matter
According to the study in the International Journal of Adolescent Medicine and Health, on a single subway line traversing the Bronx and Manhattan, “a total of 26 advertisements were identified which marketed an alcohol product. An additional 24 ads were noted for marketing another product or service whereby, alcohol was depicted as being consumed.” There was an “average of 1.5 ads on the uptown lines (heading toward and through the borough with the lowest median income) versus 0.06 ads on the downtown lines (heading toward and through the borough with the highest median income).” The findings attained statistical significance.
The ads could have real-life consequences. A 2009 study in the American Journal of Public Health evaluated the relationship between residential exposure to outdoor alcohol advertising and current problem drinking among 139 African American women aged 21 to 49 years in Central Harlem and “found that exposure to advertisements was positively related to problem drinking (13 percent greater odds), even after we controlled for a family history of alcohol problems and socioeconomic status. The results suggest that the density of alcohol advertisements in predominantly African American neighborhoods may add to problem drinking behavior of their residents.”
Investigating the placement of alcohol ads in central Harlem, a 2007 study inAlcohol & Alcoholism concluded, “Predominantly Black neighborhoods continue to face high exposure to outdoor alcohol advertising, including around sites at which youth congregate.”
“The attitudes of people, the pictures that come to mind in relation to drinking, the image of what a mature person’s relation to alcohol is, these things matter,” said Diana Silver, a professor of global public health and public health policy at New York University. “The amount of alcohol advertising, the content of it, and the placement of advertising is related to how we think about drinking.”
Indeed, research suggests that alcohol advertising works, and works very specifically: Young people are more likely to drink the kind of alcohol that is marketed to them, even if it’s a costlier choice. “Youth are sensitive to alcohol branding” and are “not simply drinking what they can come by cheaply, but rather they are responsive to the brand itself,” concluded a national US survey of 1,032 youth aged 13 to 20 who had consumed at least one drink of alcohol within the past 30 days.
That 2014 study in Substance Use & Misuse found that for each of the following categories the most popular brand for drinkers aged 13 to 20 was never the least expensive: Bud Light among beers, Smirnoff Malt among FABs, Jack Daniels among bourbons, Captain Morgan among rums, and Smirnoff among vodkas; and within the 30 days surveyed, each of these brands had been consumed by more than 100 of those surveyed.
“Over twenty longitudinal studies have found an association between youth exposure to alcohol marketing and youth drinking behavior – the more kids are exposed to alcohol advertising the more likely they are to start drinking or if already drinking to drink more,” Jernigan explains. “Given the possibility that kids may be influenced by exposure to alcohol advertisements on public transportation, there is public health interest in limiting that exposure.”
The rates and the risks
Research demonstrates that New York City teens often drink, and that drinking can have a serious effect on adolescent development.
According to a 2014 report by the Centers for Disease Control and Prevention (CDC), among New York City
high school students 26.5 percent of females and 22.7 percent of males drink alcohol; 10.4 percent of males and 11 percent of females report having five or more drinks in a row; and 1.1 percent of females and 2.1 percent of males report having ten or more drinks in a row. Notably, for each of the categories mentioned in this paragraph the CDC presents data for twenty-one large urban US school districts, and New York City high school students’ rates of alcohol use is considerably below the median in each one of the categories.
A 2008 study in the Journal of Adolescent Health of more than 700 sixth-grade girls in seven New York City schools serving low-income families found that only four of the parents were aware their daughters had used alcohol within the past year. In contrast, 22 percent of the girls themselves reported drinking during that period.
According to the December, 2008 issue of the New York City Department of Health and Mental Hygiene’s publication Vital Signs, “Teens who drank alcohol in the past month were nearly twice as likely to report having been pregnant or gotten someone pregnant as those who did not drink (9 percent vs. 4 percent).” Further, “recently sexually active boys who drank or used drugs before the last time they had sex were three times as likely to report ever getting a girl pregnant as boys who did not report alcohol or drug use before sex (34 percent vs. 10 percent).”
A study in the American Journal of Public Health in 2005 looking at 1034 African American and Hispanic youths attending middle school in Brooklyn found that “early drinkers were more likely to report subsequent alcohol problems, unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy.”
According to the CDC, alcohol plays a substantial role in all three of the leading causes of death among youth: unintentional injuries, suicides and homicides.
A 2012 in the Proceedings of the National Academy of Sciences found that alcohol affects the structural maturation of the brain. The study of 735 people aged 4 to 21 years showed that heavy underage drinkers had reduced brain volume in brain areas associated with “executive attention, cognitive control, and self regulation.”
In 2011, there were over 6,000 alcohol-related emergency department visits among New Yorkers under age 21. Heavy and binge drinking is associated with injuries, assaults, unwanted pregnancies, date rape, unsafe sex, being too intoxicated to know if sex was consensual, and suicide attempts.
According to the CDC, Americans who start drinking prior to age 15 remain at vastly increased risk of developing alcohol dependence later. Long term, heavy and binge drinking are associated with heart attack and stroke, with cancers of the mouth, tongue, throat, and female breast, with motor vehicle crashes and pedestrian injuries, with fetal alcohol syndrome.
Call for an ad ban
Launched in 2016,the Building Alcohol Ad Free Transit (BAAFT) campaign counts approximately 160 supporting organizations, including public health groups, hospitals, prevention coalitions, faith-based organizations, small businesses,” according to Robert Pezzolesi, who founded the New York Alcohol Policy Alliance in 2010.
According to Pezzolesi, BAAFT brought the issue to City Councilmember Daniel Dromm (Queens), who, last December, with 11 co-sponsors, introduced a resolution “calling on the Metropolitan Transit Authority, the Governor, and the State Legislature to prohibit advertising for alcoholic beverages on subways, buses, and other New York City Transit property.”
While banning alcohol ads in the subways would cost the MTA some advertising revenue, it could save the city the health costs associated with alcohol. Alcohol use disorder-related “hospitalizations of underage drinkers in the United States cost approximately $755 million—with more than half this total cost attributable to youth who sustained injuries,” according to a 2016 study in Substance Use and Misuse. It’s unclear what New York’s share of that total would be—just as it’s unlikely that hospital expenses are the only costs that youth drinking imposes.