Adolescence and young adulthood represent critical periods characterized by escalating alcohol use and heightened vulnerability to marketing influences. The proliferation of digital media has intensified alcohol marketing across social media and digital platforms, yet regulatory oversight remains inadequate with most countries relying on industry self-regulation lacking independent monitoring or enforcement. While prior research has established associations between alcohol marketing exposure and increased brand awareness, product appeal, and drinking behaviors among adolescents and young adults, no studies have quantitatively synthesized the pooled effects of digital alcohol marketing exposure across diverse populations or examined how platform types relate to alcohol use behaviors. Therefore, the present study aims to estimate the overall associations between digital alcohol marketing exposure and past 30-day alcohol use, binge drinking, susceptibility among never users, and lifetime alcohol use.
This study conducted a systematic review by searching six online databases using alcohol-related, digital media-related, and marketing-related search terms. Peer-reviewed English-language articles published between January 2004 and February 2025 were included. Eligible studies were required to assess self-reported exposure to digital alcohol marketing content, include an unexposed control group, measure at least one of three outcomes (past 30-day alcohol use, binge drinking, or susceptibility to alcohol use among never users), and provide either raw data for calculating odds ratios (ORs) or report ORs directly. Multilevel random-effects meta-analysis was applied to estimate pooled ORs with 95% confidence intervals, and heterogeneity (I²) was calculated for each alcohol use outcome.
This meta-analysis included 31 articles. Compared with unexposed individuals, those exposed to digital alcohol marketing content demonstrated significantly higher likelihood of past 30-day alcohol use (19 studies, 46,361 participants). Subgroup analyses revealed that recent exposure (within the past 30 days) was associated with greater likelihood of past 30-day alcohol use compared with lifetime exposure. Stronger associations were observed among participants exposed via social media platforms versus other web-based platforms, and among adolescents compared with adults. Exposure to digital alcohol marketing content was also associated with increased risk of binge drinking (13 studies, 25,603 participants), with subgroup analyses indicating that past 30-day exposure demonstrated stronger associations than lifetime exposure. Furthermore, exposed participants showed elevated likelihood of susceptibility to alcohol use among never users (7 studies, 18,698 participants) and lifetime alcohol use (14 studies, 31,953 participants) compared with unexposed individuals.
Takeaway: Exposure to digital alcohol marketing content is significantly associated with increased alcohol use behaviors, including past 30-day use, binge drinking, susceptibility among never users, and lifetime use.