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While alcohol marketing bans are considered a WHO \u2018best buy\u2019, evidence of their effectiveness remains limited. Lithuania\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u201316\u2009year-olds in Lithuania and five comparator countries (Estonia, France, Italy, Latvia and Poland) across four waves (2007, 2011, 2015 and 2019; n=84\u2009189). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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)\u202f0.65 (95%\u2009CI 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\u202f0.68 (95%\u2009CI 0.60 to 0.78)). Protective associations were also observed for alcohol use (IRR\u202f0.88 (95%\u2009CI 0.79 to 0.99))\u2009and binge drinking (IRR\u202f0.82 (95%\u2009CI 0.72 to 0.92)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004245","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:35:50Z","timestamp":1775842550000},"page":"e004245","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Full alcohol marketing ban and adolescent drinking patterns: a repeated cross-sectional analysis comparing Lithuania with other EU countries"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8886-3211","authenticated-orcid":false,"given":"Daniela","family":"Correia","sequence":"first","affiliation":[{"name":"Department of Mathematics, Faculty of Sciences, University of Porto, Porto, Portugal"},{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Manthey","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Psychiatry, University of Leipzig Faculty of Medicine, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"M\u00e5nsson","sequence":"additional","affiliation":[{"name":"Department of Global Public Health, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Allebeck","sequence":"additional","affiliation":[{"name":"Department of Global Public Health, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig","family":"Kraus","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden"},{"name":"Institute of Psychology, ELTE E\u00f6tv\u00f6s Lor\u00e1nd University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-0385","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Rehm","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada"},{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"2026041010352032000_4.2.e004245.1","unstructured":"World Health Organization . Global status report on alcohol and health and treatment of substance use disorders. Geneva, 2024."},{"key":"2026041010352032000_4.2.e004245.2","unstructured":"ESPAD Group . ESPAD report 2019: results from the european school survey project on alcohol and other drugs. Luxembourg, 2020."},{"key":"2026041010352032000_4.2.e004245.3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/add.13591","article-title":"Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008","volume":"112 Suppl 1","author":"Jernigan","year":"2017","journal-title":"Addiction"},{"key":"2026041010352032000_4.2.e004245.4","unstructured":"World Health Organization . Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva, 2013. 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The Relationship Between Exposure to Alcohol Marketing and Underage Drinking Is Causal. J Stud Alcohol Drugs Suppl 2020;113\u201324. doi:10.15288\/jsads.2020.s19.113","DOI":"10.15288\/jsads.2020.s19.113"},{"key":"2026041010352032000_4.2.e004245.8","doi-asserted-by":"publisher","DOI":"10.1111\/add.16411"},{"key":"2026041010352032000_4.2.e004245.9","article-title":"Restricting or banning alcohol advertising to reduce alcohol consumption in adults and adolescents","volume":"2014","author":"Siegfried","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2026041010352032000_4.2.e004245.10","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/acer.13331","article-title":"Self-Reported Youth and Adult Exposure to Alcohol Marketing in Traditional and Digital Media: Results of a Pilot Survey","volume":"41","author":"Jernigan","year":"2017","journal-title":"Alcohol Clin Exp Res"},{"key":"2026041010352032000_4.2.e004245.11","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/alcalc\/agz068","article-title":"Associations Between Alcohol Policies and Adolescent Alcohol Use: A Pooled Analysis of GSHS and ESPAD Data","volume":"54","author":"Noel","year":"2019","journal-title":"Alcohol Alcohol"},{"key":"2026041010352032000_4.2.e004245.12","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17103454","article-title":"Review of the Lithuanian Alcohol Control Legislation in 1990-2020","volume":"17","author":"Mi\u0161\u010dikien\u0117","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2026041010352032000_4.2.e004245.13","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1111\/dar.13289","article-title":"The alcohol advertising ban in Norway: Effects on recorded alcohol sales","volume":"40","author":"Rossow","year":"2021","journal-title":"Drug Alcohol Rev"},{"key":"2026041010352032000_4.2.e004245.14","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1097\/EDE.0000000000001857","article-title":"Alcohol Policy in Adolescence and Subsequent Alcohol-attributable Hospitalizations and Mortality at Ages 21-54 Years: A Register-based Cohort Study","volume":"36","author":"Luukkonen","year":"2025","journal-title":"Epidemiology"},{"key":"2026041010352032000_4.2.e004245.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-094586","article-title":"Assessing the impact of Lithuania\u2019s 2018 alcohol marketing ban on adolescent alcohol use by comparing trends with five EU control countries: a study protocol for a secondary data analysis","volume":"15","author":"Correia","year":"2025","journal-title":"BMJ Open"},{"key":"2026041010352032000_4.2.e004245.16","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph191912398","article-title":"The Comprehensive Alcohol Advertising Ban in Lithuania: A Case Study of Social Media","volume":"19","author":"Galkus","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026041010352032000_4.2.e004245.17","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1111\/dar.13901","article-title":"Alcohol control policy and alcohol-attributable disease burden in Finland and the Baltic countries: A longitudinal study 1995-2019","volume":"43","author":"M\u00e5nsson","year":"2024","journal-title":"Drug Alcohol Rev"},{"key":"2026041010352032000_4.2.e004245.18","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/eurpub\/ckae195","article-title":"Alcohol-attributed disease burden and formal alcohol policies in the Nordic countries (1990-2019): an analysis using the Global Burden of Disease Study 2019","volume":"35","author":"van der Velde","year":"2025","journal-title":"Eur J Public Health"},{"key":"2026041010352032000_4.2.e004245.19","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1080\/09687630701392032","article-title":"Scaling alcohol control policies across Europe","volume":"14","author":"Karlsson","year":"2007","journal-title":"Drugs Educ Prev Policy"},{"key":"2026041010352032000_4.2.e004245.20","doi-asserted-by":"crossref","unstructured":"Zhang J , Yu KF . What\u2019s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. J Am Med Assoc 1998;280. doi:10.1001\/jama.280.19.1690","DOI":"10.1001\/jama.280.19.1690"},{"key":"2026041010352032000_4.2.e004245.21","doi-asserted-by":"crossref","unstructured":"Rehm J , Room R . The cultural aspect: How to measure and interpret epidemiological data on alcohol-use disorders across cultures. NAD Nord Stud Alcohol Drugs 2017;34. doi:10.1177\/1455072517704795","DOI":"10.1177\/1455072517704795"},{"key":"2026041010352032000_4.2.e004245.22","doi-asserted-by":"crossref","first-page":"101281","DOI":"10.1016\/j.lanepe.2025.101281","article-title":"Quick buys for prevention and control of noncommunicable diseases","volume":"52","author":"Galea","year":"2025","journal-title":"Lancet Reg Health Eur"},{"key":"2026041010352032000_4.2.e004245.23","doi-asserted-by":"crossref","unstructured":"Carah N , Hayden L , Brown M-G , et al . Observing \u201ctuned\u201d advertising on digital platforms. Internet Policy Review 2024;13. doi:10.14763\/2024.2.1779","DOI":"10.14763\/2024.2.1779"},{"key":"2026041010352032000_4.2.e004245.24","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1002\/pa.1452","article-title":"Do time restrictions on alcohol advertising reduce youth exposure?","volume":"13","author":"Ross","year":"2013","journal-title":"J Public Aff"},{"key":"2026041010352032000_4.2.e004245.25","unstructured":"Hibell B , Molinaro S , Siciliano V , et al . The ESPAD validity study in four countries in 2013. Luxembourg Publications Office of the European Union; 2015."},{"key":"2026041010352032000_4.2.e004245.26","unstructured":"Shadish WR , Cook TD , Campbell DT . Experimental and quasi-experimental designs for generalized causal inference. 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