{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T17:27:26Z","timestamp":1784568446253,"version":"3.55.0"},"reference-count":59,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"British Psychological Society Social Psychology Section Pump Prime Funding"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Alcohol harm continues to present a public health priority. Whilst we know that a relationship exists between exposure to content and alcohol initiation and use in young people, the mechanism behind this effect is not well understood. Using the social identity approach as a meaning-making lens, a systematic review of the qualitative literature and meta-synthesis was conducted using Medline (all years), Embase (all years), and PsycINFO (all years). The inclusion criteria included studies which qualitatively explored the effect of exposure to content or marketing in young people (aged &lt; 26). Twenty-two articles were identified and included in the synthesis and assessed for bias using the Downe and Walsh checklist. Four themes were identified: normalisation of alcohol use, branding and identity, marketing strategies, and acting in identity congruence. A line of argument was constructed arguing that alcohol content and marketing are often targeted at and work through social identities and cultural norms to normalise alcohol use and lead to increased consumption through embedding content and marketing in culture. These findings have implications for stricter regulations around alcohol marketing and the protection of young people from alcohol content.<\/jats:p>","DOI":"10.3390\/ijerph22071078","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T02:53:07Z","timestamp":1751856787000},"page":"1078","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Effect of Exposure to Alcohol Media Content on Young People\u2019s Alcohol Use: A Qualitative Systematic Review and Meta-Synthesis"],"prefix":"10.3390","volume":"22","author":[{"given":"Sophie","family":"Getliff","sequence":"first","affiliation":[{"name":"College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4568-5114","authenticated-orcid":false,"given":"Alex B.","family":"Barker","sequence":"additional","affiliation":[{"name":"College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"q1298","DOI":"10.1136\/bmj.q1298","article-title":"WHO blames tobacco, processed food, fossil fuel, and alcohol industries for 2.7 m deaths a year in Europe","volume":"385","author":"Limb","year":"2024","journal-title":"BMJ"},{"key":"ref_2","unstructured":"Office for National Statistics (2025, February 20). Alcohol-Specific Deaths in the UK: Registered in 2023, Available online: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/causesofdeath\/bulletins\/alcoholrelateddeathsintheunitedkingdom\/registeredin2023."},{"key":"ref_3","unstructured":"Public Health England (2025, February 20). Alcohol Treatment in England 2013-14, Available online: https:\/\/webarchive.nationalarchives.gov.uk\/ukgwa\/20170807150623\/http:\/\/www.nta.nhs.uk\/uploads\/adult-alcohol-statistics-2013-14-commentary.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1111\/j.1360-0443.2004.00846.x","article-title":"Teenage drinking and the onset of alcohol dependence: A cohort study over 7 years","volume":"99","author":"Bonomo","year":"2004","journal-title":"Addiction"},{"key":"ref_5","unstructured":"World Health Organisation (2023, May 16). No Level of Alcohol Consumption is Safe for Our Health. Available online: https:\/\/www.who.int\/europe\/news\/item\/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1093\/alcalc\/agn115","article-title":"Impact of alcohol advertising and media exposure on adolescent alcohol use: A systematic review of longitudinal studies","volume":"44","author":"Anderson","year":"2009","journal-title":"Alcohol Alcohol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"agae045","DOI":"10.1093\/alcalc\/agae045","article-title":"A rapid literature review of the effect of alcohol marketing on people with, or at increased risk of, an alcohol problem","volume":"59","author":"Murray","year":"2024","journal-title":"Alcohol Alcohol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Alhabash, S., Park, S., Smith, S., Hendriks, H., and Dong, Y. (2022). Social media use and alcohol consumption: A 10-year systematic review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811796"},{"key":"ref_9","unstructured":"Bandura, A. (1977). Social Learning Theory, Prentice Hall."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1093\/pubmed\/fdac046","article-title":"Exposure to tobacco, alcohol and \u2018junk food\u2019 content in reality TV programmes broadcast in the UK between August 2019\u20132020","volume":"45","author":"Barker","year":"2022","journal-title":"J. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/alcalc\/agab039","article-title":"A Content Analysis and Population Exposure Estimate Of Guinness Branded Alcohol Marketing During the 2019 Guinness Six Nations","volume":"56","author":"Barker","year":"2021","journal-title":"Alcohol Alcohol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1136\/tobaccocontrol-2019-055025","article-title":"Exposure to \u2018Smokescreen\u2019 marketing during the 2018 Formula 1 Championship","volume":"28","author":"Barker","year":"2019","journal-title":"Tob. Control."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/dar.12929","article-title":"How alcohol advertising and sponsorship works: Effects through indirect measures","volume":"38","author":"Zerhouni","year":"2019","journal-title":"Drug Alcohol Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Haslam, C., Jetten, J., Cruwys, T., Dingle, G.A., Haslam, S.A., and Mahmood, L. (2018). The New Psychology of Health: Unlocking the Social Cure, Routeledge.","DOI":"10.4324\/9781315648569"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1089\/cyber.2016.0665","article-title":"The role of online social identity in the relationship between alcohol-related content on social networking sites and adolescent alcohol use","volume":"21","author":"Pegg","year":"2018","journal-title":"Cyberpsychology Behav. Soc. Netw."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/14792779108401862","article-title":"Social Identification, self categorization and social influence","volume":"1","author":"Abrams","year":"1990","journal-title":"Eur. Rev. Soc. Psychol."},{"key":"ref_17","unstructured":"Institute of Alcohol Studies (2025, February 20). \u2018It\u2019s Everywhere\u2019: Considering the Impact of Alcohol Marketing on People with Problematic Alcohol Use. Available online: https:\/\/www.ias.org.uk\/2023\/03\/01\/its-everywhere-considering-the-impact-of-alcohol-marketing-on-people-with-problematic-alcohol-use\/."},{"key":"ref_18","unstructured":"Pereira, S.S., and Lyons, A. (2025, February 17). Rainbow-Washing or Genuine Allyship? How Alcohol Companies Target the LGBTQ+ Community. Available online: https:\/\/www.ias.org.uk\/2025\/03\/10\/rainbow-washing-or-genuine-allyship-how-alcohol-companies-target-the-lgbtq-community\/."},{"key":"ref_19","first-page":"93","article-title":"Meta-Ethnography: Synthesising qualitative studies","volume":"44","author":"Noblit","year":"1999","journal-title":"Counterpoints"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Braun, V., and Clarke, V. (2022). Thematic Analysis: A Pratical Guide, SAGE Publications Ltd.","DOI":"10.53841\/bpsqmip.2022.1.33.46"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","article-title":"A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis","volume":"56","author":"Byrne","year":"2022","journal-title":"Qual. Quant."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"595","DOI":"10.2340\/16501977-0238","article-title":"The experience of living with stroke: A qualitative meta-synthesis","volume":"40","author":"Salter","year":"2008","journal-title":"J. Rehabil. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.midw.2005.05.004","article-title":"Appraising the quality of qualitative research","volume":"22","author":"Walsh","year":"2006","journal-title":"Midwifery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1365-2648.2006.04079.x","article-title":"Expert intrapartum maternity care: A meta-synthesis","volume":"57","author":"Downe","year":"2007","journal-title":"J. Adv. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Lincoln, Y., and Guba, E. (1985). Naturalistic Inquiry, SAGE Publications Ltd.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1177\/1049732312440330","article-title":"A meta-synthesis of midwife-led care","volume":"22","author":"Walsh","year":"2012","journal-title":"Qual. Health Res."},{"key":"ref_27","unstructured":"Rayyan (2025, June 09). Faster Systematic Literature Reviews. Available online: https:\/\/www.rayyan.ai\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e030556","DOI":"10.1136\/bmjopen-2019-030556","article-title":"Qualitative exploration of the intersection between social influences and cultural norms in relation to the development of alcohol use behaviour during adolescence","volume":"10","author":"MacArthur","year":"2020","journal-title":"BMJ Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1037\/hea0000168","article-title":"Social networking and young adults\u2019 drinking practices: Innovative qualitative methods for health behavior research","volume":"34","author":"Lyons","year":"2015","journal-title":"Health Psychol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Purves, R.I., Stead, M., and Eadie, D. (2018). \u201cI Wouldn\u2019t Be Friends with Someone If They Were Liking Too Much Rubbish\u201d: A Qualitative Study of Alcohol Brands, Youth Identity and Social Media. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15020349"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.drugpo.2016.10.019","article-title":"\u2018If I don\u2019t look good, it just doesn\u2019t go up\u2019: A qualitative study of young women\u2019s drinking cultures and practices on Social Network Sites","volume":"38","author":"Atkinson","year":"2016","journal-title":"Int. J. Drug Policy"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Scott, S., Shucksmith, J., Baker, R., and Kaner, E. (2017). \u2018Hidden Habitus\u2019: A Qualitative Study of Socio-Ecological Influences on Drinking Practices and Social Identity in Mid-Adolescence. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14060611"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1080\/08870446.2014.893345","article-title":"\u2018See it doesn\u2019t look pretty does it?\u2019 Young adults\u2019 airbrushed drinking practices on Facebook","volume":"29","author":"Niland","year":"2014","journal-title":"Psychol. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1111\/dar.13508","article-title":"The alcohol self-presentation model: Using thematic qualitative analysis to elucidate how college students self-present via alcohol-related social media posts","volume":"41","author":"Steers","year":"2022","journal-title":"Drug Alcohol Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s12529-019-09785-4","article-title":"Young Thai People\u2019s Exposure to Alcohol Portrayals in Society and the Media: A Qualitative Study for Policy Implications","volume":"26","author":"Kaewpramkusol","year":"2019","journal-title":"Int. J. Behav. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1080\/13676261.2020.1746757","article-title":"How do social media-related attachments and assemblages encourage or reduce drinking among young people?","volume":"24","author":"Torronen","year":"2021","journal-title":"J. Youth Stud."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/16066359.2016.1202930","article-title":"Awareness of alcohol advertisements and perceived influence on alcohol consumption: A qualitative study of Nigerian university students","volume":"25","author":"Dumbili","year":"2017","journal-title":"Addict. Res. Theory"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1080\/16066359.2016.1202241","article-title":"An exploration of alcohol advertising on social networking sites: An analysis of content, interactions and young people\u2019s perspectives","volume":"25","author":"Atkinson","year":"2017","journal-title":"Addict. Res. Theory"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/16066359.2016.1245293","article-title":"Alcohol marketing on social media: Young adults engage with alcohol marketing on Facebook","volume":"25","author":"Niland","year":"2016","journal-title":"Addict. Res. Theory"},{"key":"ref_40","first-page":"135","article-title":"Anywhere, everywhere: Alcohol industry promotion strategies in Nigeria and their influence on young people","volume":"15","author":"Dumbili","year":"2016","journal-title":"Afr. J. Drug Alcohol Stud."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/nvsm.388","article-title":"Critical social marketing\u2014The impact of alcohol marketing on youth drinking: Qualitative findings","volume":"15","author":"Gordon","year":"2010","journal-title":"Int. J. Nonprofit Volunt. Sect. Mark."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3109\/16066359.2012.687795","article-title":"Young peoples\u2019 perspective on the portrayal of alcohol and drinking on television: Findings of a focus group study","volume":"21","author":"Atkinson","year":"2013","journal-title":"Addict. Res. Theory"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1177\/009145090102800409","article-title":"Alcohol advertising and youth: A focus-group analysis of what young people find appealing in alcohol advertising","volume":"28","author":"Waiters","year":"2001","journal-title":"Contemp. Drug Probl."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/00913367.1998.10673545","article-title":"Exploring Life Themes and Myths in Alcohol Advertisements through a Meaning-Based Model of Advertising Experiences","volume":"27","author":"Parker","year":"1998","journal-title":"J. Advert."},{"key":"ref_45","first-page":"491","article-title":"Ten-To Sixteen-Year-Olds\u2019 Perceptions of Advertisements for Alcoholic Drinks","volume":"23","author":"Aitken","year":"1988","journal-title":"Alcohol Alcohol."},{"key":"ref_46","first-page":"30","article-title":"Alcohol advertising and adolescent drinking","volume":"12","author":"Lieberman","year":"1987","journal-title":"Alcohol Health Res. World"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1080\/15205436.2024.2440321","article-title":"A qualitative study among adolescents to unravel the perceived group dynamics underlying the use of closed SNS stories and the sharing of alcohol related content","volume":"28","author":"Vanherle","year":"2025","journal-title":"Mass Commun. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1037\/adb0000907","article-title":"Adolescents\u2019 perceptions of alcohol portrayals in the media and their impact on cognitions and behaviors","volume":"37","author":"Merrill","year":"2023","journal-title":"Psychol. Addict. Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/dar.13720","article-title":"A qualitative analysis of adolescents\u2019 perspectives on peer and influencer alcohol-related posts on social media","volume":"43","author":"Corcoran","year":"2023","journal-title":"Drug Alcohol Rev."},{"key":"ref_50","unstructured":"Atkinson, A., Sumnall, H., Begley, E., and Jones, L. (2019). A Rapid Narrative Review of Literature on Gendered Alcohol Marketing and Its Effects: Exploring the Targeting and Representation of Women, Institute of Alcohol Studies."},{"key":"ref_51","unstructured":"Advertising Standards Authority (2025, January 16). The BCAP Code Section 19\u2014Alcohol. Available online: https:\/\/www.asa.org.uk\/type\/broadcast\/code_section\/19.html."},{"key":"ref_52","unstructured":"Advertising Standards Authority (2025, March 13). The CAP Code\u201418 Alcohol. Available online: https:\/\/www.asa.org.uk\/type\/non_broadcast\/code_section\/18.html."},{"key":"ref_53","unstructured":"Ofcom (2025, March 13). The Ofcom Broadcasting Code (With the Cross-Promotion Code and the On-Demand Programme Service Rules). Available online: https:\/\/www.ofcom.org.uk\/tv-radio-and-on-demand\/broadcast-standards\/broadcast-code\/."},{"key":"ref_54","unstructured":"Ofcom (2024, March 11). Statutory Rules and Non-Binding Guidance for Providers of On-Demand Programme Services (ODPS). Available online: https:\/\/www.ofcom.org.uk\/__data\/assets\/pdf_file\/0029\/229358\/ODPS-Rules-and-Guidance.pdf."},{"key":"ref_55","unstructured":"Ofcom (2025, March 13). Quick Guide to Illegal Content Codes and Practice. Available online: https:\/\/www.ofcom.org.uk\/online-safety\/illegal-and-harmful-content\/codes-of-practice\/."},{"key":"ref_56","unstructured":"World Health Organization (2025, March 13). SAFER: Enforce Bans or Comprehensive Restrictions on Alcohol Advertising, Sponsorship, and Promotion. Available online: https:\/\/www.who.int\/initiatives\/SAFER\/alcohol-advertising."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-022-13233-6","article-title":"Population exposure to alcohol and junk food advertising during the 2018 FIFA World Cup: Implications for public health","volume":"22","author":"Alfayad","year":"2022","journal-title":"BMC Public Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e037035","DOI":"10.1136\/bmjopen-2020-037035","article-title":"Quantifying alcohol audio-visual content in UK broadcasts of the 2018 Formula 1 Championship: A content analysis and population exposure","volume":"10","author":"Barker","year":"2020","journal-title":"BMJ Open"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Murray, R., Breton, M.O., Britton, J., Cranwell, J., and Grant-Braham, B. (2018). Carlsberg alibi marketing in the UEFA euro 2016 football finals: Implications of probably inappropriate alcohol advertising. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5449-y"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1078\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:05:21Z","timestamp":1760033121000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,6]]},"references-count":59,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["ijerph22071078"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22071078","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,6]]}}}