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ANALYSIS OF SUBMISSIONS TO THE MINISTERIAL FORUM ON ALCOHOL ADVERTISING AND SPONSORSHIP

Final report

2 June 2014

1 2 Contents

Navigating this document...... 5

Key Points...... 7

1 Introduction...... 11

1.1 Purpose of this report...... 11

1.2 Methodology...... 11

1.3 Profile of respondents...... 11

1.4 Submissions received, and interpretation of comments and their treatment...... 14

1.4.1 Format of submissions received...... 14

1.4.2 Submitters’ focus...... 15

1.4.3 Treatment of evidence provided...... 15

1.4.4 Consideration of alcohol advertising and sponsorship by submitters...... 16

2 Alcohol Advertising...... 17

2.1 Overall level of support for further alcohol advertising restrictions...... 17

2.2 Rationale for supporting the introduction of further advertising restrictions...... 21

2.3 Rationale for maintaining the status quo...... 24

2.4 Evidence presented in support of or opposition to further restrictions...... 28

2.5 Proposed advertising restrictions...... 37

2.6 Challenges and solutions...... 47

3 Alcohol Sponsorship...... 52

3.1 Overall level of support for further sponsorship advertising restrictions...... 52

3.2 Rationale for supporting the introduction of further sponsorship restrictions...... 56

3.3 Rationale for maintaining the status quo...... 60

3.4 Evidence presented in support of or opposition to further restrictions...... 64

3.5 Proposed sponsorship restrictions...... 69

4 Other Comments...... 77

Appendix A: List of submitters...... 80

Appendix B: Questions to guide submitters’ responses...... 84

List of citations provided by submitters...... 86

3 4 Navigating this document

Key points are outlined in the first part of this report.

This report contains four other parts:

1. Part 1 outlines the purpose of the report. It also identifies the methodology used in analysing the submissions. It outlines the profile of respondents by their number and type by category and how many submitters made a submission to the Law Commission or Justice and Electoral Select Committee and who wants to be heard by the Forum.

2. Part 2 describes the overall level of support for further restrictions on alcohol advertising including a summary of the support for and opposition to and an analysis of view by category of submitters. It provides a detailed discussion of the rationale provided for overall view and level of evidence presented in support of the view. It then outlines the proposed restrictions presented by submitters and challenges and possible solutions.

3. Part 3 outlines the overall level of support for further restrictions on alcohol sponsorship including a summary of the support for and opposition to and an analysis of view by category of submitters. It provides a detailed discussion of the rationale provided for overall view and level of evidence presented in support of the view. It then outlines the proposed restrictions presented by submitters and challenges and possible solutions.

4. Part 4 outlines other issues raised by submitters.

Appendix A names each submitter who contributed to the Forum by way of written submission, excluding individual submitters who asked for their names to be withheld from publication, or not to be released. These submitters are identified as anonymous.

Appendix B contains the submission form provided by the Forum.

Appendix C contains a list of citations presented by submitters in support of further restrictions on alcohol advertising and sponsorship, and evidence supporting the status quo. Citations are also ordered in terms of pre- or post- 2010.

A summary of the location of material in relation to the questions asked is provided overleaf.

5 QUESTION AND LOCATION IN THE REPORT

Question 1 Section 1.3.2 Question 2 Section 2.1 Question 3 Sections 2.2 and 2.3 Question 4 Section 2.4 Question 5 Section 2.4 Question 6 Section 3.1 Question 7 Section 3.2 and 3.3 Question 8 Section 3.4 Question 9 Section 3.4 Question 10 Section 2.5.1 Question 11 Section 2.5.2 Question 12 Section 2.5.1 and section 2.4 Question 13 NB: Limited commentary provided – covered under section 2.5.1 Question 14 NB: Limited commentary provided – covered under section 2.5.1 Question 15 Section 3.5.1 Question 16 Section 3.5.2 Question 17 Section 3.5.1 and section 3.4 Question 18 NB: Limited commentary provided – covered under section 3.5.1 Question 19 NB: Limited commentary provided – covered under section 3.5.1 Question 20 Section 2.5.4 Question 21 Section 2.5.4 Question 22 Section 3.5.4 Question 23 Section 3.5.4 Question 24 Section 2.6 Question 25 Section 2.6 Question 26 Section 3.6: No commentary provided Question 27 Section 3.6: No commentary provided Question 28 Part 4

6 Key Points

 A total of 242 submissions were received. One hundred and twenty two (122) submissions were received from organisations. The remaining submissions were from individuals (120 submitters).

 Thirty-four submitters used the submission form provided by the Forum, 113 used submission templates provided by other entities. The rest of the submitters (95) provided comments on the areas that they were interested in and did not directly respond to the questions posed by the Forum in the submissions form.

 This analysis focuses on research published since 2010 (as presented by submitters). In the rationale, there are clear disagreements based on whether submitters support further restrictions or do not. These are also reflected in the evidence base and are described below. A large amount of pre-2010 research was also provided by submitters: this has not been given a high priority in the analysis due to the volume of post-2010 material and the Forum’s focus on ‘what’s changed since the Law Commission’s 2010 report’. The analysis does not contain critical appraisal of the material presented: it only reports on what was provided by submitters; however, submitters generally considered that the evidence presented was sufficient for further restrictions to be implemented (or not).

A Level of support for further restrictions on alcohol advertising and sponsorship

 All 242 submitters indicated whether they supported or did not support further restrictions on alcohol advertising and/or sponsorship over and above the measures currently in place.

Support for further alcohol advertising restrictions

- 177 submitters supported further restrictions (60 organisations, 117 individuals). - 64 submitters (61 organisations, three individuals) did not want further restrictions, effectively supporting the status quo.

Support for further alcohol sponsorship restrictions

- 173 submitters supported further restrictions (58 organisations, 115 individuals). - 61 submitters (59 organisations, two individuals) did not want further restrictions, effectively supporting the status quo.

NB: Not all submitters commented on both advertising and sponsorship.

 No submitters sought to reduce or loosen existing restrictions.

 Organisations are split 50/50 over whether further restrictions should be put in place. Individuals almost unanimously indicated a preference for further restrictions. Generally, submitters categorised as health, professional associations, community/cultural groups, researchers, and individuals were more likely to support the implementation of further restrictions. Specific groups more likely to support the status quo (and no further restrictions) were sporting bodies, advertising/media submitters, retailers, alcohol industry and trade associations.

7  Those who supported and who did not support further restrictions recognised the need to address alcohol-related harm, and many submitters noted specific measures undertaken to do this.

B Alcohol advertising

B1 Rationale presented in support of view

 The majority of submitters support the introduction of further measures to restrict advertising of alcohol. Those supporting further restrictions on alcohol advertising, did so by noting some or all of the following:

- Their concern over the nature and amount of ongoing alcohol-related harm. - Their view that the current evidence-base clearly links alcohol advertising and sponsorship to increased alcohol consumption (including impacting on the onset of drinking) and abuse. - Their view that the self-regulation currently in place is ineffective due to perceived conflicts. - Rejection of the claim that marketing is focused on brand awareness not market growth. - Reference to tobacco harm and control initiatives.

 Those who support the status quo commented on some or all of the following:

- Claimed links between alcohol advertising and alcohol-related harm: causality linking alcohol advertising to alcohol-related harm has not been demonstrated. - The perceived limited effectiveness/ability of further regulation to address alcohol-related harm. - The essential role played by funding from alcohol advertising in maintaining the viability of sports and cultural events. - Their faith in and ongoing support for the existing self-regulation of alcohol advertising and sponsorship. - Reluctance to unsettle the recently implemented legislation with further changes.

B2 Evidence presented in support of view on further restrictions

 Evidence presented reflects the rationale presented by all submitters who supported further restrictions:

- The demonstrated effectiveness of advertising restrictions as a means of reducing alcohol- related harm. - The role advertising plays in increasing consumption and influencing the onset of drinking and brand preferences. - The ineffectiveness of industry self-regulation regarding alcohol advertising (i.e., published research on code violations, youth exposure exceeding industry standards or that there were higher proportions of advertising on youth-targeted channels). - Public support for further restrictions.

8  Again, the evidence presented for the status quo closely reflected the rationale provided by those who do not want further restrictions:

- Advertising is not a strong influencer of alcohol use: parents, siblings, and friends influence the age of onset of drinking and consumption levels, as well as other (less frequently covered) influencers such as engagement with education and amount of disposable income. - Rejection of the claim that advertising is an influencer or initiator of consumption by presenting evidence of studies showing weak causal links between alcohol advertising and consumption (including by youth). - Commentary about the limited effectiveness of comprehensive advertising bans in reducing consumption or harm (including refuting other studies that have demonstrated linkages and/or drawing on any ambiguity in study findings). - Anecdotal evidence about advertising being an enabler of participation in sports. - Evidence noting that the current self-regulatory approach is effective.

B3 Proposed restrictions

There was strong support for the implementation of the Law Commission’s 2010 Stage 3 recommendations, and for health messaging that focused on reducing alcohol abuse, and managing promotion in social media spaces. Other possible restrictions supported by more than one submitter included restrictions on billboard advertising, the establishment of a new independent body to oversee alcohol advertising (effectively removing self-regulation), updating the Advertising Standards Authority Code for Advertising Liquor, restricting promotion to young people, and opposition to celebrity endorsement. No new non-regulatory initiatives were proposed although a number of submitters chose to inform the Forum about specific programmes of work they are undertaking to address alcohol-related harm (including sports and alcohol industry submitters who did not support further restrictions). The evidence posed in support of specific further restrictions reflected that provided in the rationale for supporting further restrictions in general.

C Alcohol sponsorship

C1 Rationale presented in support of view

 The majority of submitters support the introduction of further measures to restrict alcohol sponsorship. Those supporting further restrictions did so by noting some or all of the following:

- Their concern over the nature and amount of ongoing alcohol-related harm. - Increasing consumption by enhancing the credibility of brands. - Concerns that sponsorship by alcohol brands increases consumption by enabling exposure to young people in a wide range of settings and influences uptake by normalising alcohol. - Reference to tobacco harm and control initiatives.

 Those who support the status quo commented on some or all of the following:

- The withdrawal of sponsorship and the impact of this on sports and cultural events, including material on the economic value of sports to New Zealand, the essential role played by sponsorship funding in maintaining the viability of sports: without this funding, it would be difficult to maintain clubs, elite sports, and international events and concern that removal of sponsorship would cause funding difficulties for cultural events.

9 - Sporting codes were generally responsible with regard to the management of alcohol- related harm within their codes, and that this issue was well-managed. - No evidence to suggest restrictions on sponsorship would reduce alcohol-related harm (like that presented against further advertising restrictions).

C2 Evidence presented in support of view on further restrictions

 Evidence presented reflects the rationale presented by all submitters who supported further restrictions:

- Sponsorship’s role in normalising alcohol use and the creation of an alcohol culture. - The strong impact that sponsorship has on raising brand awareness among young people (and that the more brand-aware, the more likely they are to start drinking). - The link between sponsorship and harmful drinking behaviours, with research presented indicating higher levels of harm in sports facilities where alcohol sponsorship occurs. - The effectiveness of and need for restrictions on advertising or promotion in general in terms of reducing alcohol-related harm.

 Again, the evidence presented for the status quo closely reflected the rationale provided by those who do not want further restrictions:

- The negative impact that restricting sponsorship is likely to have on sports (including in regard to overall funding, participation, and spectatorship). - Sponsorship is not a driver for alcohol consumption or harm, and does not influence young people’s uptake or subsequent use.

C3 Proposed restrictions

One main restriction was proposed: a comprehensive ban (which was supported by most of the submitters who proposed further restrictions). Those supporting a ban also noted the impact that this would have on sporting and cultural events and stated that alternative sources of funding would be required.

Impacts and future challenges

The impacts identified by submitters were similar for both advertising and sponsorship. Submitters considered that further advertising restrictions would accrue benefits to young people, families, Maori and heavy drinkers. There were concerns that further advertising restrictions would impact negatively on the advertising and alcohol industries, and on sporting bodies, cultural events, and spectators/consumers.

Future challenges included concerns about promotion through social media and how to manage this (especially the cross-border components). Submitters also considered that the impacts of further advertising restrictions on international trade arrangements require further thought.

10 1 Introduction

The Ministerial Forum on Alcohol Advertising and Sponsorship (the Forum) was established in February 2014. The Forum is charged with examining whether further regulatory and non- regulatory measures are required for alcohol advertising and sponsorship in order to reduce alcohol- related harm, and if so, ensuring that recommended changes (if any) align with the Sale and Supply of Alcohol Act 2012.

To inform its deliberations, the Forum asked stakeholders whether they support further restrictions on alcohol advertising and/or sponsorship including requesting their reasons for their view and what (if any) restrictions could be implemented. They were also asked about the types of possible restrictions, implementation considerations, and the possible impacts of introducing further restrictions. Stakeholders were also asked to cite any evidence that has emerged since 2010 that supports their views (as the Forum considers the evidence presented to the Law Commission and the Justice and Electoral Select Committee, and its findings, as ‘ground zero’). The Forum provided a form to guide submitters’ feedback: the form used 28 questions to reflect the matters that the Forum was particularly interested in (including post-2010 research). Its questions are included in Appendix B of this report.

1.1 Purpose of this report

Allen + Clarke Policy and Regulatory Specialists (Allen + Clarke) was contracted by the Ministry of Health to analyse the written submissions received by the Forum and to provide a database of submissions. In keeping with the Forum’s focus on new evidence, the analysis emphasises evidence and expert opinion presented since 2010.

1.2 Methodology

Following the close of the submissions period, all submissions reviewed were supplied to Allen + Clarke in electronic format. Numerical unique identifiers were provided by the Ministry. Once received by Allen + Clarke, submissions were coded to a standard coding framework, and entered into a purpose-built Microsoft Access database. From this, specific reports by both theme and individual submitter were drawn, cleaned and used to inform this report.

1.3 Profile of respondents

A total of 242 submissions were received. One hundred and twenty two (122) submissions were received from organisations. The remaining submissions were from individuals (120 submitters).

Generally, submissions were received in three main ways:

1. On a template-type submission prepared by one entity but submitted by another (and which include references to some of the Forum’s overarching questions about whether further restrictions are required required) (113 submitters). 2. Other free-form submissions (95 submitters) that focused on issues of interest to the submitter but which may not have covered all of the Forum’s questions. 3. On the Forum’s submission form (34 submitters).

11 Submitters were asked to provide their names and the organisational details if they were submitting on its behalf. They were also asked to provide a brief description of their organisation. Based on this description, the submitters were characterised into categories (see section 1.3.1). Submitters are not identified in this report except by category of submitter.

More information about the submissions received is covered in section 1.4 of this report.

The analysis of submitters presents the type of submitter by organisation and individual.

1.3.1 Number and type by category

1.3.1.1 Non-template submissions

The Forum received 129 non-template submissions from organisations and individuals (including 34 presented on the submissions form, and 95 free-form submissions).

Organisations

The Forum received 107 free-form submissions from organisations. Organisation submission categories and the number of submitters in each class were:

 Sporting body 27 submitters  Health sector organisation 23 submitters  Advertising or media 14 submitters  Alcohol industry (including brewers and producers) 12 submitters  Community or cultural groups 9 submitters  Professional association1 6 submitters  Local government 5 submitters  Academic or research 4 submitters  Retailers 4 submitters  Trade association 2 submitters  Central government 1 submitter.

1 This includes bodies representing groups of professionals such as doctors, midwives, nurses, psychiatrists and psychologists.

12 Individuals

The Forum received 22 free-form submissions from individuals. Individual submission categories and the number of submitters in each class were:

 Public and/or consumers 15 submitters  Health sector 5 submitters  Academic and research 2 submitters.

1.3.1.2 Submitters who used template submissions developed by other entities

One hundred and thirteen submitters provided their views using template submissions. There were three types:

 A postcard developed by Alcohol HealthWatch focusing on alcohol advertising’s impact on young people and children, requesting the implementation of the Law Commission’s 2010 recommendations (i.e., comprehensive restrictions on advertising including limitations that only allow for advertising of product information, and a comprehensive ban on sponsorship activities), and ring-fenced alcohol levy to provide an alternative form of sponsorship funding.

 A form developed by the CAYAD National Implementation Team (Massey University) requesting the full implementation of the Law Commission’s 2010 recommendations.

 A template submission developed by Alcohol HealthWatch describing the Law Commission’s 2010 recommendations in detail and requesting immediate implementation.

Individuals

Mostly template submissions were received from individuals (n=98):

 CAYAD National Implementation Team form 47 submitters  Alcohol HealthWatch postcards 34 submitters  Alcohol HealthWatch template submission 17 submitters.

Organisations

The Forum received 15 template submissions from organisations.

 Alcohol HealthWatch template submission 12 submitters o Health sector organisation (seven submitters) o Community or cultural groups (four submitters) o Professional association (one submitter)

 CAYAD National Implementation Team form 3 submitters o Health sector organisation (two submitters) o Community or cultural group (one submitter).

13 1.3.2 Submission to Law Commission or Justice + Electoral Select Committee

Stakeholders were asked to identify whether they had made a submission on the Law Commission’s 2010 report, Alcohol in Our Lives: Curbing the Harm, and/or the Justice and Electoral Select Committee on alcohol advertising and sponsorship issues (Question 1).

 16 respondents submitted to the Law Commission and Justice and Electoral Select Committee.

 11 submitters made submission to the Law Commission only.

 Seven submitters made submission to the Justice and Electoral Select Committee only.

 Six submitters responded “yes” to Question 1 but did not specify who the submission was to.

Two submitters provided extracts of their previous submissions to the Law Commission. One submitter provided electronic links to their submissions to both the Law Commission and the Justice and Electoral Select Committee.

Twenty-five submitters stated that they did not make a submission to either the Commission or the Select Committee. The remaining submitters (n=177) did not respond to this question.

1.3.3 Request for hearing

Twenty-six submitters expressed interest in being heard by the Forum: six health sector organisations, five media/advertising submitters, five alcohol industry submitters, four local government submitters, three individuals, two sports bodies and two community organisations.

Four other submitters (one community organisation, one alcohol industry body, one advertiser and one individual) noted that they would like to provide further input into the process but they did not specify the nature of this input, or whether it included presenting to the Forum.

Three submitters expressly declined being heard: one District Health Board, one local government agency and one advertising/media submitter.

1.4 Submissions received and interpretation of comments and their treatment

The following section records commentary about the nature of submissions received and notes some key considerations applied during the analysis. It focuses on the differences between the types of submissions presented (i.e., those using the Forum’s submission form, template submissions and free-form submissions) and the analytical considerations required to develop a comprehensive report that, as accurately as possible, reflects submitters’ views and the evidence provided and which provides a clear platform for the Forum’s next steps.

1.4.1 Format of submissions received

The information sought by the Forum was reflected in the submission form which was a guide for submitters. This form consisted of a detailed and structured series of questions on possible

14 restrictions to be introduced for alcohol advertising and sponsorship to reduce alcohol-related harm. The comparatively low number of submitters who used the form (34 out of 242 submitters, or 14 percent of respondents) suggests that many submitters chose to focus on areas of specific interest to them.

Some submitters who used the Forum’s submission form and who, when confronted with a question about which they had no information or knowledge, completed the question box either with information or views previously produced elsewhere or with new information or views that did not relate to the question being asked. Also, the submission form was heavily structured, often with a topic building over several questions. The answering of the latter questions needed to proceed within the context of the earlier questions. Many submitters who used the Forum’s submission form completed questions at face value as if the questions were independent of each other. Therefore, submitters often would repeat information from earlier questions or would answer with new stand- alone information. The information provided in these circumstances really belonged elsewhere in the form, usually as additional explanations for viewpoints regarding restrictions or additional evidence supporting viewpoints. Where commentary is provided, submitters’ comments have been placed under the most relevant question (rather than where it appears in an individual submission). This has been done to ensure that the views of submitters are represented as accurately as possible, although it has resulted in some overlap in submitters' comments in response to these.

1.4.2 Submitters’ focus

Some questions from the Forum received a great deal of response (eg, whether restrictions were required or not at this point in time). There are a number of questions in which the Forum was interested (as reflected by the form) for which very little information has been received. This includes future interventions, impacts, commentary on how the restriction would work and emerging challenges. As such, this report does not contain specific sections relating to some of the questions in the submissions form. Information on placement is covered in the Navigation section of this report.

While relatively few submitters provided specific evidence or feedback on whether the evidence they identified was strong enough for changes to be made immediately: generally, submitters appeared to consider that the evidence presented, when taken in conjunction with evidence presented to the Law Commission, supported their view on whether further restrictions should be implemented.

1.4.3 Treatment of evidence provided

A significant proportion of submissions, especially those from organisations, provided evidence to support and explain their views. In considering the evidence provided, we have used three tiers:

1. Published evidence (such as peer-reviewed articles, publications, etc.)

2. Grey literature (such as unpublished studies, unpublished data, etc.), and

3. Anecdotal material (such as submitter’s experiences, etc.).

Submissions received from the health sector, alcohol industry, local government and research institutions particularly focused on published studies, supplemented by grey literature, while

15 community groups, retailers, sports clubs and public consumers tended to relate their own experiences through grey literature or with anecdotal evidence.

The body of evidence presented was significant in terms of number of citations provided by submitters (including the number of post-2010 citations). Approximately 15 citations were used by both those who supported further restrictions, and those who did not (NB: these are listed at the front of the Citations sheet). The analysis undertaken in this report reflects our terms of reference: we have reported on the evidence presented (for example, noting research presented in support of a particular view); however, we have not undertaken critical appraisal of the evidence presented in order to determine its strength or applicability to New Zealand’s current situation.

1.4.4 Consideration of alcohol advertising and sponsorship by submitters

Submitters generally considered alcohol advertising and sponsorship separately. For example, in the template submissions, there was always a specific comment on sponsorship. Responses using the Forum's template submission usually answered the advertising and sponsorship sections separately. Although individuals sometimes repeated in sponsorship what they said in advertising, most other submitters made original comments in both sections. In the remaining free-form submissions, the more developed submissions usually separated comment on alcohol advertising and sponsorship. Less developed submissions were more likely to use an "advertising and sponsorship" phrase when making suggestions for restrictions or status quo. However, the rationale presented for supporting further restrictions or not was often similar for both advertising and sponsorship, hence this gives rise to a considerable amount of repetition in some sections of this report.

16 2 Alcohol Advertising

2.1 Overall level of support for further alcohol advertising restrictions

The Forum’s submission form indicated its interest in feedback on whether there is support for further restrictions on alcohol advertising or whether there is opposition to the introduction of more restrictions (Question 2). In addition, the Forum requested reasons for any of the views expressed (Question 3).

A total of 241 submitters responded to Questions 2 and 3. Of these:

 177 submitters supported further restrictions (60 organisations, 117 individuals) or 73 percent.  64 submitters (61 organisations, three individuals) (27 percent) did not want further restrictions, effectively supporting the status quo.

No submitters supported the loosening or removal of existing restrictions.

Graphic 1A: Overall level of support for further advertising restrictions

Organisations are split nearly 50/50 as to whether further restrictions should be implemented. Individuals have a strong preference for further restrictions.

17 Graphic 1B: Overall level of support for further advertising restrictions by organisation

Graphic 1C: Overall level of support for further advertising restrictions by individuals

2.1.1 Categories of submitter who support further advertising restrictions

One hundred and seventy-seven submitters support further advertising restrictions.

18 Organisations  Health sector organisation 23 submitters  Professional association 6 submitters  Community or cultural groups 6 submitters  Local government 5 submitters  Academic and research 3 submitters  Trade association 1 submitter  Advertising and media 1 submitter.

A further 15 organisations providing template submissions also support further restrictions.

Individuals

 Public/consumers 13 submitters  Health sector 5 submitters  Academic and research 1 submitter.

A further 98 submissions were presented through a template submission.

2.1.2 Categories of submitter who do not support further advertising restrictions

Sixty-four submitters do not support further advertising restrictions.

Organisations  Sporting body 27 submitters  Advertising and media 13 submitters  Alcohol industry (including brewers and producers) 12 submitters  Retailers 4 submitters  Community or cultural groups 3 submitters  Public/consumers 2 submitters  Academic and research 1 submitter  Central government 1 submitter  Academic and research (individual) 1 submitter.

19 Summary of the rationale presented for and against further advertising restrictions

There are clear differences of opinion on several key rationale groups based on whether submitters support further restrictions or do not. There is also a strong correlation with the rationale provided for supporting (or not) further sponsorship restrictions.

The majority of submitters support the introduction of further measures to restrict advertising of alcohol. Those supporting further restrictions (including health, professional associations, community/cultural groups, researchers, and individuals) did so by noting some or all of the following:

- Their concern over the nature and amount of ongoing alcohol-related harm. - Evidence linking alcohol advertising and sponsorship to increased alcohol use and abuse. - Their view that the self-regulation currently in place was ineffective. - Rejection of the claim that marketing is focused on brand awareness not market growth. - Reference to tobacco harm and control initiatives.

Specific groups that were more likely to support the status quo included sporting bodies, advertising/media submitters, retailers, trade associations and alcohol industry submitters. They did so by raising points about some or all of the following:

- Doubts about the claimed links between alcohol advertising and alcohol-related harm: causality linking alcohol advertising to alcohol-related harm has not been demonstrated. - The perceived limited effectiveness/ability of further regulation to address alcohol-related harm (which contradicts views held by those who support proposals). - The essential role played by funding from alcohol advertising in maintaining the viability of sports and cultural events. - Their faith in and ongoing support for the existing self-regulation of alcohol advertising and sponsorship (which contradicts views held by those who support proposals). - Reluctance to unsettle the recently implemented legislation with further changes.

NB: Submitters generally provided similar rationale for their views on both alcohol advertising and sponsorship (particularly in the template submissions and in respect of material presented on advertising’s link to alcohol-related harm). This may reflect an assumption that sponsorship is a subset of advertising/promotion. In order to ensure that submitters’ views are fully presented, there is some repetition between sections 2.2 and 3.2. The repetition inherent in these sections is intended to ensure accurate presentation of submitters’ views.

20 2.2 Rationale for supporting the introduction of further advertising restrictions

Generally, submitters categorised as health, professional associations, community/cultural groups, researchers, and individuals were more likely to support the implementation of further restrictions. Most of those seeking further restrictions on alcohol advertising (n=143) presented their rationale for doing so: the 34 individuals who signed the Alcohol HealthWatch postcard stated the need for restrictions on alcohol advertising without explaining why this was needed. The following sections record submitters’ reasons for supporting further restrictions on alcohol advertising. Key issues raised were: concerns over the nature and amount of alcohol-related harm that is occurring in New Zealand, advertising’s role in increasing this harm, general concerns about the effectiveness of the current self-regulatory model, and comparison of alcohol to tobacco.

2.2.1 Concern over the nature and amount of alcohol-related harm

One aspect of the rationale of all submitters seeking further restrictions on alcohol advertising was concern over the nature and amount of alcohol-related harm.

2.2.1.1 Template submissions

The CAYAD National Implementation Team template submission was signed by 47 individuals and three organisations. It summarised, in the briefest way and with no specific references/citations, the overall results of research on the subject of alcohol advertising:

 The more alcohol promotion young people see, the earlier they start to drink and the more they drink  The earlier they start to drink, the greater the risk of becoming a heavy drinker, and  The more they drink, the greater the harm (to them and others).

It is not clear whether the research referred to was published pre- or post-2010.

In response to this research, those who signed the template submission requested greater restrictions on alcohol advertising in order to:

 delay the age at which young people start to drink  help de-normalise the use of alcohol, and  reduce harmful drinking.

The Alcohol HealthWatch template submission (signed by 17 individuals and the 12 organisations) provided a fuller explanation of the rationale for seeking of further restrictions on alcohol advertising. This submission stated that:

 the evidence gathered by 2010 concluded that exposure of young people to alcohol marketing sped up the onset of drinking and increased the amounts of alcohol consumed by those already drinking.  of the 2,281 submissions presented in 2010 on alcohol marketing and advertising, 86 percent supported banning or restricting all advertising of all alcohol in all media.  the Law Commission had stated three stages to move towards this position the first stage of which (making it an offence to promote the excessive consumption of alcohol) was implemented in the Sale and Supply of Alcohol Act 2012.

21  there was enough evidence to warrant immediate action and that there was strong public support to do this.  the Forum should support the immediate implementation of Stages 2 and 3 of the Law Commission's recommendations on alcohol advertising and sponsorship as set out in their report Alcohol in Our Lives: Curbing the Harm 2010 and that it should recommend an action plan which will implement the Law Commission's recommendations.  self-regulation should end as it is thought to delay effective measures to curb the harm arising from alcohol advertising.

2.2.1.2 Other commentary provided in free-form submissions

A health research group noted that, in New Zealand, there has been a marked increase in drinking by young people since the first introduction of brand advertising in the broadcast media in 1992. The reduction in the minimum purchase age in 2000 further stimulated increased consumption, particularly in those aged 16 - 17 years.

Six submitters provided additional perspectives on the nature of alcohol-related harm. One individual referred to the links between alcohol consumption as a major cause of crime, especially violent crime including that most family violence witnessed by health providers resulted from the abuse of alcohol (one professional association). Another individual who worked in the health sector noted that a linkage existed between alcohol use and use of other drugs such as methamphetamine. One professional association added that physicians frequently deal with the impacts of alcohol abuse; treating patients for acute and chronic, physiological and psychological consequences of alcohol abuse. One health sector organisation reported significant year-on-year cost increases as a consequence of dealing with the increasing effects of alcohol-related harm. Another health sector organisation claimed that heavy episodic drinking is increasing among young people and is especially problematic in sportspeople where rates of binge drinking and harm are consistently higher than non-sporting peers and the general population.

2.2.2 Alcohol advertising and increased consumption and harm

Concern that alcohol advertising increases consumption (and therefore harm) was a key part of the rationale for supporting further restrictions. This is, of course, closely related to concerns about alcohol use and harm. For example, three submitters, primarily from the health sector, provided information on the array of linkages between alcohol advertising and sponsorship and alcohol use and abuse. Submitters noted that since the Law Commission's findings of 2010, further evidence has been developed demonstrating the links between alcohol advertising/sponsorship and alcohol consumption and alcohol-related harm (details of this evidence is provided in section 2.4).

One community group noted that alcohol marketing was one of the main drivers of heavy and harmful drinking. A community group, a health research group and a health sector organisation noted that advertising contributed to reducing the age of onset of drinking and it encourages those drinking to drink more. An individual argued that advertising glamourises and encourages a culture of binge drinking. One health sector group noted alcohol advertising encouraged young women to consume alcohol even when pregnant this being associated with increasing instances of foetal alcohol spectrum disorder.

Three individuals rejected the industry claim that advertising was only about brand awareness and considered that it is intended to increase volume (see sections 2.3 and 2.4). Another individual

22 noted the increase of advertising levels and the increased range of marketing. Much of this advertising is aimed at the many products which are target youth (eg, RTDs, pop-alcohol, fruit juice cocktails).

Twelve submitters (five health sector organisations, five individuals and two community groups) supported further restrictions to implement the Law Commission's recommendations as put forward in its 2010 report. Nine other submitters (including five health organisations, two community groups, one individual and one academic) also stated that the aim of any restrictions on alcohol advertising was to help de-normalise alcohol usage, delay the age at which young people start to drink, and to reduce harmful drinking. Another health sector organisation noted that restrictions on alcohol advertising were needed to create a media and cultural environment for children in New Zealand that is alcohol-free. According to one community group, restricting alcohol advertising is one of the most cost-effective measures for reducing alcohol-related harm.

The linkage between alcohol-related harm and alcohol advertising was disputed by those who do not support further restrictions (see section 2.3.4).

2.2.3 Concern about the effectiveness of self-regulation

Having identified the way in which alcohol advertising is associated with alcohol consumption, four submitters argued that there was an urgent requirement to introduce restrictions. In doing so, three individuals specifically noted that the self-regulation currently in place was generally ineffective (although no specific details of how the current system was ineffective were provided). One professional association expressed a view that the current Advertising Standards Authority Code for Advertising Liquor fails to take into account the ways in which alcohol marketing and sponsorship can indirectly influence perceptions and behaviours whilst appearing to adhere to the Code. The association noted that the Code needed to reflect the pervasiveness, subtlety and complexity of alcohol advertising and the rapid changes occurring in social media and communication technology.

Advertisers and retailers generally supported the Code and self-regulation (see sections 2.3.2 and 3.3.2).

2.2.4 Comparing further alcohol restrictions to tobacco control initiatives

Parallels with restrictions on tobacco were applied by three submitters. Specifically, one health sector organisation and one individual drew analogies between the harm done by alcohol and the harm done by tobacco. They suggested that the restrictions implemented for tobacco be adopted for alcohol. This would include the absolute banning of promotion. Two individuals requested that this course be adopted and noted the link between the banning of tobacco industry advertising and sponsorship and subsequent reductions in the consumption of tobacco. A research organisation agreed noting that the parallel with restrictions on marketing of tobacco is an important one. It suggested that while at first many people will think it is not a useful parallel because the substances are different and the end game is different (there is no expectation alcohol will not continue to be consumed and enjoyed in New Zealand) the parallel is nevertheless a real one; marketing is a driver of the harm associated with alcohol use just as it is with tobacco use. The organisation noted that 20 years ago it seemed a very big step to ban tobacco marketing, including sponsorship. The Smoke- free Environments Act has, however, contributed to the on-going reduction in tobacco related harm and it considered that the same outcomes are possible for alcohol.

23 2.3 Rationale for maintaining the status quo

Specific groups who were more likely to support the status quo included sporting bodies, advertising/media submitters, retailers, trade associations and alcohol industry submitters. All of those opposing the introduction of further restrictions on alcohol advertising (and therefore supporting the maintenance of the status quo) presented their reasons for holding this view. The following sections record submitters’ reasons for opposing further restrictions on alcohol advertising. Key issues raised were concern about the impact of decreased revenue on the viability of clubs and sports and wanting to ensure that the Sale and Supply of Alcohol Act 2012 beds in before further changes are sought. Other points sought to refute reasons given for further restrictions including that there is no link between alcohol advertising and alcohol-related harm and that the current regulatory model for overseeing alcohol advertising is effective.

2.3.1 Funding from alcohol advertising in maintaining the viability of clubs and events

Forty-two percent of submitters supporting the status quo were sporting bodies. These submitters noted the importance of sport to the community in that it promoted health in children and for other ages. Participation in sport was also identified with the gaining of leadership and other life skills (one sporting body).

Eighteen sporting bodies and clubs stated that advertising is essential to ensure viability of sport at all levels (professional and amateur). One sporting body specifically noted the need that existed for sport to be funded by alcohol advertising if it was to hold big events and ensure their lead teams were internationally competitive (especially as only eight percent of its funding came from government sources). Six sporting bodies stated that currently alcohol advertising was required to ensure sufficient funding was available for the operation of New Zealand sports clubs and to ensure their flagship sporting facilities remained attractive as a host destination for international competitions. The funding received from sponsorship is covered in more detail in section 3.3.2 of this report.

2.3.1.1 Acknowledgment of alcohol-related harm by sporting codes and clubs and their role in prevention

Like those supporting further restrictions, submitters supporting the status quo were mindful of the harm that alcohol can cause and their role in preventing or minimising this harm. This was particularly evident in submissions from fourteen sporting bodies, which acknowledged the seriousness of alcohol-related harm. They noted, however, that any harmful alcohol behaviours in sport were not necessarily reflective of problems in the sport itself but were simply reflective of the general problems in society. Nevertheless, a number of sporting bodies stated that they supported the efforts being made in public health to reduce alcohol-related harm. They in turn promoted responsible alcohol consumption at their venues and stated how they worked with others in the community to participate in educational initiatives towards reducing alcohol-related harm. Sixteen sporting bodies suggested therefore, that the actions being undertaken by sports bodies meant that not only were they aware of the impact of alcohol-related harm but that they were part of the solution.

Despite this, two sporting bodies did not think any further restrictions were required in relation to the alcohol marketing operating within their specific sporting code. Instead, they considered that

24 the current restrictions were adequate. Two sporting bodies noted that in recent years, the level of alcohol advertising evident on sportsfields and through other media had been scaled down. One sporting body noted that administrators worked with stadium operators and their top sports people to ensure the "right balance" of alcohol-related advertising was displayed. It also considered that the current level of alcohol advertising across their sport was of "minimal influence" on children and youth. This attitude was fairly broadly held by submitters supporting retention of the status quo.

2.3.2 Effectiveness of the Code and self-regulation

One trade association pointed to the Advertising Standards Authority which they viewed as very succ essfully operating a Voluntary Code for Advertising and Promotion of Alcohol. The Code had been re vised and reissued in January 2013. In addition, other guidelines were being developed such as the Health Promotion Agency’s National Guidance on alcohol promotions for on- and off- licences. Thes e were issued as interim documents in December 2013 and confirmed in April 2014. An advertising submitter agreed that one of the strengths of the Code was that with regular reviews the code is kep t up to date and reflective of current views and generally prevailing community standards on alcoh ol in New Zealand.

The Code was said to provide guidance to the advertising industry. An advertising submitter explained all media pre-vet advertisements before they are published or broadcast. The media have different systems to suit their individual needs but one common factor is that a senior person or persons is assigned the responsibility to ensure all advertising complies with the law and the ASA Codes. It is also recognised that special care needs to be taken with certain products such as alcohol. Consequently there is a second pre- vetting process for liquor advertisements called LAPS. All of the major liquor advertisers use and support LAPS. The media have agreed not to broadcast, publish or show brand liquor advertisements unless they have received approval from LAPS.

Seven advertising submitters generally considered that the current mix of government regulation and industry self-regulation was working effectively. Another advertising submitter noted self- regulation, and compliance with self-regulatory codes by producers, are effective alternatives to Government regulation. Furthermore, Government regulation and industry self-regulation are not mutually exclusive but intended to work in tandem; self-regulation is always set within a broader framework of Government regulation. A research organisation explained at some length the theory behind this mix, which has been named Responsive Regulation, and the best practice standards of this form of regulation. Another advertising submitter explained that within this framework of self- regulation broadcasters provide free airtime on radio and television to ALAC and now Health Promot ion Agency (HPA) for moderation advertising. Airtime to the value of $1 million per year is made by both radio and television. This undertaking of free airtime commenced in 1992, when alcohol advertising on broadcast media was allowed, and has continued for the subsequent 22 years.

The effectiveness of the Code and the self-regulatory structures currently in place was disputed by those who support the introduction of further restrictions (see section 2.2.3).

2.3.3 Bedding-in the Sale and Supply of Alcohol Act 2012

One retailer supported the Sale and Supply of Alcohol Act 2012, noting that it was doing a number of things to work within the new regulations. The retailer had a number of harm reduction policies in place in their stores including an age identification programme for alcohol purchases. The stores of this retailer were being reconfigured as required by the legislation. Any stores previously licensed to

25 sell beer or wine before 7am or after 11pm have reduced their hours to the national default. The retailer had introduced a limit on the percentage of discount being promoted outside of the store environment. There was no alcohol advertising on the external windows and walls of the stores. This retailer sought greater clarity around the new advertising and promotion restrictions claiming that there were different interpretations being held between councils, retailers, Medical Officers of Health and inspectors. The retailer considered there was an opportunity to increase the effectiveness of the existing policies through greater enforcement and the removal of inconsistencies in how the law is applied. Otherwise, no further restrictions were required.

Three retailer submitters considered that as the current voluntary and regulatory controls had only been in place for a relatively short period of time, there had not yet been enough time for evaluation to ascertain whether more regulatory or legislative change as far as advertising or promotions was necessary. This view was shared by an advertising submitter who claimed that it was premature to conclude that, after such a short time, the legislation was not delivering on its objectives and that further measures should be introduced. Instead it was considered that the Act should be given time to demonstrate its effectiveness.

2.3.4 No evidence that alcohol advertising causes alcohol-related harm

Advertising/media submitters noted that there is a lack of evidence to support the existence of a direct causal relationship between alcohol advertising spend and an increase in consumption. This was supported by other categories of submitter. For example, one sporting body considered that there was no evidence that alcohol advertising was the cause of alcohol related issues in society. Five other sporting bodies stated that they were aware of international examples where advertising and sponsorship restrictions had been put in place in a sporting environment, but without the result of reducing problem drinking. One sporting body considered that it would be extremely short- sighted to regulate all sport and all sport clubs in the same manner without further sport-specific research between codes, and that further regulations be based on solid research.

One research organisation provided an analysis of data on alcohol consumption, which was then utilised by 12 alcohol and advertising industry submitters. The following are some their results:

 The age of initiation of drinking by youth 12-17: There has been a steady change in the age of initiation with youth delaying commencing drinking. This is particularly so with younger persons.  Youth drinkers and non-drinkers: There has been a dramatic change. In the 2009/10 year the number of drinkers reduced from one-half of youth to less than a third.  Binge drinking by youth: calculates that hazardous drinking by youth aged 15-17 years fell from 19.5 percent in 2007/08 to 12.2 percent in 2011/12.  Frequency of drinking by youth: Youth are drinking less frequently but the increased number of non- drinkers in 2009/10 may influence this figure.  Alcohol consumption by youth: Average number of drinks consumed by youth aged 12-17 years that drink, on last occasion. The trend shows an increasing volume but the increasing number of non- drinkers who previously drank moderately may influence the 2009/10 figure.  Product preference by youth: Beer is the preferred drink by moderate drinkers. RTDs are the preferred drink by binge drinkers.  Stated offences: Minor Drink/Consume Liquor in a Public Place. There has been a steep decline in recent years.  Road deaths: There is a significant reduction in the past two years.

26 An annual analysis of alcohol advertising spend and consumption in New Zealand was also presented to show that there is no causal relationship between alcohol advertising spend and consumption in New Zealand. Over the past 27 years both advertising spend and consumption have varied widely but independently of each other (eg. 1998 was the year of the highest advertising spend and lowest consumption). Despite these fluctuations, one other advertiser and one other alcohol industry submitter noted that the one thing that has been consistent in recent years was that from 1998 to 2006 alcohol consumption gradually increased but at the same time advertising spend decreased.

Supporters of further restrictions generally considered that the body of evidence for further restricting alcohol advertising is sufficient to act (effectively disputing the claims made by submitters supporting the status quo – see section 2.2.2 of this report).

2.3.5 Advertiser-specific considerations

Several further reasons were put forward by the alcohol and advertising industry as to why further restrictions are not required:

 The aim of advertising in a mature market such as exists in New Zealand was not to increase overall consumption. Instead advertising in a mature market works to increase brand market share not overall market growth (nine submitters).  Advertising bans in other countries have not led to a reduction in harmful alcohol consumption (five submitters). One research organisation presented a study of the impact of full and partial alcohol advertising bans in various countries. The overall finding from the 20 studies undertaken was that, in practice, advertising bans had not resulted in a reduction in consumption.  Advertising is one of many factors that influenced consumer attitudes with many international studies showing that the principal influences on youth drinking behaviour were parents and peers behaviour (five submitters). Some research indicates there is a correlation or a link, but also acknowledges it can be difficult to isolate the impact of one aspect from another and there is often a hierarchy of other factors (one submitter).

One advertising submitter suggested that without recourse to advertising and sponsorship, the result within the alcohol industry would be increased price fighting, with price by default becoming the key differentiator between brands. This outcome would drive prices down, and make alcohol more accessible and more likely to contribute to harm.

27 2.4 Evidence presented in support of or opposition to further restrictions

Summary of the evidence presented in support or opposition to further restrictions on alcohol advertising

This analysis focuses on research published since 2010 (as presented by submitters). Occasionally, relevant grey literature and anecdotal material is footnoted where it deepens research commentary. A large amount of pre-2010 research was also provided by submitters: this has not been given a high priority in the analysis due to the volume of post-2010 material and the Forum’s focus. Generally, submitters considered that the body of evidence presented was sufficient to either warrant the implementation of further restrictions (or not). Few comments on the actual strength of the evidence base were provided.

Evidence presented by both those for and against further restrictions reflects the rationale presented by submitters. Again, there are clear differences of opinion regarding what the evidence base says: the difference split is based entirely on whether the submitters support further restrictions or not. Contradictions are noted below.

A large body of evidence was presented by those in support of further restrictions. This focused on the demonstrated effectiveness of advertising restrictions as a means of reducing alcohol-related harm (including in larger international studies or publications). Evidence stating the role advertising plays in increasing consumption and influencing the onset of drinking and brand preferences was also provided. A body of evidence was produced on the ineffectiveness of industry self-regulation regarding advertising. This evidence tended to focus on issues such as code violations, youth exposure exceeding industry standards or that there were higher proportions of advertising on youth-targeted channels. Each of these areas were refuted by submitters supporting the status quo. One piece of research identified public support for further restrictions.

A smaller body of post-2010 work was presented by those wishing to maintain the status quo. Published evidence focused on some or all of the following:

- Advertising is not a strong influencer of alcohol use: parents, siblings, and friends influence the age of onset of drinking and consumption levels, as well as other (less frequently covered) influencers such as engagement with education and amount of disposable income. - Rejection of the claim that advertising is an influencer or initiator of consumption by presenting evidence of studies showing weak causal links between alcohol advertising and consumption (including by youth). - Commentary about the limited effectiveness of comprehensive advertising bans in reducing consumption or harm (including refuting other studies that have demonstrated linkages or drawing on any ambiguity in study findings). - Anecdotal evidence about advertising being an enabler of participation in sports. - Evidence noting that the current self-regulatory approach is effective.

NB: The summary presented in this section is not intended to provide a critical appraisal of the evidence presented. Rather, it summarises the key points. Commentary about the strength of the evidence is outside of the scope of this report.

28 2.4.1 Evidence presented in support of further advertising restrictions

The following set of evidence published post-20102 was submitted by those seeking further restrictions on alcohol advertising. The synopsis given reflects submitters’ views on what the evidence shows, its significance, and notes where the study relates to (where this was able to be easily identified within the submission without referring to the full text of the article). The body of evidence discussed below was presented by a small group of submitters (twelve health organisations, two individuals, one academic and one cultural group). Generally, specific studies were discussed in detail by one submitter unless otherwise noted.

2.4.1.1 Support for further restrictions (general material on advertising/marketing)

 The Alcohol Concern Youth Policy project (Alcohol Concern, 2013) surveyed the views of over 2,300 children and young people under 18 years about if, how, and to what extent alcohol pr omotion should be regulated in England and Wales. This survey revealed that young people were concerned about alcohol promotion. The majority of those surveyed wanted protectio n that robustly limits young people’s exposure, often supporting stronger regulation than alr eady exists, but not measures that infringe on advertisers reaching adult audiences. The you ng people surveyed called for greater government involvement in regulatory decision makin g, more extensive health warnings and improved access to health information. Crucially, the survey findings suggest that significant numbers of young people fail to recognise non-media alcohol promotion such as sponsorship, and advertising on social networking sites.

 The New Zealand Drug Foundation (2013) sees regulation of alcohol advertising, marketing and promotion as the second-most effective way to reduce alcohol-related harm – after increasing the minimum price of alcohol.

 Casswell’s 2012 article on the Current Status of Alcohol Marketing Policy highlights the need for effective policy to restrict alcohol marketing. There is an urgent need to respond to the exposure of alcohol marketing to young people, and points to the Framework Convention on Tobacco Control as a suitable model to respond to concerns of alcohol marketing.

2 Submitters also presented a range of pre-2010 documents in support of their views, and which reflect the later evidence base. This included work by Smith and Foxcroft (2009), which found strong evidence to conclude that exposure to marketing increases the uptake of drinking by young people and reduces the age of onset of drinking – both of which will increase the likelihood of harmful patterns of drinking and make it more difficult for those individuals wishing to quit or moderate their drinking. Anderson et al (2009) noted “Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol”. Connor, You and Casswell (2009) indicated links between the misuse of alcohol and unsafe sex practices. The evidence also shows that alcohol use is associated with sexual assault and other forms of violence. For example, a 2009 study concluded that alcohol use (by perpetrators of assaults) was a factor in more than half of reported assaults in New Zealand. The findings suggest that more than 62,000 physical assaults and 10,000 sexual assaults occur every year in this country involving a perpetrator who has been drinking. Finally, two health submitters and one academic commented on Babor et al’s (2010) study. They published a second edition of “Alcohol: No Ordinary Commodity”, in which the evidence of harm from alcohol advertising and sponsorship had been found to have strengthened by new research findings from + to +/++. It provides some of the best scientific evidence available about ways alcohol damage can be reduced in a society. In particular, it emphasises the importance of gradual legislative change to bring alcohol-related harm under control, in a similar way that tobacco has been addressed. The publication resulted in the development of the acclaimed 5+ Solution to alcohol-related harm; a multifaceted set of policy directives providing an international, evidence based direction to alcohol harm-minimisation. Reducing marketing and advertising is one of the five policy directives. Restricting advertising is consistently shown to be an effective and cost-effective mechanism to reduce the harms associated with alcohol. The conclusions included: “The findings of an effect of exposure to marketing put the question of [increased] controls on advertising high on the policy agenda.”

29  Meier (2011) noted that there have been several recent articles published in Addiction addressing the role of alcohol marketing. Closer examination of these materials may inform the government’s policy on future directions and research regarding the advertising of alcohol. One of the key themes is that governments need to provide funding to support longitudinal studies on alcohol marketing to ascertain how exposure to alcohol advertising impacts on drinking behaviours and attitudes.

 Meir (2010) noted “longitudinal studies and recent systematic reviews now contribute considerable support for causal links, and have been instrumental in generating a growing scientific consensus that advertising in the traditional media influences drinking initiation, levels of consumption and drinking patterns in young people. This is an important step in refuting arguments that marketing influences brand share but not total consumption”.

Grey literature

 The Global Alcohol Policy Conference, an international organization of alcohol researchers and advocates recommended in their 2013 action programme “Establishing the strongest possible statutory restrictions on alcohol marketing of all kinds, in recognition of the growing body of literature linking youth exposure to alcohol marketing with increased likelihood of early initiation of alcohol use, which in turn is linked to greater likelihood of adverse consequences of alcohol use including injury and dependence.”

2.4.1.2 Increasing consumption of alcohol

 Siegel, Chen, DeJong, Naimi, Ostroff, Ross, and Jernigan (2014) noted that American youth are vulnerable to the effects of ‘brand’ only advertising. A study that compared brand specific consumption of youth and adults found that many branded products had a high proportion of youth drinkers. Whether measured by market share or prevalence, consumption patterns reflected influence on youth drinking more often than adult drinking.

 Clark, Robinson, Crengle, Sheridan, Jackson and Ameratunga (2013) found that 45 percent of New Zealand secondary school students reported drinking, and 23 percent binge drinking on at least one occasion in a four-week period in 2012.

 Regional Public Health’s 2013 study ‘What’s the Harm’ investigated the prevalence of alcohol and drug abuse amongst adolescents in the Hutt Valley and its contributing factors. Among t hese were the culture of acceptance and normalisation of alcohol use, believed to be influen ced by media and marketing.

 Grenard, Dent and Stacy (2013) surveyed a total of 3,890 students once a year for four years from grades 4 to 7 (Standard 3/Year 5 to Form 3/Year 9 in New Zealand). Survey measures included questions around alcohol advertising exposure, alcohol use, problems relating to alcohol use and those around covariates such as age and drinking by peers and close adults. The authors found that measures of exposure reported in grade 4 were associated with the increasing use of alcohol over time and the development of alcohol related problems by grade 9. They note that comprehensive policies were needed to prevent youth exposure to alcohol advertising across the spectrum of media.

30  Lin, Caswell, You and Huckle (2012) conducted research among New Zealand school children aged 13 years. They found brand affiliation (having a favourite brand of alcohol) predicted the quantities consumed (more than three drinks - 15 ml, equivalent to a can of RTD or beer) as compared with one drink by drinkers without a brand affiliation. Thirteen-year old non- drinkers who had a favourite brand were 73 percent more likely to say that they would drink next year. Follow-up with this sample when they were aged 15 years showed the non- drinkers who, at aged 13 years had been exposed to electronic marketing were significantly more likely to drink larger amounts at aged 15 years. Taking into account the amounts consumed at aged 13 years (and relevant demographic variables) reports of receiving free samples of alcohol products; free gifts at concerts or sports events; receiving special price offer for alcohol and mail/email promoting alcohol brands and/or owning clothing with alcohol brands on them predicted higher quantities consumed at aged 15 years. (Submitted by two academics).

 Huckle, Pledger and Casswell (2012) found that in New Zealand, there has been a marked inc rease in drinking by young people since the first introduction of brand advertising in the bro adcast media in 1992. The reduction in the minimum purchase age in 2000 further stimulate d increased consumption, particularly in those aged 16-17 years.

 Heung, Rempel and Krank (2012) noted “among [Canadian] youth, alcohol advertising ‘has been found to promote and reinforce perceptions of drinking as positive, glamorous, and relatively risk free’, all of which encourage a higher consumption of alcohol, often well before the legal age of purchase”.

 Jones and Magee (2011) note that there is a direct association between exposure to alcohol marketing and drinking and drinking patterns (in Australian research). They specifically noted noted that“... exposure to some of these types of alcohol advertisements [advertisem ents on television, in newspapers, billboards, posters, etc.] was associated with increased alc ohol consumption, with differences by age and gender. The results are consistent with studi es from other countries and suggest that exposure to alcohol advertisements among Australi an adolescents is strongly associated with drinking patterns”. (Submitted by two health sector organisations).

Grey literature

 In 2013 the Alcohol Policy in New Zealand survey carried out as part of the International Alcohol Control study found one in three (35 percent) of those aged 16-17 years reported drinking at least eight drinks on a typical drinking occasion as did more than one in three (38 percent) of the 18 – 19 years old (unpublished data).

2.4.1.3 The impact of alcohol advertising on the onset of young people’s drinking

 The Australian National Preventive Health Agency (2014) and the Australian Medical Association (2012) noted that several recent international systematic reviews, based on longitudinal studies, conclude that alcohol marketing influences adolescents and increases the likelihood that adolescents will start to use alcohol, and will drink more if they are already using alcohol.

31  Siegel et al (2014) showed that American young people’s exposure to alcohol marketing speeds up the onset of drinking, increases the likelihood they will drink and increases the amounts consumed by those already drinking. Positive messages about alcohol significantly influence youth drinking behaviour. Some brands have been found to be ‘youth oriented’, and marketing has been found to be a factor in this orientation. (Submitted by three health sector organisations).

 Myers and Parry (2013) noted, in South Africa, “this review identified thirteen longitudinal studies that have investigated the relationship between adolescent exposure to alcohol advertising and promotion and drinking. Twelve of the thirteen studies found evidence that such exposure predicts both the onset of drinking amongst non-drinkers and increased consumption amongst existing drinkers”.

 Siegfried et al (2013), made reference to the evidence for an effect of alcohol advertising on underage drinkers and that exposure to television, music videos and billboards which contain alcohol advertising predict onset of youth drinking and increased drinking.

 Further, Siegel et al’s (2012) research showed several brands of alcohol were disproportionately consumed by youth suggesting youth are not simply mimicking brand choices of adults but that alcohol advertising may be impacting on their particular brand choices. Other recent research has identified social technologies as playing a crucial role in young adults drinking cultures and processes of identity construction.

 Lin et al’s 2012 cross sectional studies also found a positive effect of alcohol marketing on the drinking behaviour of young people. They found that exposure to all forms of alcohol marketing is associated with early initiation and drinking by young people. They also found that having established a brand allegiance at aged 13-14 years, was related to drinking patterns including consuming larger quantities. (Submitted by four health sector organisations).

 Research published in the online journal BMJ Open, found that young teenagers who watch a lot of movies featuring alcohol are twice as likely to start drinking, compared to peers who watch relatively few such films. The study also showed that these teenagers were significantly more likely to progress to binge drinking. (The Globe, 2012).

 Gordon, Harris, Mackintosh and Moodie (2011) examined the cumulative impact of alcohol marketing on alcohol initiation and drinking behaviour among Scottish youth aged 12-14 years. Significant associations were found between awareness of, and involvement with, alcohol marketing and drinking behaviour and intentions to drink in the next year. The researchers concluded that given the associations, alcohol policy needed to be revised to limit youth exposure to the seemingly pervasive marketing communications. (Submitted by four health sector organisations and one academic).

 The Alcohol and Public Policy Group (2010) noted “evidence shows that exposure of young people to alcohol marketing speeds up the onset of drinking and increases the amount consumed by those already drinking. The extent of research available is considerable and shows effects consistently with young people. Marketing contributes undoubtedly to the ongoing recruitment of young people to replace older drinkers and to expand the drinking population in emerging markets”.

32 2.4.1.4 Types of promotion of alcohol

 The New Zealand Drug Foundation (2013) noted alcohol advertising is widespread in New Zealand, including in youth settings. For example, 90 percent of New Zealand children aged 5-17 years are exposed to alcohol advertising on television every week.

 Casswell (2011) identified the many diverse communication channels that the alcohol industry uses to promote alcohol in a range of settings (eg. stakeholder marketing).

 Jones et al (2010) indicated that even very young children are being groomed by the alcohol industry into positive attitudes towards alcohol and establishment of brand preferences by the use of promotions, colours, etc.

2.4.1.5 Concern about the effectiveness of self-regulation

 Babor and Robaina (2013a) showed international evidence has shown the inadequacies of the self-regulation of alcohol-related advertising and sponsorship. Studies in the USA, European Union, Brazil, Canada, Ireland, United Kingdom and Australia have all found that self-regulatory systems are dysfunctional and systematically violated. Professor Thomas Babor has labelled self-regulation as “spectacularly ineffective”. (Submitted by one community group and one health sector organisation).

 Babor, Xuan, Damon and Noel (2013b) evaluated advertising code violations using the US Beer Institute guidelines for responsible advertising and found that between 35 percent and 74 percent of the advertisements had code violations. Consequently, the authors suggest that the alcohol industry’s current self-regulatory framework is ineffective at preventing content violations but could be improved by the use of new rating procedures designed to better detect content code violations. (Submitted by one individual and one health sector organisation).

 Jernigan et al (2013) also evaluated the proportion of advertisements that appeared on television programmes in 25 local television markets in the US and found that youth exposure exceeded the industry standard. Researchers found that approximately one in four alcohol advertisements on a sample of 40 national TV programmes popular with youths had underage audiences >30 percent, exceeding the alcohol industry’s voluntary codes. They concluded that if the alcohol advertising on popular national television programmes in the 25 largest television markets were eliminated and not replaced, total youth exposure to alcohol advertising on these programmes could drop by as much as one third. Comparable studies in the UK also found that alcohol imagery occurred in over 40 percent of broadcasts, most commonly soap operas, feature films, sport and comedies, and was equally frequent before and after the 9pm watershed. Brand appearances occurred in 21 percent of programmes, and over half of all sports programmes, a third of soap operas and comedies and a fifth of advertising/trailer. The authors concluded that it is likely that this exposure has an important effect on alcohol consumption in young people. (Submitted by two health sector organisations and one individual).

 Ross, Ostroff and Jernigan (2014) further strengthens the conclusion that self-regulatory systems for alcohol advertising are ineffective. Researchers found that despite high levels of compliance with self-regulatory guidelines, in several countries youth exposure to alcohol advertising on television has grown faster than adult exposure. The researchers found that this was a result of an increase in placement of advertisements on cable television with high

33 concentrations of underage youth aged 18-20 years. They also demonstrated that for those aged 18-20 years, exposure to alcohol advertising can be reduced while maintaining exposure to adults as young as aged 21-24 years by reducing underage composition placement guidelines. (Submitted by one health sector organisation and one individual).

 Hastings’ (2010) research elaborated on the weaknesses inherent in voluntary regulation in the United Kingdom. For example, regulatory controls are only implemented once a complaint has been made; no attention is given to the volume of advertising and the use of images and merchandising cannot be adequately controlled.

2.4.1.6 Public support for further restrictions

 Maclennan et al (2012) found that promotion of alcohol has escalated in the last three decades because of industry self-regulation but there is strong public support for local government alcohol policies restricting the availability and promotion of alcohol.

 Peck (2011) found that, in the Health Sponsorship Council’s 2010 Health and Lifestyle survey: Alcohol Related Attitudes report, 81.9 percent of participants either supported or strongly supported increasing the restrictions on alcohol advertising or promotion that is seen and heard by children and young people.

2.4.2 Evidence presented in support of the status quo

The following set of evidence published post-2010 was submitted by those seeking to maintain the status quo. The synopsis given reflects submitters’ views on what the evidence shows, its significance, and notes where the study relates to (where this was able to be easily identified within the submission without referring to the full text of the article). The body of evidence discussed below was presented by a small group of 27 submitters, but 15 sporting bodies focused on one article, and seven advertisers and four alcohol industry submitters focused on another citation. Generally, specific studies were discussed in detail by one submitter unless otherwise noted.

2.4.2.1 Influencers on alcohol use

 Jones and Magee’s (2014) research from Australia concludes that the predictors of frequent alcohol consumption among adolescents included having a sibling or a friend who consumed alcohol; believing parents, friends and/or siblings approved of drinking; drinking behaviours of parents, friends and/or siblings; and having a higher disposable income. These results support previous findings from the USA on the role of family, friends and peers in adolescent alcohol consumption with an even stronger effect found in a country with a lower legal drinking age and high adult consumption rates.

 Maimaris’ 2014 literature review challenges the assumption that early onset of drinking leads to problem drinking in later life, there is in fact, little evidence to show that this is the case. (Submitted by two alcohol industry submitters).

 Chan, Kelly, Toumbouou, Hemphill, Young, Haynes and Catalano (2013) concluded that in research from Australia the strongest factors that predicted drinking behaviour were (a) low

34 school commitment upon the transition to high school; (b) the presence of a sibling who consumed alcohol; and (c) parental attitudes favourable to alcohol use.

 Deakin University (2013) found that, in the USA, rates of teen binge drinking were reduced by 25 per cent when parents set rules not to supply or allow adolescent alcohol use.

 Roper (2012) indicated that, in the USA, parents have the greatest influence over youth consumption. Only 1.8 percent of 13-17 year olds saying ads influence their decision to drink, and 73.1 percent saying that parents influence their decisions.

 Brooks et al (2010), in a UK study about how children learn about alcohol in “ordinary families”, found that the home is an important source of learning about alcohol. Young children anticipate modelling their future behaviour on parents' drinking styles rather than on negative teenage-drinking styles, and parents often have limited view in their ability to teach children to drink responsibly, in the face of external pressures.

 Habib, Santoro, Kremer, Toumbourou, Leslie and Williams (2010) found that, in an Australian study, family management, which included practices such as parental monitoring and family rules about alcohol use, had the strongest and most consistent relationship with alcohol use in early adolescence.

2.4.2.2 Effect of advertising on alcohol consumption

 Grenard et al (2013) in a recent study of alcohol advertising and youth alcohol related problems could not verify causality.

 Bryden (2012) found little evidence of the harmful effects of alcohol advertising.

 Stoolmiller et al (2012) in a US study compared media/marketing exposures and family factors in predicting adolescent alcohol use, particularly early onset of drinking and progression to binge drinking, found that the family environment, including parent and sibling behaviour was critically important.

 Nelson’s (2011) two contemporary systematic reviews, which were heavily relied upon in the Law Commission Report, have both come under criticism for their lack of comprehensiveness with the researcher noting: “while both prior reviews recognize that their conclusions might be contaminated by publication bias, neither goes beyond mere recognition of this problem.” In his analysis, the researcher concluded “it would be equally correct to state that many studies also found evidence of a null effect for marketing exposure, especially the commercial mass media.”

 Morgenstern, Isensee, Sargent and Hanewinkel’s (2011) study on exposure to alcohol advertising and youth drinking, while showing a link in recall, did not demonstrate a causative link to excessive consumption.

 Jones and Magee (2011) in an Australian study did not demonstrate a particular effect of advertising on teen alcohol consumption.

 Fifteen sporting body submitters cited Sport New Zealand's 2010 study, 'Alcohol and Sport', which found overall that hard evidence was limited and insufficient to describe the full

35 extent and nature of alcohol-related harm in sport in New Zealand. Research to date does not provide evidence that sports have more of a problem with the misuse of alcohol than New Zealand society in general. This study was used to suggest that what happens in sport, particularly in relation to harmful alcohol behaviours, is a reflection of what is happening in New Zealand society and reflects trends in how New Zealanders are drinking generally'.

 Nelson’s (2010c) review of 20 longitudinal studies of youth drinking found substantial methodological shortcomings which precluded a causal interpretation between alcohol advertising and youth consumption. The review also noted that evidence on brand recognition or brand approval is not clear evidence regarding the general effects of advertising-marketing on youth drinking behaviours or evidence of a causal effect of advertising on youthful drinking. Recognition or receptivity does not necessarily lead to uptake. (Submitted by two alcohol industry submitters).

 The Foundation for Advertising Research provided data on alcohol consumption, which was used by 11 alcohol and advertising industry submitters. This is referred to in further detail under section 2.3.4.

2.4.2.3 Limited effect of alcohol advertising bans on decreasing consumption and harm

NB: It is not clear whether this research refers to comprehensive bans or strict restrictions on advertising content.

 The Foundation for Advertising Research’s (2014) study on the impact of full and partial alcohol advertising bans in various countries found that from the 20 studies undertaken was that, in practice, advertising bans had not resulted in a reduction in consumption.

 Nelson’s (2010a) analysis of data from 17 OECD countries for the period between 1975 and 2000, suggested advertising bans did not reduce alcohol consumption.

 Nelson’s (2010d) analysis of data from 17 OECD countries for the period between 1975 and 2000, suggested statistically insignificant or contrary effects of advertising bans on alcohol consumption.

Anecdotal evidence

 Aware of a small number of international examples where advertising and sponsorship restrictions have been put in place in relation to alcohol in a sporting environment, however four sporting bodies have seen no evidence that such restrictions have had the desired effect of reducing problem drinking, but instead put significant costs onto the tax payer to replace the funding stream.

 Virtually all scientific evidence demonstrates that alcohol advertising bans have no impact on overall alcohol consumption. Countries that have tried alcohol advertising bans, such as Canada and Norway, have experienced its ineffectiveness in reducing overall alcohol consumption.

Anecdotal evidence focused on initiatives that submitters’ are undertaking to reduce alcohol-related harm, including feedback from police that sport took a responsible attitude toward managing the

36 consumption of alcohol at sport venues and that there had been no criminal offences attributed to drinking at matches, stadia or in clubs. Another suggestion was that ground signage featuring liquor is being reduced and replaced by other providers. There have been very few successful prosecutions of off-licence holders to date which substantiates submitter's view that the current voluntary and regulatory controls are effective even although some of them have been in force for a relatively short period of time. Anecdotal evidence was also presented regarding advertising being an enabler of sports participation: recent decreases in support from the alcohol industry have led to increases in subs which had impacted on those players who benefit most from sport.

2.5 Proposed advertising restrictions

Submitters who proposed that there be further restrictions on alcohol advertising were asked by the Forum to provide further details. Firstly, the Forum asked about the nature or form of any possible restrictions (Question 10). Submitters were then asked to describe how the proposed restrictions would work in practice to reduce alcohol-related harm (Question 11). Finally, submitters were asked if they knew of any evidence that would demonstrate that their proposal would work (Question 12).

The Forum also expressed an interest in learning of the impacts arising from the proposed restrictions. Submitters were asked to identify which of the population groups would be affected by the restriction and how would they be affected (Question 20). Submitters were also asked about other impacts arising from the proposed restrictions on matters like alcohol consumption, alcohol- related harm, perceptions of alcohol, on businesses, recipients of alcohol sponsorship funds and other population groups (Question 21).

Of the 177 submitters who expressed the view that restrictions should proceed, 176 were able, to at least some degree, to record the nature of those restrictions. Very few proposed restrictions without indicating what they might be (n=1). Therefore the categories of submitters of those proposing restrictions and describing their nature essentially is the same as that presented at section 1.3.1 which records those submitters supporting restrictions (see overleaf).

Organisations

Forty-four organisations proposed further restrictions through free-form submissions:

 Health sector 23 submitters  Professional association 6 submitters  Community or cultural groups 6 submitters  Local government 5 submitters  Academic and research 3 submitters  Trade association 1 submitter.

Fifteen other organisations submitted proposed restrictions through a template submission.

37 Individuals

One hundred and seventeen individuals proposed further restrictions, including 19 who submitted through free-form submissions.

 Public/consumers 13 submitters  Health sector 5 submitters  Academic and research 1 submitter.

A further 98 individuals proposed further restrictions on a template submission.

38 Summary of proposed restrictions on alcohol advertising

While a wide range of restrictions were proposed, there was overwhelming support for the implementation of Stage 3 of the Law Commission’s recommendations with a much smaller number of other restrictions (including those that represent a subset of the Stage 3 recommendations) also being proposed. Graphic 2 (below) summarises the possible restrictions proposed by submitters.

Graphic 2: Overall level of support for further advertising restrictions

Other than alcohol industry and sports groups noting the range of steps currently taken to address or manage alcohol-related harm, there were no specific new non-regulatory initiatives proposed.

Commentary on how the possible proposals would work, the evidence supporting this, and the effectiveness and impacts of the proposals were generally only provided by those submitters who completed the Forum’s form. Information about the reasons for implementing proposals focused on the same range of issues as identified in the rationale for seeking further restrictions on alcohol advertising (i.e., the focus was on the impact of the proposed changes in terms of reducing alcohol- related harm, positively changing New Zealand’s drinking culture, and delaying the age of onset of drinking). Generally, in terms of effectiveness, submitters noted that the restrictions would reduce consumption. Several also cited international experiences in implementing advertising bans/restrictions and that there was a decrease. Parallels with tobacco control initiatives were also drawn.

Identified impacts tended to be very general, with some submitters noting that everyone would be affected (for the better). Other population groups identified as receiving a positive benefit from the further restrictions included Māori, young people, and families. Negative impacts were identified for industry and others involved in the manufacture of alcoholic beverages.

Future challenges focused on managing promotion in social media spaces and trade considerations.

39 2.5.1 Proposed restrictions

Submitters proposed a wide range of possible restrictions. There was a strong focus on implementing Stage 3 of the Law Commission’s recommendations in terms of implementing comprehensive restrictions on advertising (or subsets of these recommendations such as requiring health messaging and restricting promotion of discounts/pricing). Other options canvassed included providing guidelines on irresponsible promotion for retailers, updating the Code, and setting limits on locations where alcohol may be advertised (including on social media). Submitters also used the phrase ‘ban’ extensively when referring to the Law Commission’s recommendations. Submitters’ wording has been used in this section (resulting in terminology such as ‘ban’ and ‘comprehensive restrictions’).

2.5.1.1 Comprehensive restrictions on alcohol advertising

None of the submissions received sought a complete ban of all alcohol advertising. Nevertheless, most submitters sought a set of comprehensive advertising restrictions across all media (with the exception of advertising for product information) as envisaged by the Law Commission in its 2010 report.

Responses from template submissions

The 17 individuals and 12 organisations who signed the Alcohol HealthWatch template submission recommended that the Forum support the immediate implementation of Stage 3 of the Law Commission's recommendations on alcohol advertising and sponsorship. The recommended restrictions in relation to alcohol advertising were as follows:

 Messages and images may refer only to the qualities of products, such as origin, composition, means of production and patterns of consumption.  The banning of images of drinkers or the depiction of a drinking atmosphere.  Only allowing advertising in press with a majority readership over aged 20 years.

Submitters stated that this meant content be restricted for all forms of alcohol advertising, other than objective product information, in all media. The submitters proposed that there should be a setting out of what alcohol advertising is allowed (i.e., that associated with objective product information only – that is, the characteristics of the beverage, the manner of its production and price) with all other advertising being stopped. Submitters noted that they meant for this proposal to apply to all broadcast, billboard and outdoor advertising, all print media, and all website and social media content that is generated by New Zealand-based companies and individuals. As this was effectively an immediate end of self-regulation, submitters sought for an independent body to be established to take over the management and regulation of alcohol advertising and sponsorship.

The other template submissions proposed similar restrictions on alcohol advertising although less detail was provided. The Alcohol HealthWatch postcard, submitted by 34 individuals, simply stated their support for no alcohol advertising, in any media, other than advertising that communicated objective product information. The CAYAD National Implementation Team template submission, signed by 47 individuals and three organisations, called for the same restriction.

40 Responses from free-form submissions

Many free-form submissions also drew on the Law Commission's recommendations and proposed similar comprehensive advertising restrictions to those proposed by submitters as the template submissions. For example, six submitters (including four health sector organisations, one community group and one academic) reflected the Alcohol HealthWatch template submission's call for the adoption of the Law Commission's specific recommendations for Stage 3 regarding images of drinkers and an age limit for print media. An end to self-regulation was called for by seven health sector organisations and a community group as was the establishment of an independent body to take over the management and regulation of alcohol advertising and sponsorship. The idea of restricting all alcohol advertising, in any media, other than advertising that communicated objective product information also was reiterated by 22 other submitters (including 14 health sector organisations, six individuals, one community group, and one academic). One health sector organisation observed that a ban on alcohol advertising aligns to the 5+ Solution for Alcohol Harm Reduction. Another health sector organisation noted that removing marketing of alcohol is regarded as one of the three ‘best buys’ by the World Health Organisation; meaning one of the three most effective policies to reduce the harm from alcohol and also one of the most cost effective policies to implement.

Implementing further comprehensive restrictions would be enforced through amendments to the Sale and Supply of Alcohol Act, 2012 (three health sector organisations, two individuals). As part of its recommendations, the Law Commission explored the Loi Evin model of regulation. Five submitters (three health sector organisations, one academic and one individual) specifically referred to Loi Evin (the French law prohibiting alcohol advertising, placing strict control over messages and images, and requiring all advertisements to include a message that alcohol abuse is dangerous) as a possible basis of alcohol advertising restrictions. Similarly, one community group further pointed that a number of countries around the world had have restricted or banned various forms of alcohol advertising and suggested that these models be evaluated when assessing what might be adopted in New Zealand. One research organisation suggested that the Smoke-free Environments Act 1990 may provide a useful model as it has the advantage of thorough coverage of all marketing and sponsorship and includes internet marketing.

2.5.1.2 Other possible restrictions that are a subset of the broader recommendations to implement a comprehensive suite of restrictions

A small range of other possible restrictions were proposed. Some of these reflect what is already covered by the submitters who called for a broader range of restrictions. This includes restrictions specifically targeted at broadcast media and in social media spaces, requiring health advisory messages, restricting the advertisement of discounts/promotions, and specified restrictions on the places where advertising can occur.

Specific restrictions for broadcast media

While, as indicated in section 2.5.1.1, most submitters sought to put in place a comprehensive set of restrictions on alcohol advertising across all media, a few focused their comments on broadcast media only. One health sector organisation specifically noted that alcohol should not be advertised on the TV especially, neither in the media nor on films. Another specific suggestion regarding broadcast media came from a professional association which stated its support of a ban on all alcohol advertising on television or radio before 10:00pm.

41 Requiring health advisory messages

The 17 individuals and the 12 organisations who signed the Alcohol HealthWatch template submission recommended that any permitted alcohol advertising is accompanied by health advisory messages developed by public health experts. Seven other submitters (including five health sector organisations, one academic and one individual) made the same call. A health sector organisation suggested that one health message to be included on alcohol products might be to the effect that “alcohol abuse is dangerous for health”. This is similar to the model used in France (i.e., the Loi Evin – see section 2.5.1.1 and 2.5.4).

One research organisation recommended that following further restrictions being placed on alcohol advertising as requested by submitters, there should be an increase in the HPA (ALAC) levy to allow for increased social marketing. They commented that this would have more chance of success than the current activity in an environment no longer dominated by commercial marketing messages. They also thought that it would serve to mitigate the effect on the advertising and media industries.

Restrict promotion of discounts

One trade association sought a ban on advertising the price at which alcohol products are being sold. The submitter proposed that removal of this information would remove the incentive to use alcohol as a loss leader and, as a consequence, the off-premise retail price of alcohol products will rise. The submitter noted that for those with a tendency to binge drink it is all about how much alcohol can be purchased with the dollars available. It is expected therefore that with retailers competing for market share on the basis of the experience or brand value instead of price, prices will rise and the incidences of binge drinking will decline, particularly among young people whose discretionary income is less, which is a significant factor in how they consume alcohol.

Specific restrictions for specified locations

One health sector organisation sought to remove alcohol advertising from public transport. Another health sector organisation also produced a specific list of restrictions:

 No advertising is allowed on television or in cinemas.  No advertising on liquor stores particularly in areas of high Māori population.  No advertising on and in supermarkets.  The Whānau Ora Health Impact Assessment Tool is used in the development of appropriate interventions (although no further information about the use of this tool was provided).

Two health sector organisations stated that the marketing of alcohol at youth should be explicitly prohibited.

One media industry submitter, while not broadly supporting the idea of restricting alcohol advertising, indicated, however, that they would also support discussion on whether some form of restriction should occur on television commercials that glorify lifestyle activities along with consumption of alcoholic products. Another submitter associated with the alcohol industry, who again was broadly against wide-ranging restrictions being placed on alcohol advertising, stated that they did not object to further restriction regarding the code for advertising liquor around the

42 connection of alcohol to lifestyle or status. They also opposed endorsements that used celebrity endorsement.

2.5.1.3 Other proposed restrictions

Guidelines on irresponsible promotion

Three local government bodies, wished to draw the Forum's attention to a series of concerns they held in relation to advertising trends and practices in their areas. This included irresponsible promotions. Section 237 of the SSAA introduced a new offence relating to irresponsible promotion of supply and consumption of alcohol. While this is welcome, new national guidelines are needed on ‘irresponsible promotions’ so that communities can understand more clearly what is and is not allowed (eg, greater clarity about whether the promotion of ‘single sales’ of beer, RTDs or miniature spirits are an ‘irresponsible promotion’).

Update the Code

One professional association recommended that, given their view that the Advertising Standards Authority Code for Advertising Liquor fails to take into account the ways in which alcohol marketing and sponsorship can indirectly influence perceptions and behaviours, the Code be urgently updated and that those developing the new Code access research on the psychology of marketing to ensure that the Code reflects the reality of the impact of marketing on the public. Another local government submitter requested that the Code be amended to require that advertisements comply with local government requirements.

Places where alcohol can be advertised

Two health sector organisations suggested simply that there should be no alcohol advertising on social media sites. In addition, a community group proposed that the Government should restrict new forms of marketing that target young people using social media such as Facebook or viral text messaging. One professional association recognised that much advertising now occurs via social media and other digital platforms. They suggested, therefore, that clear and transparent rules around the content of alcohol advertisements be developed and applied to all media, including digital media. A research organisation noted that legislation needs to be written in such a way as to ban alcohol promotion completely in all modes or, as in the Loi Evin, to ban other than where specified as allowed.

Three local government bodies identified a range of types of advertising that they considered should be covered during the Forum’s deliberations: billboards, advertising on street frontages, and promotion inside supermarkets.

 Advertising on billboards: Submitters expected the regulation of billboard advertising of alcohol should remain under the control of local authorities, but thought consideration of this issue comes within the terms of reference of the Forum (and it was an issue also raised in the Alcohol HealthWatch template submission). In the view of submitters, billboards advertising or promoting alcohol are a very prominent form of promotion and had a negative impact on communities, similar to the impacts from other media (such as print and

43 broadcast media). Billboards are typically regulated either through a local authority’s district plan or bylaws (or both) but because of the nature of the regulatory power by which local authorities regulate billboards, submitters questioned whether this was sufficient to allow them to regulate or differentiate between types of content. Their sense is that a clear legislative mandate may be required. Submitters viewed that billboards advertising or promoting alcohol must be treated as one of important media being considered by the Forum as it considers the introduction of legislative measures aimed at reducing exposure to advertising, particularly for young people. Three health sector organisations also sought the removal of billboard advertising.

 Advertising on street frontages outside off-licence premises: similar to billboard, the submitters expect the regulation of signage advertising alcohol on street frontages outside off-licence premises (including sandwich boards) should remain under the control of local authorities. Again, however, submitters considered that this form of advertising must be treated as one of media being considered by the Forum and that legislation needed to be passed to clearly allow local authorities to prohibit or regulate signs advertising alcohol (including sandwich boards).

 Advertising or promotion inside supermarkets: submitters noted that sections 112 to 114 of the SSAA set out new compulsory conditions relating to display and promotion of alcohol in single areas in supermarkets and grocery stores. They considered that while the drafting of the sections is a little complex, the overall intent was clearly “to limit (so far as is reasonably practicable) the exposure of shoppers in supermarkets and grocery stores to displays and promotions of alcohol, and advertisements for alcohol.” Their concern was that, following enactment of the SSAA, some supermarkets had rearranged their ‘alcohol areas’ in a manner that is, in the view of submitters, contrary to the overall purpose of the Act while perhaps seemingly complying with the letter of them. For example, some supermarkets have rearranged their alcohol area so that it is adjacent to the main entrance to the premises or else they have created ‘stacks of beer’ or other advertising and promotions. Submitters acknowledged that supermarkets who are operating in this manner believe they are acting within the new legal requirements although submitters doubted this. If it is the case that these practices are lawful, then it is was their submission to the Forum that these sections of the SSAA must be strengthened so that the purpose of limiting (so far as is reasonably practicable) the exposure of shoppers in supermarkets and grocery stores to displays and promotions of alcohol, and advertisements for alcohol is achieved.

2.5.1.4 Future interventions

Generally, submitters considered that there was sufficient evidence for action to be undertaken now. As such, there was limited commentary about the range of future interventions that could be undertaken that was not already covered in the discussion about proposed initiatives (or they referred to non-advertising/promotion initiatives such as taxation).

2.5.2 How would the proposed restrictions work in practice? (Question 11)

Although many of the responses to Question 11 mirrored some of rationale presented earlier in this analysis (see section 2.2), they are presented here as a distinct group as intended by submitters who filled in the Forum's submission form.

44 Generally, submitters who responded focused on the impact of the proposed changes in terms of reducing alcohol-related harm and youth onset of drinking. For example, a professional association stated that the proposed restrictions on alcohol advertising would break those links which research had shown existed between the marketing and promotion of alcohol and excessive consumption (see section 2.4.1 of this report). One research organisation explained that alcohol-related harm is, to a very large extent, consequential on levels of alcohol consumption. It noted the research evidence which shows alcohol marketing increases levels of consumption in young people implies reduction in marketing will reduce their levels of consumption; in turn this will reduce associated harm. This will happen both in the short term but also longer term since there is evidence that levels of high quantity drinking among young people have effects in later life.

Six health sector groups submitted that restricting advertising would reduce the appeal of alcohol to children, young men and whānau and undermine its normalisation as being an ordinary commodity in our society. Three of these and one other health sector organisation suggested that restrictions on advertising would assist in delaying the age of drinking initiation and reduce heavy and binge drinking, thus reducing alcohol related harm, especially to young people.

Another professional association and three health sector groups noted that ending alcohol advertising, combined with a comprehensive package of interventions, is a particularly important step if there is to be a shift in the culture of drinking in New Zealand. Such action was required to reverse the impact of alcohol-related harm.

2.5.3 Evidence that the possible proposals will work (Question 12)

Several submitters, using the Forum's submission form, provided commentary on why they thought the proposed restriction on advertising would work (Question 12). Commentary focused on drawing comparisons to the success of tobacco control initiatives, evidence of success from other jurisdictions and general commentary stating that restrictions will reduce alcohol-related harms.

Two submitters drew analogies with the policy and regulation successfully used in relation to tobacco. One health sector organisation suggested that research on tobacco advertising, where direct impacts of advertising restrictions on consumption are shown and widely accepted, is also useful to predict the likely effect of advertising restrictions on drinking behaviour. To that end, a comparative study across 18 European countries by Schapp et al (2008) was cited showing that the degree of tobacco advertising restrictions has been found to predict level of smoking cessation.

Two health sector organisations and one research organisation produced further evidence on the impact of restrictions introduced in other countries. An evaluation by EuroCare (2010) of alcohol marketing regulations in other countries has found that the most effective were those of Norway and France. In Norway, all alcohol marketing is prohibited and in France the Loi Evin bans the promotion of alcohol on TV and cinemas, as well as alcohol sponsorship of cultural and sports events. One research organisation noted that although Loi Evin had not been subjected to evaluation over a decade after its introduction, but local researchers had stated: "As a consequence, since 1991 we can observe a real change in alcohol advertising: the law has modified the language of advertising losing most of its seductive character. It is no longer allowed to use drinkers and drinking atmospheres: we have observed the disappearance of the drinker from the images and the highlighting of the product itself." (Rigaud,2004). The Loi Evin model of regulation utilised in France has been shown to be successful in reducing a range of alcohol-related harms in the country. As a direct result of Loi Evin France has seen the highest reduction in deaths linked to cirhosis of the liver.

45 A health sector organisation noted that evidence from Saffer and Dave (2008) on the manner in which marketing affects drinking behaviour can be used to draw conclusions regarding the likely impact of proposed restrictions. Therefore an analysis of data from 20 countries over 26 years was cited which found that an increase of one ban (of media or beverage type) could reduce alcohol consumption by 5–8 percent. It suggested, therefore, a comprehensive advertising ban would be expected to have a significant effect on consumption levels and therefore alcohol-related harms.

One professional association pointed to the "substantial evidence" of the way that advertising of alcohol contributes to problematic consumption as a basis to assume that the proposed restriction will have a positive impact. No specific references were provided. A health sector organisation pointed to the effectiveness of social norm strategies in influencing behaviour though altering perceptions of what is socially acceptable and cited relevant research including research from the Department of Health Promotion and Protection, 2007, and Schrans et al, 2009.

Those favouring the status quo provided evidence to dispute the effectiveness of restrictions such as those put in place through Loi Evin. Their views are discussed in section 2.4.2 of this report.

2.5.4 The impacts of the possible proposals (Questions 20 and 21)

The Forum asked submitters to comment on the impacts of any proposed restrictions . Submitters identified the following impacts: universal benefits and specific positive benefits for young people, families, heavy drinkers, and Māori. Negative benefits may accrue to advertisers and the alcohol industry.

Three health sector organisations simply suggested that the restricting advertising, as part of a package of measures aimed at reversing alcohol-related harm, will impact for the better, everywhere and impact upon everyone. One health sector organisation identified that, at a population health level, the resultant decrease in early initiation and hazardous alcohol consumption would result in reductions across the population in the incidence of more than 60 different medical conditions for which alcohol is causal factor (citing Room and Rehm, 2005).

One health sector organisation similarly envisaged that the proposed interventions in sponsorship and advertising would broadly affect Māori population groups. Tamariki Māori, rangatahi Māori, whole whānau and communities of Aotearoa New Zealand, through having less exposure to alcohol promotion as an everyday harmless product, will improve Māori health outcomes, reduce health inequities between Māori and non-Māori and reduce alcohol consumption, and therefore alcohol- related harm, for Māori especially amongst young drinkers and heavy drinkers.

One health sector organisation considered that the population groups that would be positively affected by alcohol advertising restrictions included children, young people aged 14-17 years, Maori, Pacific communities and others experiencing disparities.

46 Another health sector organisation produced the following population groups who would benefit from restrictions:

 Children and young people who are affected by the perception of alcohol as an attractive and an everyday commodity.  Heavy drinkers whose addictions are constantly re-enforced by the heavy presence of alcohol marketing.  Māori youth who are more likely to report consuming large quantities of alcohol at a time (Clark et al, 2013).  Families who are affected by domestic violence and poverty associated with alcohol.

A health sector organisation observed that New Zealand youth would be the greatest affected – by reducing their exposure to alcohol advertising and removing the frequent message they receive through many forms of media that the use of alcohol and in particular heavy drinking is behaviour without risk. In the absence of heavy alcohol marketing, public health and educational messages about the risks of heavy alcohol use would more effectively reach children and young people. Two other submitters (one individual and one health sector organisation) agreed that a total immediate ban would remove any images that portrayed alcohol as cool. The evidence that it would work is that it worked for tobacco.

A health sector organisation added that those people trying to deal with alcohol problems in the community would also benefit as alcohol advertising serves as a powerful trigger for those recovering from alcohol dependence, and the current prolific placement of alcohol imagery in the community makes their recovery all the more difficult.

Another health sector organisation noted that any decrease in consumption arising from advertising and other restrictions would positively affect those individuals who are at risk of causing foetal alcohol spectrum disorder for their unborn children and the women and men within community settings and hospitals that will not have to deal with the social and behavioural problems exhibited by individuals with the disability. This, in turn, will save the government thousands in dollars.

One health sector organisation acknowledged that the alcohol industry would be affected as its profits reduce. Research was identified that highlighted how any reduction in consumption among the heavier drinkers will impact significantly on the sales and therefore the profits of the industry (Casswell, 2014). One professional association also noted negative economic impacts among those that produce, market and sell alcohol, but that over time positive economic impacts would be experienced by taxpayers who fund the many health, justice, welfare and other costs of excessive alcohol consumption. Similarly, the Government would receive less excise tax from alcohol sales but this would be offset by a reduction in health, justice and welfare costs.

2.6 Challenges and solutions

The Forum asked submitters to identify ongoing and emerging challenges that it should take into account when considering whether further restrictions on alcohol advertising were necessary to reduce alcohol-related harm (Question 24). The Forum was also interested in suggestions about the actions that could be taken to address these challenges (Question 25).

47 Issues were raised about the expansion of alcohol advertising on or in social media and calling for restrictions that would address marketing in/on social media and concerns about imposing unduly on the rights of advertisers and producers.

2.6.1 Social Media

Submitters considered that advertising and promotion in/on social media is a significant ongoing challenge. For example, a health sector organisation noted that the introduction of digital technologies has opened up new platforms for marketing and promotion, with alcohol companies aggressively harnessing the marketing potential of online video channels, mobile phones, interactive games, and social networks such as Facebook and Twitter. Marketing efforts are increasingly sophisticated and multi-dimensional, integrating online and offline promotions with the sponsorship of music and sporting events, the distribution of branded merchandise, and the proliferation of new alcoholic brands and flavours. A research organisation pointed out how extensive and growing use of social media provides extensive opportunities for the dissemination of alcohol marketing products and is likely to amplify the effects of marketing already demonstrated in research on the traditional media. Social media case studies of a selection of alcohol brands by RAND Europe in 2012 showed that these all have considerable online media presence featuring both marketer-generated and user generated content.

Other submitters addressed the issue by providing research evidence findings in relation to alcohol advertising and social media. While submitters presented a range of evidence about the increasing use of social marketing (and registered their concerns about this), few proposed solutions or ways to address this aside from noting the efforts undertaken in other countries.

 Lyons (2013) stated, “Alcohol companies employed social media to market their products to young people in sophisticated ways that meant the campaigns and actions were rarely perceived as marketing. Online alcohol marketing initiatives were actively appropriated by young people and reproduced within their Facebook pages to present tastes and preferences, facilitate social interaction, construct identities, and more generally develop cultural capital. These commercial activities within the commercial platforms that constitute social networking systems contribute heavily to a general ‘culture of intoxication’. (Submitted by two health submitters).

 Jernigan and Rushman (2014) recorded that transnational corporations such as Diageo and H eineken have commercial partnerships with social networking services allowing an integrate d relationship with the brands’ fan base which is a new development. They noted that in a l etter to the FTC in 2011, the attorneys general (the leading law enforcement officers) of 24 US states and territories warned of ‘a “brave new world” of marketing that will expose millio ns of American youth to alcohol advertising messages on their cell phones and computers w hile at the same time taxing regulators’ capacity and understanding’. They urged the FTC no t to rely solely on industry assurances of responsibility, but rather to gather the facts necessa ry for an independent assessment of what regulatory oversight is appropriate. (Submitted by one research organisation).

 In a separate analysis electronic marketing (looked at a web site for alcohol brands; downloa ded cellphone or computer screen saver for alcohol brands; used social network service cont aining alcohol brands; downloaded alcohol related ringtone; entered alcohol competition via txt/webs/radio/etc.; played online game promoting an alcohol website; viewed alcohol bran ds ads on webs; become a fan or joined any alcohol brands via SNS; completed an alcohol-rel

48 ated quiz on alcohol website) also predicted larger quantities consumed and in both analyses having a favourite brand was significantly predictive of higher amounts consumed at aged 15 years (data submitted for publication). (Submitted by one research organisation).

 Eurocare (2014) found that around the world, governments are trying to figure out how to regulate internet marketing. For example, Russia has banned all alcohol marketing originating from sites inside Russia. Finland has recently passed legislated restrictions on alcohol advertising which include restrictions on alcohol marketing in social media based on contents produced or shared by consumers themselves or games, raffles or contests. (Submitted by one research organisation).

 Lyons’ (2013) New Zealand research has shown that alcohol is a key component of University student’s identity on Facebook. It also suggests that alcohol brands are embedded within everyday Facebook practices and act like ‘friend’ relationships. (Submitted by one community organisation).

 Brodmerkel and Carah (2013) found that there is currently no effective process to measure and regulate how many or how often minors are being exposed to online alcohol marketing. (Submitted by two health sector organisations).

 Winpenny et al (2013) in an analysis carried out by RAND Europe found that Facebook, YouT ube and Twitter were the three social media sites most used by young people. RAND analys ed five alcohol brands, which all maintained a Facebook page, YouTube channel and Twitter account. Facebook features included profile pages for comments by marketers and users, an d additional content such as competitions, videos, recipes or applications such as games, invi ting users to engage with marketer content. Similarly, marketer-generated YouTube sites co ntained a variety of videos related to the product, including adverts, and in one case comedy videos. Twitter accounts contained tweets by the marketer and others, relating to the produ ct, but also tweets on a variety of other subjects including comedy, fashion and recipes. (Submitted by one health sector organisation and one researcher).

 Carranza (2012) noted the increased popularity and ability of technology platforms such as the internet and social media which has changed the landscape for alcohol marketing in recent years. Global alcohol companies have responded to the rise of social media by repositioning their marketing focus and are now channelling most of their marketing spends into this platform. In January 2011, Bacardi announced it would shift up to 90 percent of its digital spend to Facebook as it no longer deems dotcom sites relevant. Alcohol companies are also now partnering with social media companies with Diageo engaging in a multi-million dollar partnership with Facebook. By September 2011, alcohol brands had the third highest consumer ‘engagement rate’ on Facebook after automobiles and retail. By 2012 indications were that Alcohol had the highest industry engagement rate overtaking industries such as automotive, FMCG, airlines, finance and electronics. (Submitted by one community group).

 Sthapitanonda (2012) carried out research in Thailand has found that alcohol companies are using their consumers to also act as promoters of their product and have labelled this phenomenon as ‘prosumer’.

 The Australian Medical Association (2012) found that young people are now exposed to alcohol marketing at an unprecedented level and from multiple sources. Digital technologies have opened up new platforms for the marketing and promotion of alcohol, eg, online video

49 channels, mobile phones, interactive games, and social networks like Facebook and Twitter. (Submitted by one health sector organisation).

 Liquor companies are increasingly using social media to promote their products to young people. An Australian study found that one company, Budweiser, sent 286 tweets on Twitter to 15,000 followers. These messages were retweeted by those followers 13,000 times, providing huge exposure for minimum outlay. The age of recipients is not controlled. Thus companies are engaging people to do their advertising. “The internet makes it absurdly easy for marketers to harness the tiniest twinges of boredom or loneliness or desire, channelling them into sales.” (Oliver Burkeman in Guardian Weekly).

 Griffiths and Casswell (2010) has shown the use of these social network services provide you ng New Zealanders with the opportunity to create and share ‘intoxigenic social identities’ an d digital spaces which further contribute to the normalisation of youth consumption of alcoh ol. The response on sites such as Facebook has dramatically increased since 2012 and undera ge users can access alcohol material. (Submitted by one research organisation).

 Gordon (2010) investigated the effects of online marketing, in particular via social media. More than 27 of the 40 leading alcohol brands hosting dedicated websites that use sports, music, games, downloads and competition to attract consumers. There is growing concern for this unmonitored platform of advertising that has a particular appeal to children. (Submitted by one health sector organisation).

2.6.2 Property rights and international law

Three alcohol industry submitters and one advertising submitter noted that the implementation of any further restrictions to alcohol advertising may have implications associated with the New Zealand Bill of Rights or International Law.

2.6.2.1 Bill of Rights

The submitters noted that restrictions must also be justified in accordance with the New Zealand Bill of Rights Act 1990 and pass the 'rational connection', 'minimal impairment' or 'proportionality' tests. A legal opinion was cited of the Attorney General in 2009 given in relation to the Liquor Advertising (Television and Radio) Bill. The Attorney-General applied two tests:

1. Did the provision serve an important and significant social objective? And 2. Was there a rational and proportionate connection between that objective and the provision?

The Attorney-General concluded that the Bill would meet the first test but fail on the second. A total ban was not a proportionate response and would be a limitation of the freedom of expression in s14 of the Bill of Rights Act. In the view of the submitters, given the potential cost and the weak evidence of potential benefits, further restrictions on advertising and sponsorship would not be a proportionate response to the problem of harmful use of alcoholic beverages.

50 2.6.2.2 International trade concerns

The submitters noted that New Zealand is a signatory to a number of international trade agreements including the World Trade Organisation Agreement on Technical Barriers to Trade, the General Agreement on Tariffs and Trade and several free trade agreements and bilateral investment treaties. These agreements include obligations that regulatory measures of this nature are not discriminatory, are evidence-based and are not more restrictive than necessary to achieve a legitimate objective. The submitters pointed out that these obligations will need to be accounted for in any proposed measures.

51 3 Alcohol Sponsorship

3.1 Overall level of support for further sponsorship advertising restrictions

The Forum’s submission form requested feedback on whether there is support for further restrictions on alcohol sponsorship or whether there is not (Question 6). In addition, the Forum requested reasons for any of the views expressed (Question 7).

A total of 234 submitters responded to Questions 6 and 7. Of these:

 173 submitters supported further restrictions (58 organisations, 115 individuals) or 74 percent.  61 submitters (59 organisations, two individuals) (26 percent) did not want further restrictions, effectively supporting the status quo.

No submitters supported the loosening or removal of existing restrictions.

Graphic 3A: Overall level of support for further sponsorship restrictions

Organisations are split nearly 50/50 as to whether further restrictions should be implemented. Individuals have a strong preference for further restrictions.

52 Graphic 3B: Overall level of support for further advertising restrictions by organisation

Graphic 3C: Overall level of support for further advertising restrictions by individuals

3.1.1 Categories of submitter who support further sponsorship restrictions

One hundred and seventy-three submitters support further sponsorship restrictions.

53 Organisations

 Health sector organisation 23 submitters  Professional association 6 submitters  Community or cultural group 5 submitters  Local government 5 submitters  Academic and research 3 submitters  Trade association 1 submitter.

A further 15 organisations providing template submissions also support further restrictions.

Individuals

 Public or consumers 12 submitters  Health sector 4 submitters  Academic and research 1 submitter.

A further 98 individuals provided template submissions also support further restrictions.

3.1.2 Categories of submitter who do not support further sponsorship restrictions

Sixty-one submitters do not support further sponsorship restrictions.

Organisations

 Sporting body 27 submitters  Alcohol industry (including brewers and producers) 12 submitters  Advertising or media 10 submitters  Community or cultural groups 4 submitters  Retailers 3 submitters  Trade association 1 submitters  Academic and research 1 submitter  Central government 1 submitter.

Individuals

 Public and consumers 1 submitter  Academic and research 1 submitter.

54 Summary of the rationale presented for and against further sponsorship restrictions

There are clear differences of opinion on several key rationale groups based on whether submitters support further restrictions or do not. There is also a strong correlation with the rationale provided for supporting (or not) further advertising restrictions.

The majority of submitters support the introduction of further measures to restrict sponsorship. Those supporting further restrictions (including health, professional bodies, community/cultural groups, researchers, and individuals) did so by noting some or all of the following:

- Their concern over the nature and amount of ongoing alcohol-related harm. - Increasing consumption by enhancing the credibility of brands. - Concerns that sponsorship by alcohol brands increases consumption by enabling exposure to young people in a wide range of settings and influences uptake by normalising alcohol. - Reference to tobacco harm and control initiatives.

Specific groups who were more likely to support the status quo included sporting bodies, advertising/media submitters, retailers, trade associations and alcohol industry submitters. One of the biggest concerns was the withdrawal of sponsorship and the impact of this on sports and cultural events. Specific comments including material on:

- the economic value of sports to New Zealand Inc. - the essential role played by sponsorship funding in maintaining the viability of sports: without this funding, it would be difficult to maintain clubs, elite sports, and international events. - concern that removal of sponsorship would cause funding difficulties for cultural events.

Other reasons for supporting the status quo included that sporting codes were generally responsible with regard to the management of alcohol-related harm within their codes, and that this issue was well-managed, and concerns that there was no evidence to suggest restrictions on sponsorship would reduce alcohol-related harm (like that presented against further advertising restrictions).

NB: Submitters generally provided similar rationale for their views on both alcohol advertising and sponsorship (particularly in the template submissions and in respect of material presented on sponsorship’s link to alcohol-related harm). This may reflect an assumption that sponsorship is a subset of advertising/promotion. In order to ensure that submitters’ views are fully presented, there is some repetition between sections 3.2 and 2.2. The repetition inherent in these sections is intended to ensure accurate presentation of submitters’ views.

55 3.2 Rationale for supporting the introduction of further sponsorship restrictions

As with advertising, submitters categorised as health, professional associations, community/cultural groups, researchers, and individuals were more likely to support the implementation of further sponsorship restrictions.

Most of those seeking further restrictions on alcohol sponsorship presented a rationale for doing so: the 34 individuals who signed the Alcohol HealthWatch postcard stated the need for restrictions on alcohol sponsorship of cultural or sports events without explaining why this was needed. The following sections record submitters’ reasons for supporting further restrictions on alcohol sponsorship which included:

 concern about the nature and amount of alcohol-related harm  the role that sponsorship plays in increasing alcohol consumption including sponsorship’s role in enhancing alcohol’s credibility and influence on onset of drinking, and  concern about the effectiveness of self-regulation.

These reasons reflect, but are not identical to, the rationale provided for seeking further advertising restrictions.

3.2.1 Concern about the nature and amount of alcohol-related harm

One aspect of the rationale of all submitters seeking further restrictions on alcohol sponsorship was concern over the nature and amount of alcohol-related harm, and the role that sponsorship plays in driving consumption (and therefore harm).

3.2.1.1 Template responses

The CAYAD National Implementation Team template submission was signed by 47 individual submitters and three organisations. It summarised, in the briefest way and with no specific references/citations, the overall results of research on the subject of alcohol sponsorship:

 The more alcohol promotion young people see, the earlier they start to drink and drink more  The earlier they start to drink, the greater the risk of becoming a heavy drinker, and  The more they drink, the greater the harm (to them and others).

It is not clear whether the research referred to was published pre- or post-2010.

In response to this research, those who signed the template submission requested greater restrictions on alcohol sponsorship in order to:

 delay the age at which young people start to drink  help de-normalise the use of alcohol, and  reduce harmful drinking.

The Alcohol HealthWatch template submission (signed by 17 individual submitters and 12 organisations) provided a fuller explanation of the rationale for seeking of further restrictions on alcohol sponsorship.

56 Submitters stated that:

 the evidence gathered by 2010 concluded that exposure of young people to alcohol marketing sped up the onset of drinking and increased the amounts of alcohol consumed by those already drinking.  of the 2,281 submissions presented in 2010 on alcohol marketing and advertising, 86 percent supported banning or restricting all advertising of all alcohol in all media.  the Law Commission had stated three stages to move towards this position the first stage of which (making it an offence to promote the excessive consumption of alcohol) was implemented in the Sale and Supply of Alcohol Act 2012.  there was enough evidence to warrant immediate action and that there was strong public support to do this.  the Forum should support the immediate implementation of Stages 2 and 3 of the Law Commission's recommendations on alcohol advertising and sponsorship as set out in their report Alcohol in Our Lives: Curbing the Harm 2010 and that it should recommend an action plan which will implement the Law Commission's recommendations.  self-regulation should end as it is thought to delay effective measures to curb the harm arising from alcohol advertising.

3. 2.1.2 Other commentary provided in non-form submissions

Despite the brevity of the content of template submissions, the rationale put forward was largely shared by all submitters seeking further restrictions on alcohol sponsorship, although free-form submissions elaborated further on these concepts and supported their views by varying degrees of evidence. For example, six submitters provided additional perspectives on the nature of that harm. One individual submitter referred to the links between alcohol consumption as a major cause of crime, especially violent crime including that most family violence witnessed by health providers resulted from the misuse of alcohol (one professional association). Another individual who worked in the health sector noted that a linkage existed between alcohol use and use of other drugs such as methamphetamine. One professional association added that physicians frequently deal with the impacts of alcohol abuse; treating patients for acute and chronic, physiological and psychological consequences of alcohol abuse. One health sector organisation reported significant year-on-year cost increases as a consequence of dealing with the increasing effects of alcohol-related harm. Another health sector organisation claimed that heavy episodic drinking is increasing among young people and is especially problematic in sportspeople where rates of binge drinking and harm are consistently higher than non-sporting peers and the general population.

Three submitters (two individuals and one academic) noted that since the Law Commission's findings of 2010, further evidence has become available demonstrating the links between alcohol sponsorship and alcohol consumption and alcohol-related harm. Based on a recent research study (see section 2.3), one health sector organisation in its submission claimed that there is a greater incidence of hazardous alcohol use in New Zealand sports clubs with alcohol sponsorship than in those without alcohol sponsorship. A health sector organisation noted that in both Australia and New Zealand, alcohol sponsorship was found to be related to increased drinking. Another health sector organisation stated that sponsorship has become an important vehicle for alcohol marketing adding that it is a significant factor contributing to the prevalence of, and casual attitude towards drinking and alcohol-related harm.

57 3.2.2 Alcohol sponsorship and increased consumption

3.2.2.1 Increasing consumption by enhancing the credibility of alcohol brands and products

One professional association presented its view of where sponsorship sat within the spectrum of alcohol marketing. Commercial sponsorship was described as typically involving the payment of a fee or the provision of goods or services in return for access to commercial exposure. Sponsorship was described by the association to be a form of marketing which takes advantage of courtesy status (i.e., the status that is derived by having a product associated with a highly valued activity such as sport and/or high status individuals or groups). This form of advertising was noted as frequently taking advantage of exposure and access to particular market segments (eg. promoting alcohol products to younger people). As sponsorship is a form of marketing, albeit less direct than other forms, the Association considered that many of the research findings associated with direct marketing have relevance for sponsorship (see section 3.4 of this report).

One health sector organisation agreed with the Law Commission findings that alcohol sponsorship essentially seeks to associate alcohol with the credibility of positive pursuits, like sport and cultural events. It added that, at the community level, sponsorship very much enhanced the credibility of the alcohol producer and its brand in such a way that bore no relation to the product they are providing. A health sector organisation noted that the alcohol industry uses the appeal and excitement of sports events to increase their brand awareness and can readily target a particular available audience. Sports sponsorship is used to build brand and fan allegiances and sports events have become synonymous with drinking.

One health sector organisation, noting that sports plays a central role as a marketing tool for alcohol sales, stated that Māori, as a population group are avid spectators of sports. Therefore any sponsorship by alcohol companies of sports is exposing large Māori audiences of all ages (tamariki Māori, rangatahi Māori and whole Māori whānau) to alcohol. Alcohol sponsorship through sports, cultural activities and any other activities not only normalises the role of drinking and alcohol in whānau life but it also mistakenly associates drinking with healthy living and with sporting role models. According to a health sector organisation, a very similar situation is observed to exist in relation to Pasifika peoples as a population group especially in a sport such as rugby where many of the game's elite players are Pasifika.

3.2.2.2 Influence on early uptake of drinking by normalising alcohol

A health sector organisation stated that research shows a link between positive attitudes to alcohol sponsorship and the early uptake of drinking as well as a heavier level of consumption. The organisation noted how alcohol sponsorship places alcohol branding around sports fields every weekend, into major music and cultural events, and throughout TV broadcasts of sports or other events. It cited research where schoolchildren have been found to clearly and favourably remember the alcohol brands they see.

Five community and health sector organisations noted that alcohol sponsorship of sports, music festivals and other cultural events normalises alcohol to young people. One health organisation noted that alcohol sponsorship is especially focused on national sports that attract young males (although it did not specify in what ways). This normalises an association between national pride, sport and the heavy consumption of alcohol. As noted by another professional association, the

58 sponsorship by the alcohol industry of concerts, DJs, musicians and free music festivals target young drinkers in ways that are relatively invisible to older segments of the population.

One health sector organisation and a community group noted that marketing strategies are becoming more sophisticated and multi-dimensional, integrating online and offline promotions with the sponsorship of music and sporting events, the distribution of branded merchandise, and the proliferation of new alcoholic brands and flavours (citing the Australian Medical Association, 2012). A health sector organisation observed that this method of marketing helps embed alcohol brands and products into the everyday lives of young people. One community group emphasised that the introduction of digital technologies has opened up new platforms for marketing and promotion, with alcohol companies aggressively harnessing the marketing potential of online video channels, mobile phones, interactive games, and social networks such as Facebook and Twitter.

One health sector organisation noted that restrictions on alcohol sponsorship were needed to create a media and cultural environment for children in New Zealand that is alcohol-free. Nine submitters (five individuals, three health sector organisations, one academic) supported further restrictions to implement the Law Commission's recommendations as put forward in their 2010 report. The aim of any restrictions on alcohol sponsorship was to help de-normalise alcohol usage, delay the age at which young people start to drink, and to reduce harmful drinking.

3.2.3 Concern about the effectiveness of self-regulation

Having identified the way in which alcohol sponsorship is associated with alcohol consumption, some submitters claimed that there was an urgent requirement to introduce restrictions. In doing so, three submitters (two individuals and one community group) specifically stated their view that the self-regulation currently in place for alcohol sponsorship was ineffective (although they did not specify how). One professional association expressed a view that the current Advertising Standards Authority Code for Advertising Liquor fails to take into account the ways in which alcohol sponsorship indirectly influences perceptions and behaviours while appearing to adhere to the Code. For example, young people see logos of brands of alcohol on the shirts of rugby players they admire. The association considered that this was exposure to advertising and as such was contrary to Principle 4 (3) of the Code “Liquor advertisements shall not use or refer to identifiable heroes or heroines of the young”. The association noted that the Code needed to reflect the pervasiveness, subtlety and complexity of alcohol sponsorship and the rapid changes occurring in social media and communication technology.

Advertisers and retailers generally supported the Code and self-regulation.

3.2.4 Comparing further alcohol restrictions to tobacco control initiatives

One health organisation and one individual drew analogies between the harm done by alcohol and the harm done by tobacco (as they did with advertising). They therefore suggested that the restrictions implemented for tobacco be adopted for alcohol. This would include the absolute banning of promotion. Two individual submitters urged that this course be adopted noted the link between the banning of tobacco industry sponsorship and subsequent reductions in the consumption of tobacco.

59 3.3 Rationale for maintaining the status quo

Specific groups who were more likely to support the status quo (i.e., no further restrictions on alcohol sponsorship) included sporting bodies, advertising/media submitters, retailers, trade associations and alcohol industry submitters. All of those opposing the introduction of further restrictions on alcohol advertising presented their reasons for holding this view. Key reasons were the importance/value of sports and arts events to New Zealand and the value of sponsorship to sports. Submitters also focused on efforts currently underway to reduce alcohol-related harm, their concerns that sponsorship was not closely correlated with alcohol-related harm, and their support for the current self-regulatory model (all of which differs from the reasons for supporting further sponsorship restrictions).

3.3.1 The value of sponsorship to sports and arts events

Sporting body submitters often began by noting the importance of sport to the community in that it promoted health in children and for all other ages. For example, a central government agency conducted research which found that the economic, social, health and personal benefits of sport and recreation to New Zealand totalled $12.2 billion in 2008/09. Sport and recreation added $5.2 billion (2.8 percent of GDP) to the economy. This was comprised of contributions from sport and recreation industries, facility development, volunteer involvement and tax revenue. Increased work productivity and better health outcomes provided benefits of $1 billion and personal benefits of participation contributed $6 billion. The benefit of sport and recreation keeping New Zealanders active also helped prevent more than 1,126 premature deaths per year (SPARC, 2011). Participation in sport was also identified with the gaining of leadership and other life skills (one sporting body).

3.3.1.1 Value to sports

The value provided by sponsorship was a significant reason for not wanting to have further restrictions. Issues canvassed included the overall monetary value provided to sports at all levels and for spectators as well as participants, the need to have sponsorship funding to ensure viability (both as local clubs and for international events), and the impact on sports should sponsorship options be withdrawn (including loss of participation opportunities).

A trade association commented at some length on the impacts that would arise from a ban against alcohol sponsorship noting that it would materially affect sports and cultural events at all levels, fro m major events through to national, regional, club and community based activities across sport, pop ular music, fashion, theatre, the arts and specialist events. It noted that the biggest impact of a sponsorship ban would be on lower-tier sports, clubs and grass-roots community events, damaging t he social capital of communities nationwide.

A central government agency reported research that estimated the value of alcohol sponsorship to sport. National and professional level sponsorship was estimated at $13.5 million (7.4 percent) out of a total of $182 million sport sponsorship in 2012/2013. The figure represents the rights fees paid to professional teams, organisations and participation events only. It does not include direct sponsorship arrangements at the community level.

The relative importance of alcohol sponsorship to sport also has been researched. A central government agency reported survey-based research of 211 rugby union, rugby league, softball, netball, bowls and cricket sports clubs which found that 69 percent of respondents received one or

60 more forms of sponsorship from the alcohol industry (eg, pubs, suppliers or retailers). Most commonly clubs received uniforms, equipment or gear (28 percent), and or/had been supplied with alcohol at a discounted price (27 percent). On average, the proportion of income from alcohol industry sponsorship (including an estimated value of products/supplies ‘in kind’) received by sports clubs surveyed was fairly low, at around 9 percent.

A central government agency has cited a specific piece of research which indicated that club rugby players paid just 12 percent of the cost of playing the game through their membership fees. Two sporting bodies observed that if the withdrawal of sponsorship occurred, their costs will either have to be passed onto sporting members, many of whom will not be able to pay increased subscriptions, or onto the public with higher event ticket prices. These increases would lessen participation and attendance. A central government agency has cited event organiser feedback that in some cases without any sponsorship, participants’ costs in events such as the Auckland marathon would double. In addition, free community events that currently are underwritten by alcohol sponsorship would come to an end (one cultural group). Two sporting bodies stated that recent decreases in sponsorship from the alcohol industry, due to tighter economic conditions, had already resulted in increases in subscriptions.

Within New Zealand sport, alcohol sponsorship was stated by three sports bodies as providing much of the required sponsorship funding. Currently, alcohol sponsorship was required to ensure sufficient funding was available for the operation of New Zealand clubs and for their flagship sporting facilities to remain attractive as a host destination for international sports competitions (six sporting bodies). Two cultural groups and one alcohol industry submitter described how sponsorship was important to them without specifically indicating their view of further restrictions.

One sporting body noted the need that existed for sport to be funded through sponsorship if it was to provide big events and ensure their elite teams were internationally competitive. Fourteen sporting bodies and clubs stated that sponsorship is essential to ensure the viability of sport at all levels (professional and amateur).

Four submitters from sporting bodies expressed their view that if alcohol sponsorship ended, other sponsors could not readily be found to fill in the funding gap especially at a provincial and community level. This in turn would undermine the economic viability of a particular sporting body or the overall sport in general (four other sporting bodies). It was suggested by one sporting body that reduced funding to sporting organisations would impact on sport's ability to be a major force for social and economic good and community wellbeing. It was noted that many international tournaments were sponsored by international alcohol brands. These raised the profile of sport. Without these tournaments there would be lower participation levels in sport. If the situation arose of sports being prohibited from being able to profile internationally recognised alcohol industry brands, then existing tournaments could go to other countries. International players who had sponsorship deals with alcohol brands are required to promote their sponsors in the tournaments in which they played. A ban could mean they would not be able to come (one sports body).

One individual noted that the banning of tobacco sponsorship had produced a negative effect on sport and had undermined the ability of New Zealand teams to remain competitive internationally. It was suggested by one sports body that the only reason that the withdrawal of tobacco sponsorship did not have greater impact on sport was that the funding gap was filled with gaming machines. In relation to gaming funding, a central government agency has reported that decreases to gaming funding available to the community sport sector are another important factor creating financial pressures. Research has shown that between 2007 and 2012 there had been an overall decrease of 20.7 percent of funding to sport and recreation. It was thought that this decrease in

61 gaming funding may continue due to increasing strong public opinion and pressures for future restrictions on gaming machines in communities.

A trade association, however, suggested that there had been a significant effect by the removal of tobacco sponsorship funds. Once the three-year replacement funding from Government ended, many sports and events were unable to replace that funding or if so, only to a lesser value, materially impacting on those sports and events. This was said to be particularly so for secondary sports, such as motor racing, softball, rallying, resulting in the loss or scaling back of previously significant national or international events. Those sports have generally not recovered from that situation. This organisation also commented that sports organisations might maintain their elite teams, but cut back on the services to the grassroots and long term development of the sport therefore impacting adversely on domestic sports development structures and objectives. In the longer run, this could have a negative impact on the performance of national sports teams as fewer good, new players came up from lower grade. In turn, it was suggested that poor sporting performance at the national level could impact on keeping the interest of other corporate sponsorship.

Given the importance of sponsorship, as described by the submitters, it is unlikely that these submitters would endorse comprehensive restrictions against alcohol sponsorship.

3.3.1.2 Value to cultural events

Other comments against alcohol sponsorship restrictions were received from event organisers. For the hospitality industry, the use of alcohol sponsorship is a legitimate business tool. As with sports, sponsorship was usually essential to ensure the viability of events (one cultural group). For many festival organisers, their alcohol sponsors were viewed as partners who played an integral role in the development of branding and event growth (one cultural group). Two cultural groups claimed that there had been not been any problems with alcohol at the events which they ran.

3.3.2 Responsibility to reduce alcohol-related harm

In accordance with the sporting bodies that commented on their efforts to reduce alcohol-related harm (see section 2.3.1.1 of this report), a trade association submitted that it is widely understood and accepted by both rights holders and sponsors in New Zealand that both have an obligation to promote responsible attitudes toward alcohol and its consumption and those that bodies are typically responsible in the handling of this issue. A central government agency also reported that there is evidence of the New Zealand sport sector increasingly showing leadership in reducing reliance on alcohol-related funding (eg rugby league’s ‘more than just a game’ model) and proactively managing alcohol related harm and that this was occurring without regulatory restrictions around sponsorship or advertising. One sports body and one cultural group claimed that they had a responsible attitude to alcohol consumption. The sale of alcohol at sporting events proceeded under strict licensing provisions which were well policed the inference being that this managed any potential alcohol-related harm occurring at the events. Three sporting bodies did not think any further restrictions were required in relation to the alcohol sponsorship that operated within their code. Instead, they considered it should be left up to sporting promoters to achieve the right balance and not make an event about the alcohol but instead to ensure safe environments and that no alcohol-related harm occurred at sporting events.

62 3.3.3 No evidence that alcohol sponsorship restrictions will reduce harm

Aside from not being in favour of further restrictions being brought into effect in relation to alcohol sponsorship, five sporting bodies stated that they were aware of international examples where advertising and sponsorship restrictions had been put in place in a sporting environment, but without the result of reducing problem drinking. Few further details were provided.

Similarly, submitters from the alcohol and advertising industries similarly were not supportive of restrictions on alcohol sponsorship. For example, a trade association stated its findings as being that there was no compelling evidence demonstrating a causal link between alcohol sponsorship and alco hol-related harm. It was said to be widely understood that the take-up of alcohol by adolescents an d its misuse by some drinkers are multi-dimensional problems where the intense pressure from peer s and social environmental influences are of paramount importance. It was suggested that the Foru m should recognise that alcohol related harm is multi-faceted. It was suggested that among the pot ential influences on alcohol misuse or early take-up by young people, alcohol sponsorship is an insig nificant variable. It was posited, therefore, that any recommendation to further restrict alcohol bran d sponsorship would be both disproportionate and ineffectual.

Supporters of further restrictions generally considered that the body of evidence for further restricting alcohol advertising is sufficient to act (effectively disputing the claims made by submitters supporting the status quo).

3.3.4 Effectiveness of the Code and self-regulation

As with advertising, submitters who support the status quo considered that further sponsorship restrictions were unnecessary because of the effectiveness of the current regulatory and voluntary arrangements. For example, one retailer noted that the Advertising Standards Authority very successfully operated a Voluntary Code for Advertising and Promotion of Alcohol (see section 2.3.2). A trade association stated its view that the self-regulatory framework for sponsorship by alcohol brands in place, under the auspices of the Advertising Standards Authority’s Codes of Practice provides an appropriate level of control that protect the interests of the community, while allowing alcohol brand owners to communicate to adult audiences.

3.3.5 Other practical considerations

A trade association sought to point out that a ban on alcohol sponsorship in New Zealand would not realise a blanket elimination of the presence of alcohol brands given the involvement of alcohol bran ds in a wide range of sporting and other events globally which have significant public viewership in t his country. It was suggested, therefore, the ban would simply harm local brands at the expense of g lobal brands. It also pointed out the complexities that could arise from a local national ban on sponsorship. Where international events include New Zealand-based events, such as the V8 Superca rs round at Pukekohe, a ban on advertising and promotion of these team sponsors at the New Zeala nd event would place that event in jeopardy. Alternatively, if the sponsors were given dispensation t o show their livery in New Zealand at that event, this would provide a significant marketing advantag e to those brands and would encourage New Zealand brands to invest into Australian-based events t o maintain a sponsorship presence. In events where New Zealand is an equal partner, it could result in an anomaly such as the Australian Wallabies, sponsored by Hahn Super Dry and the Springboks by Castle Lager competing in the Rugby Championship with the All Blacks. An even more confusing situ ation would arise with New Zealand teams, eg, the New Zealand Warriors or Rugby Super15 teams pl

63 aying in competitions overseas. They could potentially carry jersey sponsorship when playing in Aust ralia but not in New Zealand. All that would do would be to create an economic burden for those fra nchises.

3.4 Evidence presented in support of or opposition to further restrictions

Having stated their views in relation to further restrictions on alcohol sponsorship, submitters were asked to identify what evidence was available to support their stated views. The Forum requested that the focus should be on evidence produced since 2010 if this was available.

Summary of the evidence presented in support or opposition to further restrictions on alcohol sponsorship

This analysis focuses on research published since 2010 (as presented by submitters). Occasionally, relevant grey literature and anecdotal material is footnoted where it deepens research commentary. A large amount of pre-2010 research was also provided by submitters: this has not been given a high priority in the analysis due to the volume of post-2010 material and the Forum’s focus. Generally, submitters considered that the body of evidence presented was sufficient to either warrant the implementation of further restrictions (or not). Few comments on the actual strength of the evidence base were provided.

Evidence presented by both those for and against further restrictions reflects the rationale presented by submitters. Again, there are clear differences of opinion regarding what the evidence base says: the difference split is based entirely on whether the submitters support further restrictions or not. Contradictions are noted below.

Submitters supporting further restrictions provided a small body of evidence outlining sponsorship’s role in normalising alcohol use and the creation of an alcohol culture. They also noted the strong impact that sponsorship has on raising brand awareness among young people (and that the more brand-aware, the more likely they are to start drinking). Evidence was also presented on the link between sponsorship and harmful drinking behaviours, with research presented indicating higher levels of harm in sports facilities where alcohol sponsorship occurs. Finally, submitters presented evidence that generally spoke to the need for restrictions on advertising or promotion (and which is covered in detail under section 2.4.1 of this report).

Submitters who support the status quo focused their evidence largely on the negative impact that restricting sponsorship is likely to have on sports (including in regard to overall funding, participation, and spectatorship). They also refuted some of the arguments put forward by those who support further restrictions. For example, the evidence base presented focused on sponsorship not being a driver for alcohol consumption or harm, or influencing young people’s uptake or subsequent use.

3.4.1 Evidence presented in support of further sponsorship restrictions

The following set of evidence published post-2010 was submitted by those seeking further restrictions on alcohol sponsorship (and health organisations in particular). The synopsis given reflects submitters’ views on what the evidence shows and its significance, and indicates New

64 Zealand-specific research where possible. Generally, evidence was discussed by one submitter unless otherwise noted.

3.4.1.1 Creation of a culture that normalises alcohol consumption

 Gee, Jackson and Sam (2014) noted that alcohol sponsorship of sports events creates a drinking culture that naturalises the relationship between sport and alcohol. For example, 90 percent of participants at the Wellington Sevens and 65 percent at the T20 and ODI cricket agreed that these sports events created the expectation that one should consume alcohol.

 Gee, Jackson, and Sam (2013) examined the culture of alcohol promotion and consumption at well-known sporting events. The study found that it was not possible to experience the 2011 Rugby World Cup without being exposed to alcohol promotion and consumption. It also highlighted that promotion-driven alcohol consumption was synonymous with the culture of the Wellington Sevens tournament. The vast majority (91 percent) of participants at the Wellington Sevens agreed that alcohol consumption was part of the atmosphere of the event. The authors note an “increasingly naturalised alcohol-sport link” in major sports entertainment in New Zealand. (Submitted by five health sector organisations).

 A health sector organisation noted that in both Australia and New Zealand, alcohol sponsorship was found to be related to increased drinking. Groups of people sponsored by industries other than alcohol have been found to drink less than those with alcohol industry sponsors. (O’Brien and Kypri, 2008: O’Brien, Kolt,Martens, Ruffman, Miller, and Lynott 2012; O’Brien, Miller, Kolt, Materns and Webber 2011).

Anecdotal evidence

 One health organisation recorded major alcohol brands sponsoring social and cultural events. The table below is a snapshot of some of the 2014 summer events in New Zealand that are sponsored by alcohol companies:

2014 Summer Events Sponsors Big Day Out (Auckland) Heineken Laneways Festival (Auckland) Becks, Smirnoff, Isaac’s Cider Jim Beam Homegrown (Wellington) Jim Beam NZI Wellington Sevens Speights Rhythm and Vines (Gisborne) Smirnoff, Coruba, Scrumpy, Jagermeister Heineken Tennis Open Heineken, Moet Chandon Champagne Bay of Island Sailing Week Heineken, Mt Gay Rum Wellington Cup Racing Carnival Mills Reef Winery Auckland Seafood Festival Monteith’s, Villa Maria New Zealand Open Golf Moa Brewing Co. Raggamuffin (Rotorua) Coruba Splore Festival (Tapapakanga) Tiger, Peter Yealands Wines, Jagermeister

65 3.4.1.2 Influence of sponsorship on young people’s brand awareness

 Pettigrew, Ferguson and Rosenberg (2013) have demonstrated how Australian children as young as five are likely to be sub-consciously absorbing sports sponsorship messages and can align sponsors with the relevant sport. This is concerning due to the significant extent of alcohol sponsorship. They demonstrated for the first time in that children are likely to be subconsciously absorbing multi-million dollar sports sponsorship messages. More than 160 children aged 5-12 years took part in an activity that assessed their conscious and subconscious associations between sporting teams and a range of sponsors. The researchers found that more than three-quarters of the children aligned at least one correct sponsor with the relevant sport. The researchers concluded that this was a concern given the current extent of sponsorship of alcohol and fast food companies, noting ‘while sponsors may argue that they are not unintentionally targeting children, it is clear their efforts are producing this ‘unintended’ consequence and that as a result they should come under closer scrutiny’. They recommended limiting children’s exposure to sponsorship messages of companies promoting unhealthy food and drinks is an important element of public policy efforts. (Submitted by five health submitters).

 The Australian Medical Association (2012) noted that evidence is accumulating that young people encounter alcohol messages, associations and products in a raft of everyday settings, such as alcohol-sponsored music and sporting events, free gift promotions, alcohol-branded merchandise and interactive competitions.

 Gordon et al (2011) and Lin et al (2012) were presented as evidence that the more types of marketing 12-14 year olds and other young people were aware of, the more likely they were to be a drinker or to intend to drink in the next year. (Submitted by one health sector organisation and one academic).

Grey literature

 A Health Research Council-funded survey of school children carried out in 2010 showed, not only were the young Maori and Pasifika drinkers (aged 13 years) in the sample reporting heavier drinking compared with young European and Asian origin New Zealanders, but they were also much more likely to report owning clothing such as sports tops and hats with alcohol brands on them, were more likely to have seen screen savers featuring alcohol brands and to have seen alcohol brands on SNS sites (unpublished data).

3.4.1.3 Sponsorship, consumption and alcohol-related harm

 O’Brien, Lynott and Miller (2013) found that, in Australia, there was higher levels of drinking among sportspeople in teams sponsored by the alcohol industry and “receipt of alcohol industry sponsorship [was] associated with alcohol-related aggression/antisocial behaviours in university sportspeople”.

 O’Brien et al (2013) found that higher alcohol problem use scores, gender and receipt of alcohol industry sponsorship were associated with alcohol-related aggression/antisocial behaviours in university sportspeople. The authors concluded that sport administrators should consider action to reduce the harms associated with excessive alcohol consumption and alcohol industry sponsorship in sport.

66  Kerry et al (2012) noted that “The present work is the first to examine associations between receipt of alcohol industry sponsorship in sports people/athletes and alcohol-related aggressive and antisocial behaviour. Alcohol industry sponsorship was associated with increased rates of receiving aggression, but AUDIT-C scores [an alcohol screening instrument] and the gender of the sports people were more important factors in most of the other aggressive and antisocial behaviours examined here”.

Anecdotal evidence

 The cricket ‘Catch a Million’ promotion by Tui produced 10.3 million hits online and six million comments on Facebook. Tui sales in central Auckland rose by 77 percent over the same period the previous year. (Mediawatch Radio NZ 16 March 2014).

3.4.1.4 Evidence focusing on advertising/marketing but presented for sponsorship

Several citations were presented for sponsorship as well as advertising. Rather than repeat commentary from section 2.4.1, citations only are listed here:

 Research noting the inadequacies of self-regulation of alcohol-related advertising and sponsorship (Babor, 2013);  Research noting the effectiveness of further alcohol restrictions (Babor et al, 2010); and  Research that links positive attitudes to alcohol advertising with early onset of drinking (Jones and Magee, 2011).

3.4.2 Evidence presented in support of the status quo

The following set of evidence published post-2010 was submitted by those seeking to maintain the status quo. Generally, the evidence presented follows the rationale presented (with a strong focus on the negative impact on sports should further restrictions be put in place). The synopsis given reflects submitters’ views on what the evidence shows and its significance, and indicates New Zealand-specific research where possible.

3.4.2.1 Restrictions will negatively impact on sports and spectators

 Litmus’ (2014) research on decreases to gaming funding found that “In 2012 a total of $78,123,572 was granted by four gaming machine societies to sport ($69,829,635 - 89 percent) and physical activity/recreation ($8,293,937 - 11 percent). In 2007 a total of $98,457,866 was granted [by the same four societies] to sport ($89,789,534, 91 percent) and physical activity/recreation ($8,668,332, 9 percent)”. This is an overall decrease of 20.7 percent of funding to sport and recreation in five years.

 The most comprehensive review of the economic impact of sponsorship bans has been made by Econometrix (2013). They note that when considering a possible ban on sports sponsorship, there will be an impact not simply on the sports bodies themselves, but on the sportsmen and women, on sport development, on stadium owners, and on the general public who might not be able to view sports on broadcast media (as broadcasters will not be

67 able to raise the sponsorship required). (Submitted by one trade association, one alcohol industry submitter and one government agency).

 Wright (2013) estimated the value of alcohol sponsorship to sport, at the national and professional level, at $13.5 million (7.4 percent) out of a total of $182 million sport sponsorship in 2012/2013. The figure represents the rights fees paid to professional teams, organisations and participation events alone. This does not include direct sponsorship arrangements at the community level.

 Milne’s 2013 research on community sport participation and the value of sponsorship showed Wellington club rugby players paid just 12 percent of the cost of playing the game through their membership fees.

 The GEMBA Group’s 2013 survey-based research stated that 62 percent identified costs as one of the main reasons New Zealanders (16-64 years) did not currently participate in sports/activities they are interested in.

 SPARC (2011) found that the economic, social, health and personal benefits of sport and recreation to New Zealand totalled $12.2 billion in 2008/09. Sport and recreation added $5.2 billion (2.8 percent of GDP) to our economy, comprising contributions from sport and recreation industries, facility development, volunteer involvement and tax revenue. Increased work productivity and better health outcomes provided benefits of $1 billion and personal benefits of participation contributed $6 billion. The benefit of sport and recreation keeping New Zealanders active also helped prevent more than 1,126 premature deaths per year.

 PS Services’ (2010) research on the relationship between alcohol and sport found that, of the sports clubs that responded, a reasonably high proportion (69 percent) received one or more forms of sponsorship from the alcohol industry (eg, pubs, suppliers or retailers). A total of 211 clubs from rugby union, rugby league, softball, netball, bowls and cricket responded to the survey. Most commonly clubs received uniforms, equipment or gear (28 percent), and or/had been supplied with alcohol at a discounted price (27 percent). On average, the proportion of income from alcohol industry sponsorship (including an estimated value of products/supplies ‘in kind’) received by sports clubs surveyed was fairly low, at around 9 percent.

Anecdotal evidence

 Over the last six years there has been a downturn in liquor sales and this has been reflected in less sponsorship and reduced Community Trust funding and this is already having effect.

3.4.2.2 Sponsorship does not drive consumption

 Gee et al (2013) were quoted for work on a 2013 survey conducted by the Health Promotion Agency. Participants were asked whether sponsorship material added to or shaped the atmosphere at significant sports events. Forty-four percent considered it did not compared with 26 percent that did. In addition, 82 percent agreed that drinking alcohol was part of the atmosphere. In the same survey, over half of the respondents had seen messages about moderating alcohol consumption while 47 percent indicated they were not concerned over

68 the exposure of youth at the events to alcohol messages. Twenty-seven percent indicated they were concerned. (Submitted by three sports bodies).

Anecdotal evidence

 Aware of a small number of international examples where advertising and sponsorship restrictions have been put in place in relation to alcohol in a sporting environment, however we have seen no evidence that such restrictions have had the desired effect of reducing problem drinking, but instead put significant costs onto the tax payer to replace the funding stream. (Submitted by four sports bodies).

 Licensing records and police feedback shows no problems with alcohol sales and use at a horseracing club.

3.4.3.3 Sponsorship does not determine alcohol use among young people

 Mays, De Padilla, Thompson, Kushner and Windle (2010) stated that sport in isolation is not a determinant of problem alcohol use by adolescents but “sport in combination with other activities.”

3.5 Proposed sponsorship restrictions

Submitters who proposed that there be further restrictions on alcohol sponsorship were asked by the Forum to provide further details. Firstly, the Forum asked about the nature or form of the restriction (Question 15). Submitters were then asked to describe how the proposed restrictions would work in practice to reduce alcohol-related harm (Question 16). Finally, submitters were asked if they knew of any evidence that would demonstrate that their proposal would work (Question 17).

The Forum also expressed an interest in learning of the impacts arising from the proposed restrictions. Submitters were asked to identify which of the population groups would be affected by the restriction and how would they be affected (Question 22). Submitters were also asked about other impacts arising from the proposed restrictions on matters like alcohol consumption, alcohol- related harm, perceptions of alcohol, on businesses, on recipients of alcohol sponsorship funds and other population groups (Question 23).

Those who expressed the view that restrictions should proceed were able, to at least some degree, to record the nature of those restrictions (n=173). Therefore the categories of submitters of those proposing restrictions and describing their nature essentially is the same as that presented at 3.1 which records those submitters supporting restrictions.

69 Organisations

Forty-three organisations proposed further restrictions through free-form submissions:

 Health sector 23 submitters  Professional association 6 submitters  Community or cultural groups 5 submitters  Local government 5 submitters  Academic and research 3 submitters  Trade association 1 submitter.

Individuals

 Public/consumers 12 submitters  Health sector 4 submitters  Academic and research 1 submitter.

A further 113 submissions were presented through a template submission (15 organisations and 98 individuals).

Summary of proposed restrictions on alcohol sponsorship

There was overwhelming support for the implementation of Stage 3 of the Law Commission’s recommendations; however, more limited information on the suite of restrictions was provided. Graphic 3 (below) summarises the possible restrictions proposed by submitters.

Graphic 3: Overall level of support for further sponsorship restrictions

One important thing to note is that submitters who support further restrictions on sponsorship focused on identifying a range of possible alternative funding options for sports (including tax increases, ring-fencing taxes on alcohol products, community sponsorship funds, support to clubs for alternative revenue generation, etc.). The impact of further restrictions on funding for sports and cultural events was clearly a concern for those who submitted in favour of such restrictions.

70 3.5.1 Proposed restrictions

Three possible restrictions were proposed by submitters: comprehensive restrictions on alcohol- related sponsorship, ensuring that there were alternative sources of funding created for those groups/events that currently rely on alcohol sponsorship in some way, and updating the Advertising Standards Authority’s Code for Advertising Liquor.

3.5.1.1 Comprehensive restrictions on sponsorship

There was strong support for comprehensive restrictions on sponsorship, although most submitters did not specify the scope/extent of comprehensive restrictions. For example, nineteen submitters simply included a brief comment that it be brought to an end. One health sector group emphasised that such restrictions need to be comprehensive for all forms of alcohol sponsorship including events, activities, organisations, merchandise, equipment and any other form of brand promotion. This high-level commentary was also reflected in the form submissions. The Alcohol HealthWatch postcard, submitted by 34 individuals, simply stated that no alcohol sponsorship of cultural or sports events should be allowed. The CAYAD National Implementation Team form letter, signed by 47 individual submitters and three organisations, called for a ban on alcohol sponsorship of sporting and cultural events.

The 29 submitters who signed the Alcohol HealthWatch template submission sought an end to any alcohol-related sponsorship of any cultural or sports events or activities (the Law Commission’s Stage 3 recommendations). Submitters stated that this meant a ban on all forms of alcohol sponsorship in all media. Also, New Zealand companies and individuals would be prohibited from contributing to any overseas-based promotions being run in New Zealand.

Eight other submissions from health sector organisations, community groups and professional associations adopted similar phraseology of the template submissions. Four endorsed the Law Commission's recommendations that there be no alcohol-related sponsorship of any cultural or sports events or activities and that New Zealand companies and individuals be prohibited from contributing to any overseas based promotions in New Zealand. They proposed the ban should be enforced through amendments to the Sale and Supply of Alcohol Act 2012, and that the new law should restrict future forms of alcohol promotion by default, with penalties that will effectively discourage promoters from breaking the law.

Four submitters specifically acknowledged that any ban of sponsorship would in practice involve a phased approach although they urged that this be initiated as soon as possible.

One community group pointed that a number of countries around the world had restricted or banned various forms of alcohol sponsorship and suggested that these models be evaluated when assessing what might be adopted in New Zealand.

Two health sector organisations suggested that in the event that a total ban on alcohol sponsorship not being carried out, that specific measures urgently be adopted to remove sponsorship from any sporting pursuit and cultural event that appealed to children.

71 3.5.1.2 Alternative sources of funding

While not specifically a further restriction, submitters focused on identifying a range of possible alternative funding mechanisms to support sports and events that could be adversely affected by the implementation of a comprehensive suite of sponsorship restrictions. This included a general mechanism to replace sponsorship funding and taxation initiatives.

Organisational mechanisms

Three submitters proposed mechanisms on how to fill the sponsorship void that would be left by the banning of alcohol sponsorship. These submitters suggested that the Health Sponsorship Council model, implemented when the changes to tobacco sponsorship occurred as a result of the passing of the Smokefree Environments Act 1990, could also be adopted to replace alcohol sponsorship. A central government agency provided further detail on this point: when the Smoke-free Environments Act 1990 stopped new tobacco sponsorship, the Health Sponsorship Council (HSC) was allocated $6 million by the Government to provide to organisations for alternative sponsorship and to fund the HSC.

One professional association suggested that the government should sponsor sporting bodies or assist them in seeking alternative funding options as alcohol sponsorship is phased out over the next 1-2 years.

Increase agency capacity to support events/activities currently sponsored by alcohol

One health sector organisation stated that the Australian government had recently provided funds to buy out alcohol sponsorship in community sports clubs (the ‘Be the Influence’ strategy). An increase in tax on alcopops was ring-fenced to provide replacement government funding for 12 leading sporting organisations to end all existing and future alcohol sponsorship agreements. The sports involved included soccer, basketball, netball, swimming cycling and hockey. Six other submitters referred briefly to this ‘buy-out’ of alcohol sponsorship Australian government. A central government agency provided further information on this point: the Australian Community Sponsorship Fund as being AUD $25 million for four years. It suggested that this approach had not been straightforward with possible lessons to be learnt. While 16 Australian national sporting organisations (NSOs) signed up to the fund and have no alcohol sponsorship, several large NSOs did not and alcohol sponsorship of Australian sport remains significant. The Australian Government is reviewing the fund, with no confirmed funding after this financial year. Despite the fund, Australia is reported as the highest proportion of alcohol sponsorship of any major economy. The central government agency advised that there are issues with comparing Australia and New Zealand in this area as the proportion of and value of alcohol sponsorships to sport are far greater in Australia than in New Zealand. However, the Australian experience indicates that while a substitution-type fund may be attractive and viable for certain codes, it may not be attractive to those with the ability to gain more significant and longer-term alcohol sponsorship deals. Nevertheless, one health sector organisation reported that currently more than a million Australian children each year play sport in an environment free of alcohol marketing and sponsorship.

A health organisation recommended the introduction of the Good Sports programme into New Zealand. The submitter considered that the programme is proving to be effective in Australia and was also likely to be successful in New Zealand. One of the benefits of this programme is that it supports clubs to diversify their revenue and this will help local clubs to be better prepared for an

72 eventual ban on alcohol sponsorship, should this go ahead. The programme is run by the Australian Drug Foundation. The Good Sports programme aims to support these clubs to progressively change their culture and reduce hazardous drinking. This is done by offering a well-supported, three stage accreditation process which increases the clubs capacity to serve alcohol responsibly, diversify their revenue streams, reduce alcohol related harms and ultimately shift their focus from alcohol consumption to young people, families and participation in sport. Clubs are expected to communicate with their members regularly throughout the accreditation process to help promote the new direction. Over 6,500 sports clubs are currently engaged in the Good Sports programme.

One health sector organisation recommended that the capacity of the Health Promotion Agency be increased to aid and support events and activities currently supported by alcohol sponsorship in order to ease the transition for organisations that have become reliant on financial support from the liquor industry. Another health organisation agreed and suggested the levy be increased to allow for a buy out as the HPA was seen as having the necessary experience and expertise to carry out such a process.

Taxation initiatives

Four submitters proposed that a portion of the alcohol excise tax collected by the New Zealand government be ring-fenced to provide alternative sponsorship for sport and cultural activities. The 17 individuals and 12 organisations who signed the Alcohol HealthWatch template submission also recommended that the Review Forum support the establishment of fund from alcohol excise tax to support alternative funding options for alcohol sponsorship.

3.5.1.3 Other amendments applying to both sponsorship and advertising

One professional association, which supported the phasing out of alcohol sports sponsorship, also recommended that, given its view that the Advertising Standards Authority Code for Advertising Liquor fails to take into account the ways in which alcohol marketing and sponsorship can indirectly influence perceptions and behaviours, the Code be urgently updated and that those developing the new Code access research on the psychology of marketing to ensure that the Code reflects the reality of the impact of marketing on the public.

Thirty-two submitters also called for an immediate end to self-regulation and that an independent body be established to take over the management and regulation of alcohol advertising and sponsorship.

3.5.1.4 Future interventions

Generally, submitters considered that there was sufficient evidence for action to be undertaken now. As such, there was limited commentary about the range of future interventions that could be undertaken that was not already covered in the discussion about proposed initiatives (or they referred to non-sponsorship initiatives such as taxation).

73 3.5.2 How would the proposed restrictions work in practice? (Question 16)

As indicated above, those seeking restrictions on alcohol sponsorship essentially sought its total removal either immediately or in a phased approach. Although many of these responses mirrored some of rationale presented earlier in this analysis (see section 3.2), they are presented here as a distinct group as intended by submitters who filled in the Forum's submission form.

A health sector organisation explained that sponsorship restrictions would remove drinking alcohol as a social norm from society. Citing Voigt et al (2013), it explained that social norm strategies attempt to influence behaviour though altering perceptions of what is socially acceptable. Social norm strategies can include reducing the visibility of targeted behaviour, challenging views on social acceptability, prevention of early alcohol exposure, early intervention and using strategies to help to shape youth culture, including media and marketing.

One professional association and a health sector group noted that ending alcohol sponsorship of sporting icons is a particularly important step if there is to be a shift in the culture of drinking in New Zealand. It acknowledged that for this to be achieved, a comprehensive package of responses, in addition to advertising and sponsorship restrictions, was required to reverse the impact of alcohol- related harm.

Another professional association stated that the sponsorship ban would go towards breaking the links which research had shown existed between the marketing and promotion of alcohol and excessive consumption. Six health sector groups also submitted that banning sponsorship would reduce the appeal of alcohol to children, young men and whānau and undermine its normalisation as being an ordinary commodity in our society. One health sector organisation suggested that restrictions on sponsorship and advertising would change the perception held by young adults of heavy drinking being part of a national identity. Four submitters expected a ban to delay the uptake age of drinking and reduce heavy and binge drinking, thus reducing alcohol related harm, especially to young people.

A health sector organisation suggested that there would be a reduction in hazardous drinking seen in sports clubs with sponsorship down to levels of alcohol consumption seen in clubs without sponsors hip. A reduction in hazardous drinking would be associated with reductions in the rate of alcohol rel ated mortality and morbidity, including a reduction in violence and alcohol related motor vehicle acc idents.

One research organisation suggested that the very visible buy out of alcohol sponsorship by a health promotion agency gives a powerful symbolic message about the need to protect children.

2.5.3 Evidence that the possible proposals will work (Question 17)

One professional association drew analogies with the policy and regulation used to introduce restrictions over tobacco sponsorship. One research organisation agreed that there is as much reason to value a ban on alcohol sponsorship as there was on tobacco sponsorship. It added that credible assumptions on effectiveness could be based on the importance of branding in consumer socialisation, the role of sponsorship in branding and the association with aspirational activities and celebrities.

One health sector organisation, which had proposed mechanisms to fill the sponsorship void that would be left by the banning of alcohol sponsorship, expressed the view that the Health Sponsorship

74 Council had often succeeded as an interim funding stream for those organisations immediately affected by the sponsorship ban on tobacco. The Royal NZ Ballet and the NZ Cricket team were cited as examples of organisations which successfully found alternative sponsorship after tobacco sponsorship was ended. Another individual submitter pointed to motor racing surviving the tobacco sponsorship ban.

One professional association referred to the "substantial evidence" of the way that sponsorship of alcohol contributes to problematic consumption as a basis to assume that the proposed restriction will have a positive impact.

A health sector organisation pointed to the effectiveness of social norm strategies in influencing behaviour through altering perceptions of what is socially acceptable and cited relevant research. (Department of Health Promotion and Protection, 2007: Schrans et al, 2009)

3.5.5 The impacts of the possible proposals (Questions 22 and 23)

Some health sector organisations simply suggested that the banning of sponsorship, as part of a package of measures aimed at reversing alcohol-related harm, will impact for the better, everywhere and upon everyone. One health sector organisation suggested that a change in the drinking culture to one which does not normalise heavy drinking via the use of sporting associations would reduce harm across the board, but most particularly for youth and current heavy drinkers of all ages.

One health sector organisation similarly envisaged that the proposed interventions in sponsorship and advertising would broadly affect Māori population groups such as tamariki Māori, rangatahi Māori, whole whānau and communities of Aotearoa New Zealand. This would arise from these groups having less exposure to alcohol promotion as an everyday harmless product. This would improve Māori health outcomes, reduce health inequities between Māori and non-Māori and reduce alcohol consumption, and therefore alcohol-related harm, for Māori especially amongst young drinkers and heavy drinkers. A research organisation agreed noting it is lower socio economic populations who are most at risk from heavy occasion drinking (and this, of course is relevant for Maori and Pasifika to the extent they remain disproportionately represented among heavier consumers). The submitter noted that alcohol contributes to the health inequalities we experience in New Zealand and restrictions on alcohol marketing will contribute to reducing these inequalities by removing the adverse influence of marketing, and allowing a better chance for health promotion and social marketing to have a positive impact.

Two health sector organisations acknowledged that sporting organisations would be affected by the reduction in alcohol industry funds but noted that the impact would be low if the sponsorship replacement measures they had proposed [eg the Health Sponsorship Model] were adopted.

One health sector organisation and one professional association, while acknowledging that sports and cultural teams and events sponsored by alcohol brands may initially be disadvantaged through the loss of the financial support, considered that this was necessary as the alcohol related harms that those involved with alcohol sponsored activities are exhibiting is a serious concern. By way of example, the organisation cited numerous professional sports players including New Zealand Cricket players and members of the All Blacks that have all been visible in the media for alcohol misuse.

One professional association noted negative economic impacts among those that produce, market and sell alcohol, but that over time positive economic impacts would be experienced by taxpayers

75 who fund the many health, justice, welfare and other costs of excessive alcohol consumption. Similarly, the Government would receive less excise tax from alcohol sales but this would be offset by a reduction in health, justice and welfare costs.

One trade association wished to draw the Forum's attention to a newly developed Code of Practice from the United Kingdom. This was not necessarily to recommend this as a future intervention but to keep the Forum up to date with developments in international best practice. The Portman Group Alcohol Sponsorship Code, which came into effect in 2014, brings together drinks producers, leading sports, music and venue organisations to promote responsible drinking through sponsorships. The Portman Group Code was actively developed in partnership with major sports, music and venue rights holders, who have also formally endorsed it including the Association of Independent Festivals, British Horseracing, DF Concerts, England and Wales Cricket Board, European Sponsorship Association, Football Association, Rugby Football Union, Rugby Football League, Lawn Tennis Association, Premier League, Scottish Golf Union, Scottish Rugby, and the Sport and Recreation Alliance. The Portman Group Code formalises much of the activity which was already central to the alcohol industries’ sponsorship agreements. Furthermore, it establishes a new ‘positive commitment’ for alcohol producers to promote responsible drinking as a part of the deals they sign. Comparing the ASA Code against the Portman Group Code for sponsorship revealed only one significant variance where the Portman Code states: “As an integral part of each new alcohol sponsorship agreement, drinks companies must ensure there is recognisable commitment to promoting responsible drinking and/or supporting diversionary activities: taking into account the size, scale, reach and length of sponsorship". It suggested that this approach is worth considering.

3.6 Challenges and solutions

Through its submission form, the Forum asked submitters to identify ongoing and emerging challenges that the Forum should take into account when considering whether further restrictions on alcohol sponsorship were necessary to reduce alcohol-related harm (Question 26). For those who answered this question, the Forum was interested in suggestions about the actions that could be taken to address these challenges (Question 27). Comparatively little attention was paid to this question by the majority of submitters. This effectively meant there was no substantive commentary to analyse.

76 4 Other Comments

Eighty-five submitters provided general comments that will not directly inform the Ministerial Forum on Alcohol Advertising and Sponsorship’s deliberations on alcohol advertising and sponsorship; however, a number of these issues are still note-worthy. Part 4 of this report covers material provided in response to Question 28 of the Forum’s submission form, as well as other material presented elsewhere in submissions where that information relates to:

 general comments about submitters’ backgrounds  general comments and research on the sale, supply, and consumption of alcohol and its associated harms  the Forum’s work, and  other initiatives to reduce alcohol-related harm that do not relate to sponsorship or advertising.

4.1 General comments about submitters’ backgrounds

Sixty-eight submitters provided commentary on their organisation its background and its activities (or in a small number of cases, the individual described their experience). These submitters commented either broadly about their work, or specifically related to how they address or manage alcohol-related harm such as through community and education based initiatives (eg, like support for and/or implementation of host responsibility/responsible drinking policies or activities). Some of these submitters provided information about their activities as evidence for their overall view about implementing further restrictions on advertising or sponsorship (or not). Submitters also noted their support for efforts to promote responsible consumption and/or the regulation of the sale and supply and consumption of alcohol (including a number of the sporting bodies submitting on this issue). This information is covered in more detail in Parts 2 and 3 of this report.

4.2 General comments and research on the sale, supply, and consumption of alc ohol and associated harms

Twelve submitters (including six health sector bodies, two local government groups, one individual one community group, one alcohol industry and one advertising/media group) provided research or views on the extent of alcohol use and impact of alcohol-related harm in New Zealand generally (including citing published studies about harm or anecdotal commentary on the burden of alcohol- related harm or perceived ease of accessibility to alcohol). This included material on gender differences in drinking patterns, data specific to certain regions in New Zealand, the link between violence and alcohol consumption, data on the link between alcohol and health-related harm such as cancer. The evidence presented was generally a mix between pre-2010 and post-2010 data. One researcher provided pre-2010 evidence about the link between the promotion of alcohol products and alcohol-related harm. More information about alcohol consumption and related harm is covered in Parts 2 and 3 of this report.

Two health sector organisations made comments about the nature of alcohol, noting that it is no ordinary commodity but that it is promoted as a normal product. One community organisation noted that the harm associated with excessive consumption means that it creates a significant

77 burden for New Zealand communities. One sporting body noted that alcohol will always be a part of New Zealand’s culture.

This detailed material is not discussed further in this section as it does not specifically relate to the Forum’s terms of reference.

4.3 The Forum’s work

Twelve submitters noted points about the work of the Forum. Most of these comments related to the questions posed in the submission form: generally, these comments were negative or stakeholders chose not to use the provided form or refer to the questions at all. Two alcohol industry submitters and one sporting body were particularly concerned that the questions:

 created a significant level of predetermination that further restrictions are favoured  did not contain enough focus for those submitters who did not support further restrictions, and/or  do not support adequate consideration of the positive aspects of advertising and sponsorship.

The structure of the questions was also an issue for three other submitters (one sports body, one community group, one individual) who found the approach taken to be overly complex.

Two submitters (one individual and one health sector organisation) did not consider that adequate time was provided for the submissions process, that it would have been preferable to develop a literature review on the evidence for introducing further restrictions for public comment which would have allowed for better engagement (one individual), that the overall approach was unfair to some of New Zealand’s larger employers (one individual), and that gender analysis should be a component of the Forum’s work (one health organisation).

Finally, a small number of issues with the Forum’s terms of reference and membership were noted:

 One academic was concerned the advertising/media representation on the Forum created conflicts of interest and was concerned about the disclosure of this and other possible conflicts among Forum members.  The Law Commission covered the issues comprehensively and that therefore the Forum and the consultation undertaken is a delay to implementing the Commission’s recommendation (one professional association).  Develop an action plan that operationalises the Law Commission’s 2010 recommendations (one health sector organisation).

 The Forum’s terms of reference should refer more broadly to initiatives to reduce alcohol- related harm rather than focusing on single aspects such as sponsorship (one sporting body).  There is an inherent conflict between promotion of a product where the harmful effects of alcohol use are already known and the inclusion of considerations of a commercial or financial nature in the Forum’s brief (one individual).

A number of submitters also repeated information that outlined the Forum’s terms of reference and background to the establishment of the Forum.

78 4.4 Other initiatives to reduce alcohol-related harm that do not relate to adverti sing or sponsorship

Nine submitters identified a range of non-advertising or sponsorship related-activities which they considered should also be implemented as a way to curb alcohol-related harm. These initiatives included:

 Increases in taxation or other pricing mechanisms designed to end the availability of cheap alcohol, including the supermarket practice of using alcohol as a loss leader (one individual, one trade association, and one professional association)3

 Generic comments such as requiring an approach broader than alcohol advertising and sponsorship to address the harm from this legal product and New Zealand’s binge drinking culture, ensuring greater levels of parental responsibility, and policies to reduce the availability and promotion of alcohol (two individuals and one health sector organisation)

 Measures that encourage individual responsibility and that address binge drinking such as offences like being drunk in a public place (one trade association)

 Limit online sales (one retailer), and

 Funding for longitudinal studies on alcohol marketing to ascertain how exposure impacts on drinking behaviours and practices (one health sector organisation).

4.5 Other miscellaneous comments

The following other comments were made: provision of Copies of the Advertising Standards Authority Code for Advertising and Promotion of Alcohol (two advertising/media submitters) and a request for copies of alcohol and cigarette guidelines (one individual).

3 One trade association noted that a decade ago it was possible to source a dozen beers at the supermarket for around $1 a bottle while that same bottle would have retailed in a bar or a restaurant for around $2.50. Today on special it is still possible to find a dozen beer selling for $1 a bottle at a supermarket, while that same bottle in a bar or restaurant is likely to be $6 or $7 per bottle. The widening gap in pricing between on and off premise has naturally seen a significant shift in where New Zealanders are drinking. When supermarkets first entered the market around 40 percent of alcohol was consumed on licensed premises with 60 percent consumed at home or in an otherwise unsupervised environment. Today the percentage consumed on licensed premises has dropped below 25 percent.

79 Appendix A: List of submitters

Organisations

Advertising Standards Authority Alcohol Action Hamilton Alcohol Action Hawkes Bay Alcohol HealthWatch Allied Press Limited (Greymouth Star Limited) Association of New Zealand Advertisers Incorporated Auckland Council Auckland Regional Public Health Service Auckland Rugby Auckland Rugby League Incorporated Bauer Media Group Bowls New Zealand Brewers Guild Brewers’ Association Burnside Rugby Football Club Cancer Society Cancer Society (Auckland/Northland) Canterbury District Health Board Christchurch City Council Clemenger Group College of Nurses Aotearoa Communications Agencies Association of New Zealand Community Action Youth and Drugs (Clendon/Manurewa) Community Action Youth and Drugs (Hawkes Bay) Community Action Youth and Drugs (Murupara) Te Ika Whenua Hauora Inc Community Action Youth and Drugs (Otautahi) Community Alcohol and Drug Services (Auckland) DB Breweries Limited Diageo Australia Distilled Spirits Association of New Zealand Ellerslie Racing Club Family Planning Far North Midwives Foetal Alcohol Support Group (Dunedin) Food and Grocery Council Foundation for Advertising Research Hapai Te Hauora Hawkes Bay District Health Board Hawkes Bay Rugby Union Health Action Trust Health Promotion Forum of New Zealand Hikurangi Rugby Club Hospitality New Zealand Hurricanes and Wellington Rugby Independent Liquor Injury Prevention Network of New Zealand

80 INP Medical Centre JWT New Zealand Law for Change Group Lion Manawatu Rugby Club Mangere-Otahuhu Local Board Manurewa Local Board Marketing Association Massey University Napier Pirate Rugby and Sports Club National Addiction Centre (University of Otago) National Public Health Alcohol Working Group New Zealand College of Midwives New Zealand Comedy Trust and NZ International Comedy Festival New Zealand Cricket New Zealand Drug Foundation New Zealand Football New Zealand Golf New Zealand Medical Association New Zealand Nurses Organisation New Zealand Olympic Committee New Zealand Pacific Union Conference of the Seventh-day Adventist Church New Zealand Psychological Society New Zealand Retailers’ Association New Zealand Rugby New Zealand Rugby League New Zealand Sponsorship Association New Zealand Warriors Limited New Zealand Winegrowers Newspaper Publishers' Association Nga Tai O Te Awa Trust Northland District Health Board Northland Rugby Otago Rugby Football Union Otamatea Hawks Rugby Club Otara-Papatoetoe Local Board Otiria Rugby Union Football and Sports Club Palmerston North Women's Health Collective Parents Centre New Zealand Incorporated Pernod Ricard Winemakers PHD Group Poverty Action Waikato Progressive Enterprises Limited Radio Broadcasters Association Raglan Community House Rainbow Youth Regional Public Health Royal Australasian College of Physicians and New Zealand Society of Gastroenterology Royal Australian New Zealand College of Psychiatrists Rugby Southland Saatchi & Saatchi

81 Salvation Army SHORE and Whariki Research Centre Sileni Estates Limited Society of Beer Advocates South Canterbury Alcohol Action Southern Primary Health Organisation Splore Dynamics Limited Sport NZ Super Liquor Holdings Taradale Rugby and Sports Club Incorporated Te Mata Estate Winery Tennis Auckland Think TV THRIVE Teen Parent Support Trust Volvo Ocean Race Waikato District Health Board Wairarapa-Bush Rugby Football Union Incorporated Waitemata Child and Youth Mortality Review West Coast Well Women's Centre Incorporated Whanganui District Health Board Women's Christian Temperance Union Women's Health Action Trust World of Wearable Art Limited Yachting New Zealand ZenithOptimedia

Individuals

Personal information of individuals is withheld under section 9(2)(a) of the Official Information Act 1982.

82 83 Appendix B: Questions to guide submitters’ responses

1. Did you/your group/your organisation make a submission on the 2010 Law Commission report Alcohol in our Lives: Curbing the Harm and/or to the Justice and Electoral select committee, on alcohol advertising and sponsorship issues? If yes, please specify whether you submitted to the Law Commission and/or Select Committee. 2. Do you support further restrictions on alcohol advertising (over and above the measures currently undertaken) to reduce alcohol-related harm? 3. What reasons do you have for your view? Please include details. 4. What evidence is available to support your view (please cite references if available, or provide supporting information). Please focus on evidence since 2010 if this is available. 5. Do you think the available evidence is strong enough for changes to be made now? Explain your reasons. 6. Do you support further restrictions on alcohol sponsorship to reduce alcohol-related harm? 7. What reasons do you have for your view? Please include details. 8. What evidence is available to support your view (please cite references if available, or provide supporting information). Please focus on evidence since 2010 if this is available. 9. Do you think the available evidence is strong enough for changes to be made now? Explain your reasons.

Types of possible restrictions (if supported)

10. If further restrictions to alcohol advertising are necessary, what do you think should be done? 11. How would these proposed restrictions work in practice to reduce alcohol-related harm (eg, crime, disorder, negative public health outcomes)? 12. What evidence is available that your proposal(s) would work? 13. What other interventions could potentially be tried in future? 14. Why should these other interventions be considered? 15. If further restrictions to alcohol sponsorship are necessary, what do you think should be done? 16. How would these proposed restrictions work in practice to reduce alcohol-related harm (eg, crime, disorder, negative public health outcomes)? 17. What evidence is available that your proposal(s) would work? 18. What other interventions could potentially be tried in future? 19. Why should these other interventions be considered?

Impacts of proposals

20. Who would be affected by your proposals to restrict alcohol advertising and how? 21. How might these proposals impact on:  alcohol consumption, particularly among young drinkers and heavy drinkers;  the perception of alcohol as an everyday commodity, particularly among children and young people;  alcohol-related harm;  businesses, such as the alcohol and advertising industries;  the recipients of alcohol sponsorship funds; and  different populations – eg, youth, children, Māori, Pasifika, lower socio-economic populations. 22. Who would be affected by your proposals to restrict alcohol sponsorship and how?

84 23. How might these proposals impact on:  alcohol consumption, particularly among young drinkers and heavy drinkers;  the perception of alcohol as an everyday commodity, particularly among children and young people;  alcohol-related harm;  businesses, such as the alcohol and advertising industries;  the recipients of alcohol sponsorship funds; and  different populations – eg, youth, children, Māori, Pasifika, lower socio-economic populations.

Ongoing and new challenges

24. What ongoing and emerging challenges does the Forum need to take into account when considering whether further restrictions on alcohol advertising are necessary to reduce alcohol-related harm? 25. What action, if any, could be taken to address these matters? 26. What ongoing and emerging challenges does the Forum need to take into account when considering whether further restrictions on alcohol sponsorship (eg, of sporting, cultural and other events) are necessary to reduce alcohol-related harm? 27. What action, if any, could be taken to address these matters?

Other comments

28. Do you have any other comments?

85 Appendix C: List of citations provided by submitters

This section of the report includes many of the citations provided by submitters. These citations are have been collated from a range of sources, and as such there may be some differences in formatting (including inconsistencies regarding authors, page numbers, information about journal volume or number, publisher, etc.). We have not listed citations that were provided as incomplete where we could not provide the basic information such as author, date of publication, and title.

Assessment of these citations, and the evidence presented for and against, is outside the scope of Allen + Clarke’s contract; however, we would like to note that the following citations were presented by both submitters who support further restrictions, and those who do not:

 Bryden, A., Roberts, B., McKee, M., Pettigrew, M. (2012). A systematic review of the influence on alcohol us e of community level availability and marketing of alcohol. Health and Place, 18(2), 349-357.  Gee, S. (2013). The culture of alcohol sponsorship during the 2011 Rugby World Cup: an (auto) ethnographi c and (con) textual analysis. Sport in Society, 16(7), 912-930.  Gee, S., Jackson, S., Sam, M. (2014). Carnivalesque culture and alcohol promotion and consumption at an a nnual international sports event in New Zealand. International Review for the Sociology of Sport, 10126902 14522461.  Gee, S., Jackson, S., Sam, M. (2013). The culture of alcohol promotion and consumption at major sports events in New Zealand. [No further details].  Grenard, JL., Dent, CW., Stacy, AW. (2013). Exposure to alcohol advertisements and teenage alcohol- related problems. Pediatrics, 131(2), e369-e379.  Hibell, B., Guttormsson, U., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., Kraus, L. (2012). The 2011 ESPAD report. Substance use among students in, 36.  Jones, SC. (2010). When does alcohol sponsorship of sport become sports sponsorship of alcohol? A case st udy of developments in sport in Australia. International Journal of Sports Marketing and Sponsorship, 11(3). [No further details].  Jones, SC., Magee, CA. (2011). Exposure to alcohol advertising and alcohol consumption among Australian a dolescents. Alcohol and Alcoholism, 46(5), 630-637.  Ministry of Health. (2012). Hazardous Drinking in 2001/12 – Findings from the New Zealand Health Survey. Wellington, MOH.  Morgenstern, M., Isensee, B., Sargent, JD., Hanewinkel, R. (2011). Exposure to alcohol advertising and teen drinking. Preventive Medicine, 52(2), 146-151.  O'Brien, KS., Lynott, D., Miller, PG. (2013). Alcohol industry sponsorship and alcohol‐related harms in Austra lian university sportspeople/athletes. Drug and Alcohol Review, 32(3), 241-247.  O'Brien, KS., Miller, PG., Kolt, GS., Martens, MP., Webber, A. (2011). Alcohol industry and non-alcohol industry sponsorship of sportspeople and drinking. Alcohol and Alcoholism, 46(2), 210-213.  Pettigrew, S., Rosenberg, M., Ferguson, R., Houghton, S., Wood, L. (2013). Game on: do children absorb sports sponsorship messages?. Public Health Nutrition, 16(12), 2197-2204.  Sloane, K., Wilson, N., Imlach Gunasekara, F. (2013). A content analysis of the portrayal of alcohol in televised music videos in New Zealand: Changes over time. Drug and Alcohol Review, 32(1), 47-52.  Stoolmiller, M., Wills, TA., McClure, AC., Tanski, SE., Worth, KA., Gerrard, M., Sargent, JD. (2012). Comparing media and family predictors of alcohol use: a cohort study of US adolescents. BMJ Open, 2(1).

86 A Citations provided in favour of further restrictions on advertising and sponso rship

A.1 Evidence published post-2010

ABAC. (2013). Best practice for the responsible marketing of alcohol beverages in digital marketing. Advertising Standards Authority. (No date). Bugger…it’s ok! The case for advertising self-regulation. Wellington, NZ: Advertising Standards Authority. Alcohol Advisory Council. (2012). Maori Action Plan 2009-2012. Wellington, NZ: Health Promotion Agency. Alcohol Advisory Council. (2012). The Impacts of Liquor Outlets in Manukau City Summary Report. Alcohol Advisory Council (April 2011). Alcohol advertising and young people. Alcohol NZ. Pg.23. Alcohol Advisory Council (April 2011). Alcohol NZ Briefs. Alcohol NZ. Vol.1, No.1. Pg.34. Wellington: NZ Alcohol Advisory Council (April 2011). Charting alcohol exposure at the rugby sevens. Alcohol NZ. Alcohol Advisory Council (April 2011). Over-exposed at the world cup 2010. Alcohol NZ. Pp.30-31. Alcohol Advisory Council (April 2011). What’s happening with the ASA review? Alcohol NZ. Alcohol Concern (2013). Alcohol advertising regulation that balances commercial and public interest. London: UK. Alcohol Concern. (2011). An unhealthy mix? Alcohol industry sponsorship of sport and cultural events. Alcohol Concern: Cardiff Alcohol Concern (2011). Overexposed and overlooked: Young people’s views on the regulation of alcohol promotion. London. Alcohol Marketing and Young People: Time for a new policy agenda Alcohol marketing and young people : time for a new policy agenda ISBN: 9780949535412 (loose-leaf ) Alcohol Marketing Communications Monitoring Body (2011). Limiting the exposure of young people to alcohol advertising. AMA. (2012). National summit on alcohol marketing to young people. Communique. Ameratunga S, Waayer D, Robinson E, Clark TC, Crengle S, Denny S, Sheridan J, Teevale T. (2011). Youth'07: Th e Health and Wellbeing of Secondary School Students in New Zealand. Young People and Alcohol. Auckland, Ne w Zealand: The University of Auckland, Adolescent Health Research Group. Anderson, P. (April 2011). Time to ban alcohol advertising? Alcohol NZ. Vol.1, Pp.24 - 29. Anderson, P., Braddick, F., Reynolds, J., Gual, A. (2012). Alcohol Policy in Europe: Evidence from AMPHORA. The AMPHORA project, available online: http://amphoraproject. net/view. php. Archer, C., Ouschan, R. (2011). ‘Alcohol between the covers: the portrayal of alcohol in online versions of magazines read by young women.’ In D. Sanders and K Mizerski (eds), Proceedings of Australian and New Zealand Marketing Academy conference. Australian and New Zealand Marketing Academy Australian adolescents. Alcohol and Alcoholism, 46 (5), 630-637. Australian Government, (2012). Convergence review: final report. Commonwealth of Australia: Canberra. Australian National Preventative Health Agency. (2013). National Binge Drinking Strategy [Online]. Canberra, ACT. Available: h t t p : // w w w.a nph a. go v .a u / i n t e r n e t / a nph a / pub lish ing . n sf/Content/NBDS Australian National Preventive Health Agency. (2014). Alcohol advertising: The effectiveness of current regulatory codes in addressing community concern. Draft Report. Australian National Preventive Health Agency, (2013). National Binge Drinking Strategy [Online]. Canberra, ACT. Available: http://www.anpha.gov.au/internet/anpha/publishing.nsf/Content/NBDS

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A.2 Web links (post-2010) http://resources.ccc.govt.nz/files/thecouncil/policiesreportsstrategies/policies/groups/alcohol/draftlapsumma ryandanalysisofsubmissionsjuly2013.pdf http://resources.ccc.govt.nz/files/thecouncil/policiesreportsstrategies/policies/groups/alcohol/draftlapsumma ryandanalysisofsubmissionsjuly2013.pdf http://www.2shine.org.nz/library/Documents/RWC percent20special percent20collection/mitigatingriskofvawincrsgduringrwc.pdf http://www.3news.co.nz/Black-Caps-pair-Jesse-Ryder and Doug-Bracewell-fined-by NZ-Cricket-Story http:/ / www . aba c .o r g.a u /u p l oad s / Fi l e / A B A C percent 20 C od e percent 20 AB C N e w s ( 2 013 ) . E n d a l c oh o l a d v e r t i s i n g i n li v e s po r t: O ’ C a l l ag h an. A cc e ss ed f r om http:/ / www . ab c .n e t.a u /n e w s /20 1 3 - 06 - 1 9 /p r e m i e r- den i e s- l a ck- o f - r e s ou rc e s - m a k i ng - po l ... on 21 / 06/ 1 3 . http : / / ww w . aba c .o r g . au / wp -c ont e nt / up l oad s / 2 013 / 11 / B e s t - P r a c t i c e - i n - D i g i t a l - a nd- S o c i a l - M ed i a - N o v e m be r- 2013. p df http://www.alcohol.org.nz/InpowerFiles percent5CPoliciesAndSubmissions percent5CDocument.Document.33180.aee93376-dd00-471a-8ae3-e683807e3376.pdf http:/ / www. a l c o h o l a d r e v i e w . c o m .au h t t p : // w w w .a n ph a . g o v .a u/ i n t e r n e t/ a nph a/ p u b li s h i n g . n s f /C on t e n t/ b t i - t b d - ho me a http://www.arphs.govt.nz/Portals/0/About percent20us/Submissions/2009 percent20Submissions/October pe rcent202009/20091030_LawComissionReport.pdf http://www.asa.co.nz/code_promo_advert_liquor.php retrieved24 April 2014 http:/ / www . b i o m ed c ent r a l . c o m /1471 - 245 8 /9/ 5 1 d o i : D O I:10 . 11 8 6/1 4 71 - 2 458 - 9 - 51 http://www.cbsnews.com/news/palcohol-powdered-alcohol-may-present-serious-health-risks/ http:/ / www . d i a .g o v t .n z / d i a web s i t e .n s f / w p g_U R L / S e rv i c e s - Ca s i no - a nd- Non - Ca si no -G a m i ng - T he - Ru l e s- f o r-

95 Runn i ng - a -G a m b l i ng - A c t iv i t y #e ight http://www.globalgapa.org/pdfs/who-statement-of-concern-080213.pdf http://www.ias.org.uk/uploads/pdf/Factsheets/Marketing percent20and percent20alcohol percent20FS perce nt20May percent202013.pdf http://www.nzherald.co.nz/news/print.cfm?objectid=11119193andpnum=1 http://www.parliament.nz/resource/0000157162 http://www.racp.edu.au/page/policy-and-advocacy/public-health-andsocial-policy http://www.richmondroversrugbyleague.com/2/post/2014/03/richmond-rovers-rugby-league-sports-club-to- become-alcohol-free-in-2014.html http://www.richmondroversrugbyleague.com/2/post/2014/03/richmond-rovers-rugby-league-sports-club-to- become-alcohol-free-in-2014.html http://ww w . r o y m o r g a n. c o m / f i nd i ng s / 5201 - d i g i t a l - t r ad i t i o n a l - m ed i a - ne w - z ea l and - 2 013 http://www.scielo.org.za/scielo.php?pid=S0256-95742012000700010andscript=sci_arttextandtlng=es http://www.scoop.co.nz/stories/BU1402/S00219/kiwis-makehistory-launch-jim-beams-latest-brand- campaign.htm http://www.stuff.co.nz/sport/league/9705271/Sevens-behaviour-won-t-be-tolerated-at-nines http://www.thinktv.co.nz/insights/research/television-and-online-social-media/ http://www.wma.net/en/30publications/10policies/a22/ http : ww w . f i nnb a y . c o m / f i n l and - i nt r o du c e s- nat i o n - w i de - a l c oh o l - a d v e r t i s i n g - ban- e x pe r t s- d i s ag r e e https://www.surfingaustralia.com/wa/event.php?id=864

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Alcohol Advisory Council. (2009) Submission to the New Zealand Law Commission on the Alcohol in our Lives Issues Paper. Advertising Standards Authority. (2005). 05/352 – Tui television advertisement. Alcohol HealthWatch. (2005). ‘Alcohol Marketing – An Update’. Alinz, M. (1998). Alcohol Availability and Targeted Advertising in Racial/Ethnic Minority Communities, Alcohol Health and Research World, 22(4). Anderson, P., Chisholm, D., Fuhr, DC. (2009). Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. The Lancet, 373(9682), 2234-2246. Anderson, P., De Bruijn, A., Angus, K., Gordon, R., Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol and Alcoholism, 44(3), 229-243. Anderson, P., Foxcroft, D., Kaner, E., Martinic, M., Moskalewicz, J., Nociar, A. (2009). Does Marketing Communication Impact on the Volume and Patterns of Consumption of Alcoholic Beverages, Especially by Young People? A Review of Longitudinal Studies. In Scientific Opinion of the Science Group of the European Alcohol and Health Forum. Anderson, SJ., Dewhirst, T., Ling, PM. (2006). Every document and picture tells a story: using internal corporate document reviews, semiotics, and content analysis to assess tobacco advertising. Tobacco Control, 15(3), 254- 261. Blecher, E. (2008). The impact of tobacco advertising bans on consumption in developing countries. Journal of Health Economics, 27(4), 930-942.

96 Bonomo, YA., Bowes, G., Coffey, C., Carlin, JB., Patton, GC. (2004). Teenage drinking and the onset of alcohol dependence: a cohort study over seven years. Addiction, 99(12), 1520-1528. Booth, A., Meier, P., Stockwell, T., Sutton, A., Wilkinson, A., Wong, R., Taylor, K. (2008). Independent review of the effects of alcohol pricing and promotion. Part A: systematic reviews. In Independent review of the effects o f alcohol pricing and promotion. Part A: systematic reviews. University of Sheffield. Brand, DA., Saisana, M., Rynn, LA., Pennoni, F., Lowenfels, AB. (2007). Comparative analysis of alcohol control policies in 30 countries. PLoS Medicine, 4(4), e151. Braun, V. (2008). “She'll be right”? National identity explanations for poor sexual health statistics in Aotearoa/New Zealand. Social Science and Medicine, 67(11), 1817-1825. British Medical Association. (2009). Under the influence: the damaging effect of alcohol marketing on young people. London: BMA Library. Casswell, S. (2004). Alcohol brans in young people’s everyday lives: new developments in marketing. Alcohol and Alcoholism, 39(6), 471-476. Casswell, S., Thamarangsi, T. (2009). Reducing harm from alcohol: call to action. The Lancet, 373(9682), 2247- 2257. Casswell, S., Zhang, JF. (1998). Impact of liking for advertising and brand allegiance on drinking and alcohol‐ related aggression: a longitudinal study. Addiction, 93(8), 1209-1217. Casswell, S., Maxwell, A. (2005) Regulation of alcohol marketing: a global view. 26 Journal of public health policy 343 at 353 Chen, MJ., Grube, JW., Bersamin, M., Waiters, E., Keefe, DB. (2005). Alcohol advertising: what makes it attracti ve to youth?. Journal of Health Communication, 10(6), 553-565. Christchurch City Council. (2001). Policy to reduce alcohol-related harm at public events. Connor, J., You, R., Casswell, S. (2009). Alcohol-related harm to others: a survey of physical and sexual assault in New Zealand. The New Zealand Medical Journal, 122(1303), 10–20. Cousins, K., Kypri, K. (2008). Alcohol advertising in the New Zealand university student press. Drug and Alcohol Review, 27(5), 566–9. doi:10.1080/09595230802245246 Department of Health Promotion and Protection. (2007). Changing the culture of alcohol use in Nova Scotia. (A. (Cape B. D. health A. Brown, S. (Addiction S. Cukier, E. (Cape B. H. A. Findlay, K. (Guysborough H. A. Finnigan, P. (Capital H. Hetuirg, A. (Capital H. Hudson, T. (Addiction S. C. Leader, et al., Eds.). Nova Scotia. Fielder, L., Donovan, RJ., Ouschan, R. (2009). Exposure of children and adolescents to alcohol advertising on Au stralian metropolitan free‐to‐air television. Addiction, 104(7), 1157-1165. Hanewinkel, R., Tanski, SE., Sargent, JD. (2007). Exposure to alcohol use in motion pictures and teen drinking in Germany. International Journal of Epidemiology, 36(5), 1068-1077. Hastings, G. (2009). “They'll drink bucket loads of the stuff”: an analysis of internal alcohol industry advertising documents. Hingson, RW., Heeren, T., Winter, MR. (2006). Age at drinking onset and alcohol dependence: age at onset, dur ation, and severity. Archives of Pediatrics and Adolescent Medicine, 160(7), 739-746. Hollingworth, W., Ebel, BE., McCarty, CA., Garrison, MM., Christakis, DA., Rivara, FP. (2006). Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers. Journal of Studies on Alcohol and Drugs, 67(2), 300. Hopkins, S. (2002). Girl heroes: The new force in popular culture. Pluto Press Australia. Huckle, T., Sweetsur, P., Moyes, S., Casswell, S. (2008). Ready to drinks are associated with heavier drinking patterns among young females. Drug and Alcohol Review, 27(4), 398-403. Jones, SC., Donovan, RJ. (2002). Self‐regulation of alcohol advertising: is it working for Australia?. Journal of Pu blic Affairs, 2(3), 153-165. King E et al. (2005) Australian Alcohol Beverage Advertising in Mainstream Australian Media 2003 to 2005:

97 Expenditure, Exposure and Related Issues. Research and Marketing Group: Department of Health and Ageing Kypri, K., O'Brien, K., Miller, P. (2009). Time for precautionary action on alcohol industry funding of sporting bo dies. Addiction, 104(12), 1949-1950. Laugesen, M., Swinburn, B. (2000). New Zealand's tobacco control programme 1985-1998. Tobacco Control, 9 (2), 155-162. McCreanor, T., Barnes, HM., Gregory, M., Kaiwai, H., Borell, S. (2005). Consuming identities: Alcohol marketing and the commodification of youth experience. Addiction Research and Theory, 13(6), 579-590. Measham, F. (2006). The new policy mix: Alcohol, harm minimisation, and determined drunkenness in contemporary society. International Journal of Drug Policy, 17(4), 258-268. Ministry of Health. (2009). Alcohol use in New Zealand: Key results of the 2007/08 New Zealand Alcohol and Dr ug Use Survey. Wellington: Ministry of Health. Mosher, JF., Johnsson, D. (2005). Flavored alcoholic beverages: An international marketing campaign that targe ts youth. Journal of Public Health Policy, 326-342. New Zealand Drug Foundation. (2006). Alcohol advertising policy in New Zealand: an experiment in industry self-regulation. Oakley Browne, MA,. Wells, JE,. Scott, KM. (eds). (2006). Te Rau Hinengaro: The New Zealand Mental Health Survey. Wellington: Ministry of Health. O'Brien, KS., Kypri, K. (2008). Alcohol industry sponsorship and hazardous drinking among sportspeople. Addiction, 103(12), 1961-1966. Odgers, CL., Caspi A., Nagin, D., Piquero, A., Slutske, WS., Milne, B. (2008). Is It Important to Prevent Early onset and binge drinking among U.S adolescents. BMJ Open, 20. Pitkänen, T., Lyyra, AL., Pulkkinen, L. (2005). Age of onset of drinking and the use of alcohol in adulthood: a follow‐up study from age 8–42 for females and males. Addiction, 100(5), 652-661. Roche, A., Bywood, P., Borlagdan, J., Lunnay, B., Freeman, T., Lawton, L., Nicholas, R. (2007). Young people and alcohol: The role of cultural influences. Adelaide: National Centre for Education and Training on Addiction. Saffer, H., Dave, D. (2002). Alcohol consumption and alcohol advertising bans. Applied Economics, 34(11), 132 5-1334. Sargent, JD., Wills, TA., Stoolmiller, M., Gibson, J., Gibbons, FX. (2006). Alcohol use in motion pictures and its re lation with early-onset teen drinking.Journal of studies on Alcohol and Drugs, 67(1), 54. Schrans, T., Schellinck, T., Yi, Z. (2009). Child and youth drinking: The context of alcohol use among adolescents in Nova Scotia. Focal Research Consultants Ltd. Halifax. Sheron, N., Olsen, N., Gilmore, I. (2008). An evidence-based alcohol policy. Gut, 57(10), 1341-1344. Slack, A., Nana, G., Webster, M., Stokes, F., Wu, J. (2009). Costs of harmful alcohol and other drug use. BERL Ec onomics, 40. Smith, LA., Foxcroft, DR. (2009). The effect of alcohol advertising, marketing and portrayal on drinking behavio ur in young people: systematic review of prospective cohort studies. BMC public health, 9(1), 51. Snyder, LB., Milici, FF., Slater, M., Sun, H., Strizhakova, Y. (2006). Effects of alcohol advertising exposure on drinking among youth. Archives of Pediatrics and Adolescent Medicine, 160(1), 18-24. Squeglia, LM., Jacobus, J., Tapert, SF. (2009). The influence of substance use on adolescent brain development. Clinical EEG and Neuroscience, 40(1), 31-38. Stark, J. (2007). Insider tells of young drinkers being targeted. The Age, 6, 3. Targets Youth. (2005). Journal of Public Health Policy, 26, 326 - 342. Thamarangsi T. (2008). Alcohol Policy Process in Thailand [A thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy]. Auckland: Massey University. The Royal Australasian College of Physicians. (2009). Marketing of Alcohol: a position statement. Australia.

98 Thomson, G., Wilson, N. (1997). Resource Document, a Brief History of Tobacco Control in New Zealand. AFPH M (NZ). Toomey, TL., Lenk, KM., Wagenaar, AC. (2007). Environmental policies to reduce college drinking: An update of research findings. Journal of Studies on Alcohol and Drugs, 68(2), 208. Treise, DM., Taylor, RE., Wells, LG. (1995). How recovering alcoholics interpret alcoholic-beverage advertising. Health Marketing Quarterly, 12(2), 125-139. Viner, RM., Taylor, B. (2007). Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort. Journal of epidemiology and community health, 61(10), 902-907. Wells, JE., Horwood, LJ., Fergusson, DM. (2004). Drinking patterns in mid‐adolescence and psychosocial outcomes in late adolescence and early adulthood. Addiction, 99(12), 1529-1541. World Health Organization. (2009). Harmful Use of Alcohol: The Problem. Geneve: WHO.

A.4 Web links (pre-2010)

h tt p : // w ww . a l c o h o l . or g . nz /s i te s / d e f a ul t / f i l e s/u s e r u p l oa d s / R e s o u r c e p d f s/02859 _ C P T E D _ G u i d e l i n e s _ r e d u ce d . p df h t t p : / /w w w . s ce n i c . o r g / bi ll b o a r d s - a - s i g n-c o n t r o l / t o o l s -fo r - a c t io n /109 - a l c o h o l - a d v e r t i s i n g - o n - bi ll b o ar ds h tt p : / / ww w . s ce n ic . o r g/ b i ll b o a r ds - a - s i g n-c o n t ro l / t o o l s -fo r - a c t i o n /109 - a l c o h o l - a d v e r ti s i n g - o n - bi ll b o a r ds http://www.thinktv.co.nz/insights/research/television-ads-and-the-mind/ http://www.thinktv.co.nz/insights/research/tv-response-the-new-rules/ http://www.thinktv.co.nz/wp-content/uploads/Television-and-online1.pdf http://www.thinktv.co.nz/wp-content/uploads/TVTrends-2012.pdf http://www.tradingeconomics.com/new-zealand/households-with-television-percent-wb-data.html http://www.euro.who.int/__data/assets/pdf_file/0020/43319/E92823.pdf

99 B Citations presented in opposition of further restriction on advertising and sp onsorship

B.1 Evidence published post-2010

Advertising Standards Authority. (2013), Code for Advertising and Promotion of Alcohol. ASA. Advertising Standards Authority (2013). Guidance Notes for the Code For Advertising and Promotion of Alcohol. ASA. Alcohol Advisory Council. (2011). Alcohol Monitor – Adult and Youth 2009-10 Drinking Behaviours Report. Batty, R. (2013). Community sports events, sponsorship and the impacts of a public health agenda. Presentation to the Sport Management Association of Australia and New Zealand 2013 Conference. Bryden, A., Roberts, B., McKee, M., Petticrew, M. (2012). A systematic review of the influence on alcohol use of community level availability and marketing of alcohol. Health and Place, 18(2), 349-357. Chan, GC., Kelly, AB., Toumbourou, JW., Hemphill, SA., Young, RM., Haynes, MA., Catalano, RF. (2013). Predicting steep escalations in alcohol use over the teenage years: age‐related variations in key social influences. Addiction, 108(11), 1924-1932. Cody, K., Jackson, S. (2014). The contested terrain of alcohol sponsorship of sport in New Zealand. Internationa l Review for the Sociology of Sport, 1012690214526399. Cox, S. (2012). Game of life – how sport and recreation can make us healthier, happier and richer. United Kingdom: Sport and Recreation Alliance. Dalziel, P. (2011). The economic and social value of sport and recreation to New Zealand. Lincoln University. Agricultural Economics Research Unit. Dietary Guidelines Advisory Committee. (2010). Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. Agricultural Research Service. Eadie, D., MacAskill, S., Brooks, O., Heim, D., Forsyth, A., Punch, S. (2010). Pre-teens learning about alcohol. Joseph Rowntree Foundation. Econometrix. (2013), Economic Impact of an Advertising Ban on Alcoholic Beverages. pp118-123 Foundation for Advertising Research. (2014). “No correlation between alcohol ad-spend and consumption”, Management Digest. March. Foundation for Advertising Research. (2010). The Quantum of Alcohol Sponsorship in New Zealand. Foundation for Alcohol Research and Education. (2013). A red light for preventive health - Assessing progress against the Preventative Health Strategy’s alcohol-specific actions. Australian Capital Territory: Foundation for Alcohol Research and Education. Gallet, C., Andres, A. (2011). “International evidence on the determinants of alcohol advertising restrictions.” A pplied Economics Letters, 18:14, 1359-1362. Gee, S. (2013). The culture of alcohol sponsorship during the 2011 Rugby World Cup: an (auto) ethnographic a nd (con) textual analysis. Sport in Society, 16(7), 912-930. Gee, S., Jackson, S., Sam, M. (2014). Carnivalesque culture and alcohol promotion and consumption at an annu al international sports event in New Zealand. International Review for the Sociology of Sport, 10126902145224 61. Gee, S., Jackson, S., Sam, M. (2013). The culture of alcohol promotion and consumption at major sports events in New Zealand.

100 GEMBA Group (2013). Confidential Report to Sport New Zealand - Gemba Sports and Entertainment Report – P art One – Main Body. April 2012 - March 2013. Auckland: The GEMBA Group. Gibson, A., Miller, M., Smith, P., Bell, A., Crothers, C. (2013). The internet in New Zealand 2013. Gilmore, I. “Alcohol and Social Marketing” (2009) BMJ 339-585 at 585 Gordon, R. (2011). Alcohol marketing and youth drinking: A rejoinder to the alcohol industry. Alcohol and Alcoholism, 46(4), 369-370. Grenard, JL., Dent, CW., Stacy, AW. (2013). Exposure to alcohol advertisements and teenage alcohol-related problems. Pediatrics, 131(2), e369-e379. Habib, C., Santoro, J., Kremer, P., Toumbourou, J., Leslie., E., Williams, J. (2010). The importance of family management, closeness with father and family structure in early adolescent alcohol use. Addiction, 105(10), 1750-1758. Health and Social Care Information Centre. Statistics on Alcohol: England, 2012. London: Office of National Statistics; 2012. Health Promotion Agency. (2013). Annual Report, page 7. Wellington: HPA. Health Promotion Agency. 2013. “The culture of alcohol promotion and consumption at major sports events in New Zealand.” Wellington: HPA. Health Promotion Agency. (2012). Attitudes and Behaviours Towards Alcohol Survey. Wellington: HPA. Hibell, B., Guttormsson, U., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., Kraus, L. (2012). The 2011 ESPAD report. Substance use among students in, 36. Jernigan, DH. (2010). Extent of Global Alcohol Marketing and Its Impact on Youth, The. Contemp. Drug Problems, 37, 57. Johnston, LD., O'Malley, PM., Bachman, JG., Schulenberg, JE. (2010). Monitoring the Future: National Survey Results on Drug Use, 1975-2009. Volume I: Secondary School Students. NIH Publication No. 10-7584. National Institute on Drug Abuse (NIDA). Jones, SC. (2010). When does alcohol sponsorship of sport become sports sponsorship of alcohol? A case study of developments in sport in Australia. International Journal of Sports Marketing and Sponsorship, 11(3). Jones, SC., Magee, CA. (2014). The role of family, friends and peers in Australian adolescent's alcohol consumpt ion. Drug and alcohol review. Jones, SC., Magee, CA. (2011). Exposure to alcohol advertising and alcohol consumption among Australian adol escents. Alcohol and Alcoholism, 46(5), 630-637. Joyce, S. (Hon). (July 31, 2013). Major events investment benefits New Zealand – report. New Zealand Government website. New Zealand Law Commission. (2010). Alcohol in our lives: Curbing the harm. A report on the review of the regulatory framework for the sale and supply of liquor. Wellington: Law Commission. Litmus. (2014 - in press). Gaming Funding into the Sport and Physical Activity/Recreation Sector 2012. Wellington: Litmus. Livingston, M. (2014). Trends in non‐drinking among Australian adolescents. Addiction, 109(6), 922-929. Maimaris, W., McCambridge, J. (2014). Age of first drinking and adult alcohol problems: systematic review of prospective cohort studies. Journal of Epidemiology and Community Health, 68(3), 268-274. Mays, D., DePadilla, L., Thompson, N. J., Kushner, H. I., Windle, M. (2010). Sports participation and problem alcohol use: a multi-wave national sample of adolescents. American Journal of Preventive Medicine, 38(5), 491- 498. Milne, A. (2013). The Cost of the Game? The Cost of a Game (Full Report). Wellington: Victoria University of Wellington, Faculty of Commerce. Ministry of Health (2013) Annual Health Survey 2012/2013. Wellington: Ministry of Health.

101 Ministry of Health. (2013). New Zealand Health Survey: Annual Update of Key Findings 2012/13. Wellington: Ministry of Health. Ministry of Health. (2013). A New National Drug Policy for New Zealand: Discussion Document. Wellington: Ministry of Health. Ministry of Health. (no date) Hazardous drinking in 2011/12: Findings from the New Zealand Health Survey. Wellington, Ministry of Health. Morgenstern, M., Isensee, B., Sargent, JD., Hanewinkel, R. (2011). Exposure to alcohol advertising and teen dri nking. Preventive Medicine, 52(2), 146-151. Nelson, JP. (2010a). Alcohol advertising bans, consumption and control policies in seventeen OECD countries, 1975–2000. Applied Economics, 42(7), 803-823. Nelson, JP. (2010b). What is learned from longitudinal studies of advertising and youth drinking and smoking? A critical assessment. International Journal of Environmental Research and Public Health, 7(3), 870-926. Nelson, JP. (2010c). Alcohol Marketing, Adolescent Drinking and Publication Bias in Longitudinal Studies: A Critical Survey using Meta-Analysis. Journal of Economic Surveys, published online on 23 August 2010. Nelson, JP (2010d) Alcohol, unemployment rates and advertising bans: international panel evidence, 1975- 2000. Journal of Public Affairs, 10, 75-87. Nelson, JP. (2011). Alcohol Marketing, Adolescent Drinking And Publication Bias In Longitudinal Studies: A Critical Survey Using Meta‐Analysis. Journal of Economic Surveys, 25(2), 191-232. NZ Herald. (April 27 2014). Minors and young drunks nabbed, violence drops under new laws. O'Brien, KS., Lynott, D., Miller, PG. (2013). Alcohol industry sponsorship and alcohol‐related harms in Australia n university sportspeople/athletes. Drug and Alcohol Review, 32(3), 241-247. O'Brien, KS., Miller, PG., Kolt, GS., Martens, MP., Webber, A. (2011). Alcohol industry and non-alcohol industry sponsorship of sportspeople and drinking. Alcohol and Alcoholism, 46(2), 210-213. O’Brien, K., Lynott, D. Miller, PG. (2013). Alcohol industry sponsorship and alcohol-related harms in Australian university sportspeople/athletes. Drug and Alcohol Review, 32, 241-247. Parliamentary Monitoring Group South Africa. (October 29, 2013). Role and effects of alcohol advertising in sport: meeting with stakeholders. Parliamentary Monitoring Group website. Parry, C., Burnhams, N. H., London, L. (2012). A total ban on alcohol advertising: Presenting the public health c ase. SAMJ: South African Medical Journal, 102(7), 602-604. Pettigrew, S., Rosenberg, M., Ferguson, R., Houghton, S., Wood, L. (2013). Game on: do children absorb sports sponsorship messages?. Public Health Nutrition, 16(12), 2197-2204. Plumb, S. Napier, L. (July 14, 2013). Sponsor loss sees Triathlon New Zealand make cut backs. Published online: www.s tuff.co.nz. Plumb, S. (May 19, 2013). Trouble behind the scenes for Bike NZ. Published online: www.s tuff.co.nz. Portman Group. (2013). Code of Practice on Alcohol Sponsorship. PS Services. (2010). Alcohol and sport: What is the nature of the relationship and is there a problem? A scoping study prepared for SPARC Ihi Aotearoa. Wellington: PS Services. Sharp, B., Ehrenberg-Bass. (2010). How brands grow: What marketers don't know (Vol. 189). South Melbourne: Oxford University Press. Sloane, K., Wilson, N., Imlach Gunasekara, F. (2013). A content analysis of the portrayal of alcohol in televised music videos in New Zealand: Changes over time. Drug and Alcohol Review, 32(1), 47-52. SPARC. (2011). The Economic and Social Value of Sport and Recreation to New Zealand: An Overview. Wellingto n: SPARC. SPARC. (2010). Alcohol and Sport –What is the nature of the relationship and is there a problem?. Wellington: SPARC.

102 Statistics New Zealand. (2010). Time use survey. Wellington: Statistics New Zealand. Stoolmiller, M., Wills, TA., McClure, AC., Tanski, SE., Worth, KA., Gerrard, M., Sargent, JD. (2012). Comparing media and family predictors of alcohol use: a cohort study of US adolescents. BMJ Open, 2(1). Thompson, PL. (2012). J-curve revisited: cardiovascular benefits of moderate alcohol use cannot be dismissed. The Medical journal of Australia, 198(8), 419-422. Tourism New Zealand. (2014). Tourist Special Interest: Wine Tourism. Wellington, Tourism NZ. UMR Research. (2014). Public awareness of the Advertising Standards Authority. Wilson, I., Munro, G., Hagger, A., Dilkes-Frayne, E. (2012). Alcohol sponsorship of Good Sports Clubs (Survey report). Melbourne: Victorian Health Promotion Foundation. World Health Organisation. (2011). Global Status Report: Alcohol Policy; “Global Status Report on Alcohol and Health”. Geneve: WHO. Wright, C. (June 13, 2013). Report examines the impact of sport sponsorship in Australia and New Zealand. Published online: Sport Business Insider.

B.2 Web links (post-2010)

h t t p://www.an t h il l o n li n e . c o m / re s e a rc h - t e e n s -g eeks - d o n t - d o m i n ate - a u s si e - yo u t u be - u s a g e / http://www.adcorp.co.nz/news-blog/Social-Media-Statistics-Aust-and-NZ-Apr13 http://www.adnews.com.au/adnews/drinkwise-launches-classy-campaign-to-change-drinking-culture http://www.alcohol.org.nz/research-resources/say-now http://www.alcoholstats.com/uploads/InfluencesOnYouthsDecisionsAboutDrinking.pdf http://www.asa.co.nz/pdfs/Guidance percent20Notes percent20for percent20Code percent20for percent20Advertising percent20and percent20Promotion percent20of percent20Alcohol percent20January percent202013.pdf http://www.carlsberggroup.com/investor/news/Pages/Standingoutinadarkmarket.aspx http://www.craftbrewingcapital.co.nz/wp-content/uploads/2011/08/NZH12138_brochure.pdf http://www.deakin.edu.au/news/2013/151013teenalcohol.php http://www.drugfree.org/join-together/alcohol/french-teen-drinking-raising-serious-concerns http://www.ignitesocialmedia.com/social-media-stats/2012-social-network-analysis-report/ h t t p://www . i g n ite s oci a l m e d i a. co m / s oci al -m e d i a - s t a t s/201 2 - s oci a l - n et w ork - a n a ly s i s - re p or t http://www.imrpublications.com/newsdetails.aspx?nid=44 http://www.lancaster.ac.uk/staff/lynottd/publications_files/OBrien-Lynott-Miller-2013- AlcoholSponsorshipSportsPeople.pdf http://www.marketinggum.com/facebook-statistics-for-new-zealand/ http://www.nzherald.co.nz/business/news/article.cfm?c_id=3andobjectid=10788984 http://www.rnzb.org.nz/media/19578/rnzb_beer_on_pointe.pdf h t tp :/ / ww w .s oci a l b aker s. co m / f a ce b oo k - p a g e s/ br a n d s /c o u ntry /n e w- ze a l a n d/ http://www.socialbakers.com/facebook-statistics/new-zealand h t t p://www . s oci a l b aker s. co m / f a ce b oo k - s t a ti s t ic s/ ne w - ze a l a n d h t t p://www . s oci a l b aker s. co m / t w itt e r / g ro u p /b r a n d s /c o u ntry /n e w - ze a l a n d h t t p://www . s oci a l b aker s. co m /y o u t u be - s t a ti s t i c s/ co u ntry /n e w- ze a l a n d

103 http://www.strobe-statement.org/ http://www.stuff.co.nz/national/royal-tour/9927574/A-Wither-Hills-lunch-for-Wills-and-Kate http://www.theguardian.com/world/2011/jul/17/lyon-reduce-le-binge-drinking http://www.tourismnewzealand.com/sector-marketing/major-sports-events/ http://www.who.int/substance_abuse/publications/en/france.pdf h t t p://www . wh o . i n t /s u b st a nce_ a b u se /p u b lic a t i o n s / g lo b al_ a lco h ol_r e p o r t /p rofi l e s/ e n/ http://www2.potsdam.edu/alcohol/Advertising.html#.U1hocstWFMs

B.3 Evidence published pre-2010

Active New Zealand. 2007/08 Active New Zealand Survey. Advertising Standards Authority. (2009). Code for the Naming, Labelling, Packaging and Promotion of Liquor. Alcohol Advisory Council. (2008). Drinking Behaviours Report. Alcohol Advisory Council. (2007). Alcohol Sponsorship: a literature review. Anderson, P., Baumberg, B. (2006). Alcohol in Europe. London: Institute of Alcohol Studies, 2, 73-75. Anderson, P., De Bruijn, A., Angus, K., Gordon, R., Hastings, G. (2009). Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol and Alcoholism, 44(3), 229-243. Arvanitidou, M., Tirodimos, I., Kyriakidis, I., Tsinaslanidou, Z., Seretopoulos, D. (2007). Decreasing prevalence of alcohol consumption among Greek adolescents. The American Journal of Drug and Alcohol Abuse, 33(3), 411-417. Attorney General. (2009). Report of the Attorney-General under the New Zealand Bill of Rights Act 1990 on the Liquor Advertising (Television and Radio) Bill, presented to the House of Representatives pursuant to Section 7 of the New Zealand Bill of Rights Act. Baer, JS. (2002). Student factors: Understanding individual variation in college drinking. Journal of Studies on Alcohol and Drugs, (14),40. Berger, G. et al. (1999). La Loi relative à la lutte contre le tabagisme et l'alcoolisme : rapport d'évaluation. La Documentation Française, p. 106 Bonnie RJ, O'Connell ME (editors). (No date). National Research Council (US) and Institute of Medicine (US) Committee on Developing a Strategy to Reduce and Prevent Underage Drinking; Washington (DC). Broadbent, T. (2008). Does advertising grow markets? More evidence from the United Kingdom. International Journal of Advertising, 27(5), 745–770. Calfee, JE., Scheraga, C. (1994). The influence of advertising on alcohol consumption: a literature review and an econometric analysis of four European nations. International Journal of Advertising, 13, 287-287. Calfee, JE. (1991). “Comments on ‘Youth and Alcohol: Controlling Alcohol Advertising That Appeals to Youth’”. Casswell, S., Maxwell, A. (2005). Regulation of alcohol marketing: a global view. Journal of Public Health Policy, 343-358. Chief Medical Officer. (2009). Guidance on the consumption of alcohol by children and young people: A report by the Chief Medical Officer UK Government. Chuang, YC., Ennett, ST., Bauman, KE., Foshee, VA. (2005). Neighborhood influences on adolescent cigarette and alcohol use: mediating effects through parent and peer behaviors. Journal of Health and Social Behavior, 46(2), 187-204. Commissie Gedistelleerd (Commission for Distilled Spirits). (2005). W orld drink t r ends 2005 . Henley-on-

104 Thames, U.K.: NTC Publications. Dahl, RE. (2004). Adolescent brain development: a period of vulnerabilities and opportunities. Keynote address. Annals of the New York Academy of Sciences,1021(1), 1-22. Davies, F. (2009). An investigation into the effects of sporting involvement and alcohol sponsorship on underage drinking. International Journal of Sports Marketing and Sponsorship, 11(1). Doll, R., Peto, R., Hall, E., Wheatley, K., Gray, R. (1994). Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ, 309(6959), 911. Donovan, JE. (2004) Adolescent alcohol initiation: a review of psychosocial risk factors. Journal of Adolescent Health, 35(6):529.e7-18 Epstein, JA., Griffin, KW., Botvin, G. J. (2008). A social influence model of alcohol use for inner-city adolescents: Family drinking, perceived drinking norms, and perceived social benefits of drinking. Journal of Studies on Alcohol and Drugs, 69(3), 397. ESPAD. (2009). Substance abuse amongst students in 36 European Countries. European Sponsorship Association. (2009), Alcohol Sponsorship Research. Fielder, L., Donovan, RJ., Ouschan, R. (2009). Exposure of children and adolescents to alcohol advertising on Australian metropolitan free‐to‐air television. Addiction, 104(7), 1157-1165. Fowler, T., Shelton, K., Lifford, K., Rice, F., McBride, A., Nikolov, I., Van Den Bree, M. (2007). Genetic and environmental influences on the relationship between peer alcohol use and own alcohol use in adolescents. Addiction,102(6), 894-903. Fox A. Sociocultural Factors that Foster or Inhibit Alcohol-related Violence, International Economics 12, 213- 228. Grube, J. (2004) Alcohol in the Media: Drinking Portrayals, Alcohol Advertising, and Alcohol Consumption Among Youth, Chapter 11 of ‘Reducing Underage Drinking: A Collective Responsibility’, Grube, JW., Waiters, E. (2005). Alcohol in the media: content and effects on drinking views and behaviors among youth. Adolescent Medicine Clinics,16(2), 327-43. Hoadley, JF., Fuchs, BC., Holder, HD. (1984). The effect of alcohol beverage restrictions on consumption: A 25-year longitudinal analysis. American Journal of Drug and Alcohol Abuse 10,375-401. Hoffmann, JP. (2006). Extracurricular activities, athletic participation, and adolescent alcohol use: Gender- differentiated and school-contextual effects.Journal of Health and Social Behavior, 47(3), 275-290. Kuntsche, E., Vorst, H. V. D., Engels, R. (2009). The earlier the more? Differences in the links between age at first drink and adolescent alcohol use and related problems according to quality of parent-child relationships. Journal of Studies on Alcohol and Drugs, 70(3), 346. Makowsky, CR., Whitehead, PC. (1991). Advertising and alcohol sales: A legal impact study. Journal of Studies on Alcohol and Drugs, 52(6), 555. Markowitz, S., Grossman, M., (1998). Alcohol regulation and domestic violence towards children. Contemporary Economic Policy, 16,309-320. McCreanor, T., Barnes, HM., Kaiwai, H., Borell, S., Gregory, A. (2008). Creating intoxigenic environments: Marketing alcohol to young people in Aotearoa New Zealand. Social Science and Medicine, 67(6), 938-946. Milyo, J., Waldfogel, J., (1999). The Effect of Price Advertising on Prices: Evidence in the Wake of 44 Liquormart. The American Economic Review; 89,5. Ministry of Consumer Affairs. (1997). Market Self-Regulation and Codes of Practice. Wellington: MCA. Ministry of Health. (2009). 2007/8 New Zealand Alcohol and Drug Use Survey. Wellington, Ministry of Health. Ministry of Justice. (2007). The Sale and Supply of Alcohol to Under-18s in New Zealand: A systematic overview of International and New Zealand Literature. Wellington: Ministry of Justice. Ministry of Transport v Noort [1992] 3 NZLR 260

105 Mogro-Wilson, C. (2008). The influence of parental warmth and control on Latino adolescent alcohol use. Hispanic Journal of Behavioral Sciences, 30(1), 89-105. Moreira, MT., Smith, LA., Foxcroft, D. (2009). Social norms interventions to reduce alcohol misuse in university or college students. Cochrane Database Systematic Review, 3. National Institute on Alcohol Abuse and Alcoholism. (2000). T enth special r epo r t t o the U.S. C ong r ess on al c ohol and health. Washington, DC: U.S. Department of Health and Human Services. Nelson, JP. (2008). Reply to Siegel et al.: alcohol advertising in magazines and disproportionate exposure. Contemporary Economic Policy, 26(3), 493-504. Nelson, JP. (2004). Advertising Bans in the United States. EH.Net Encyclopaedia, Nelson, JP, (2003). Advertising bans, Monopoly, and Alcohol Demand: testing for Substitution Effects using State Panel Data. Review of Industrial Organization, 22, 1-25 Nelson, JP. (2001). Alcohol Advertising and Advertising bans: A Survey of Research Methods, Results, and Policy Implications. Chapter 11, Advances in Applied Microeconomics, Volume 10: Advertising and Differentiated Products. Nelson, JP. (1999). Broadcast advertising and US demand for alcoholic beverages. Southern Economic Journal, 774-790. Nelson, JP, (1990). Effect of regulation on alcoholic beverage consumption: Regression diagnostics and influential data, in: Watson, R.R. (Ed.), Drug and Alcohol Abuse Reviews: Prevention. Humana Press, Clifton, NJ, pp. 223-243. Nelson, JP, Young DJ. (2003). Meta-Analysis of Alcohol bans: Cumulative Econometric Estimates of Regulatory Effects. Unpublished. Nelson, JP., Young, DJ. (2001). Do advertising bans work? An international comparison. International Journal of Advertising, 20(3), 273-296. O'Brien, KS., Kypri, K. (2008). Alcohol industry sponsorship and hazardous drinking among sportspeople. Addiction, 103(12), 1961-1966. Ogborne, AC., Smart, RG. (1980). Will restrictions on alcohol advertising reduce alcohol consumption?. British Journal of Addiction, 75(3), 293-296. Ornstein, SO., Hanssens, DM. (1985). Alcohol control laws and the consumption of distilled spirits and beer. Journal of Consumer Research, 12, 200-213. Research New Zealand. (2006). ‘A healthy drinking culture: A search and review of international and New Zealand literature. Wellington, Research NZ. Rigaud, A., Craplet, M. (2004). The ‘Loi Evin’: a French exception. The Globe, 1(2), 33-36. Roche, A., Bywood, P., Borlagdan, J., Lunnay, B., Freeman, T., Lawton, L., Nicholas, R. (2007). Young people and alcohol: The role of cultural influences. Adelaide: National Centre for Education and Training on Addiction. Sass, TR., Saurman, DS. (1995). Advertising restrictions and concentration: the case of malt beverages. The Review of Economics and Statistics, 77(1), 66-81 Scholte, RH., Poelen, EA., Willemsen, G., Boomsma, DI., Engels, RC. (2008). Relative risks of adolescent and young adult alcohol use: The role of drinking fathers, mothers, siblings, and friends. Addictive Behaviors, 33(1), 1-14. Schweitzer, SO., Intriligator, MD., Salehi, H. (1983). Alcoholism: An econometric model of its causes, its effect and its control, in: Grant, M., Plant, M., Williams, A. (Eds.), Economics and Alcohol: Consumption and Controls. Harwood, New York, pp. 107-127. Simons, LA., McCallum, J., Friedlander, Y., Ortiz, M., Simons, J. (2000). Moderate alcohol intake is associated with survival in the elderly: the Dubbo Study. Medical Journal of Australia, 173(3), 121-124. Smart, D., Toumbourou, JW., Sanson, A. (2004). Parenting influences on adolescent alcohol use (pp. 30-40). Canberra: Australian Institute of Family Studies.

106 Smart, RG., Cutler, RE. (1976). The alcohol advertising ban in British Columbia: Problems and effects on beverage consumption. British Journal of Addiction to Alcohol and Other Drugs, 71(1), 13-21. Smith, LA., Foxcroft, DR. (2009). The effect of alcohol advertising, marketing and portrayal on drinking behavio ur in young people: systematic review of prospective cohort studies. BMC Public Health, 9(1), 51. Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental review, 28(1), 78-106. Steinberg, L. (2007). Risk taking in adolescence new perspectives from brain and behavioral science. Current Directions in Psychological Science, 16(2), 55-59. Sunstein, CR., Ullmann-Margalit, E. (2000). Solidarity in Consumption. US Federal Trade Commission. (2008). S elf-regulation in the alcohol indust r y . Repo r t of the F ede r al T r ade C ommission . Washington, DC. Unpublished PhD. dissertation, Department of Economics, Vanderbilt University. Van Der Vorst, H., Engels, RC., Meeus, W., Deković, M., Van Leeuwe, J. (2007). Similarities and bi-directional influences regarding alcohol consumption in adolescent sibling pairs. Addictive behaviors, 32(9), 1814-1825. Wilkinson, JT. (1985). Alcohol and Accidents: An Economic Approach to Drunken Driving. Wilkinson, JT., (1987). The effects of regulation on the demand for alcohol. Unpublished paper, Department of Economics, University of Missouri. Winter, MV., Donovan, RJ., Fielder, LJ. (2008). Exposure of children and adolescents to alcohol advertising on television in Australia. Journal of Studies on Alcohol and Drugs, 69(5), 676. Young, DJ. (1993). Alcohol advertising bans and alcohol abuse: Comment. Journal of Health

B.4 Web links (pre-2010) http://ec.europa.eu/health/archive/ph_determinants/life_style/alcohol/forum/docs/ev_20090609_co03_en.p df h t t p : // e h . ne t/ e ncyc l oped i a / a r ti c l e / N e l son . A d B a ns http://www.diageo.com/e n ‐r o w/N e wsMedia/P a ges/reso u rce.asp x ?reso u rceid =1 287 http:// w ww.drinkinq.c o m/ en ‐row/ D oc u men ts /Diageo percent20Digita l percent2005.pdf http://www.economist.com/node/2354558 http:// w ww . i c a p . o r g .

107 C Other references (alcohol related harm, economic contribution of the indust ry)

American Liver Foundation. (2012). Cirrhosis. http://www.liverfoundation.org/abouttheliver/info/cirrhosis/ CANGO: Election Manifesto Addressing the New Zealand Cancer Burden: Available at www.cancernz.org.nz/assets/files/info/CANGO/CANGOManifesto_2Apr2014.pdf Chelimo C, Casswell S. (2013). Effect of alcohol consumption on cancer risk: A review of meta-analyses (2007-2 013). Auckland: SHORE and Whariki Research Centre, School of Public Health, Massey University. Child and Youth Mortality Review Committee. (2011). Special Report: The involvement of alcohol consumption in the deaths of children and young people in New Zealand during the years 2005 – 2007. Deloitte Access Economics (2014). Lion Economic Contribution FY2013. Exposure to Drugs and Alcohol Among Adolescents? Psychological Science. (Wiley-Blackwell). 19:1037-44 Follow-up study from age 8–42 for females and males. Addiction 100:652. Hamilton City Council. (No date). Local Alcohol Policy - Summary of Information and Statement of Proposal. International Agency for Research on Cancer. (1998). IARC monographs on the evaluation of carcinogenic risks to humans. Volume 44. Alcohol drinking. Lyon, France: International Agency for Research on Cancer. Ministry of Business, Innovation, and Employment. (2013). Regional Activity Report. Wellington: MBIE. Ministry of Health. (2006). Prevalence rates for 1990 from Ministry of Health: Tobacco Trends 2006: Monitoring tobacco use in New Zealand. Wellington: Ministry of Health. Nelson, DE., Jarman, DW., Rehm, J., Greenfield, TK., Rey, G., Kerr, WC., Naimi, TS. (2013). Alcohol-attributable c ancer deaths and years of potential life lost in the United States. American Journal of Public Health, 103(4), 64 1-648. National Institute of Health. (2014). Alcohol’s Effects on the Body. National Institute on Alcohol Abuse and Alcoholism. Northland DHB. (2013). Position Statement on Alcohol Harm. NZ Child and Youth Mortality Review Committee. (2013). 9th Data Report 2008 – 2012. Prepared by the NZ Mortality Review Data Group. NZIER. (2014). “The economic contribution of the New Zealand wine sector, the impact of growth since 2008”, Report to New Zealand Winegrowers March 2014 (available on request) SHORE. (No date). Social Supply of Alcohol to Young People in Taranaki and Mangere. Report to Ministry of Health. SHORE and Whariki Research Centre School of Public Health, Centre for Social and Health Smokefree 2025. (2012). History of Tobacco in New Zealand. World Health Organisation. (2014). Global battle against cancer won’t be won with treatment alone - Effective prevention measures urgently needed to prevent cancer crisis Press Release No 224 Lyon/London. http://ara.co.za/eei/ http://smokefree.org.nz/smokefree-rally-and-smokefree-fashion-awards h tt p : / / ww w . t a u p o d c. g o v t. nz / o u r - s er v i c e s /H e a l t h - L i q u o r - a n d - F o o d/ l i q u o r /l i q u or - l i c e n s i n g/ D o c u m e n t s / A pp l i c a t io n - f or -n e w - O FF - L i c e nc e. p df h t tp : / / w w w . tr an s p ort . go v t. n z/ a s s e t s / U p lo ad s /A b o u t/D o c u me n t s / RI S - s a f e r - j ou r n e y s - l o we ri n g - l e ga l -alc oh ol- li m it s -f o r - d r i v i n g. pd f, P g 2. h t tp : / / w ww .tra n s p ort . g o v t. n z/ as se t s / U p lo ads /Le g i s la t io n /D oc u me n t s /L o we r i n g - t h e - l e ga l - a l co h ol - l i m it s -f o r - d r i v i n g - Ca b i n e t - p a p e r - N o v - 2 0 13.p d f h t tp : / / w w w .tra n s p ort . g o v t. n z/ a s s e t s / U p lo ad s / L e g i s la t io n / Doc u m e n t s /Lo w e ri n g - t h e - l e g a l - alc oh ol - l i m i t s - f or- d ri v i ng- Ca b i n e t - p a p e r - N o v - 2 0 13.p d f .Pg. 4 .

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