Young adolescents who own t-shirts, hats and other merchandise with an alcohol brand name on it are more likely to begin drinking than kids who do not own these items, according to a study by Dartmouth Medical School researchers published in the April issue of the American Journal of Preventive Medicine.

“This study is a first look at the association between alcohol-branded merchandise and initiation of alcohol use in teens,” said Dr. Auden McClure, clinical instructor in pediatrics at Dartmouth Medical School and lead author of the study. “Our research found that students who owned an alcohol-branded item were significantly more likely to have initiated alcohol use than students who did not own one,” she said. “We recommend that parents discourage their children from wearing these products and that schools limit the display of alcohol-branded items among students.”

Over 2,000 Northern New England middle school students, ages 10-14 took part in the study in 1999 and were surveyed to determine if they drank alcohol.

From that group, students who said they had not used alcohol were followed up 1 to 2 years later with a phone interview that asked about their drinking, that of their peers, and whether they owned alcohol-branded merchandise (such as a t-shirt or a hat with an alcohol name on it). At follow up, 15% of baseline never drinkers had started using alcohol and 14% owned an item with an alcohol brand or logo on it. Rate of drinking among those who owned a branded item was 25.5%, compared to 13.1% of those who did not own a branded item. The study concluded that even after controlling for other risk factors for drinking, students who owned alcohol-branded merchandise were 1.5 times more likely to initiate drinking than students who did not.

“This study raises concern about the relationship between the products that promote alcohol brands and early-onset teen drinking,” said McClure, a practicing pediatrician at Dartmouth-Hitchcock Medical Center.

“We worry about early-onset drinking because these kids are more likely to go on to misuse alcohol when they reach high school,” added Dr. James Sargent, professor of pediatrics at Dartmouth Medical School and senior author on the study. “We know from multiple studies conducted during the 1990s that ownership of tobacco branded merchandise was linked with teen smoking. That’s why the tobacco companies voluntarily agreed to give up this type of marketing.”

The most common category of alcohol-branded merchandise was an article of clothing, such as a t-shirt, hat, pants, or jacket (83%). Remaining categories were bag/backpack (6%), alcohol paraphernalia (2%), wall decor (1%), electronic item (1%), and other miscellaneous (7%). The brand of alcohol was not asked but of the 32 students who volunteered the brand, all but 3 promoted beer companies, wrote the researchers.

McClure notes that the results of this study are limited by the fact that the adolescents were from one region of the country, that several other risk factors such as parent drinking and access to alcohol were not examined, and that, because ownership of alcohol branded merchandise was not determined prior to the assessment of alcohol use, causality could not be established. But she and colleagues have begun a larger, national study that will provide more conclusive evidence, and will include information on other potentially confounding risk factors, such as parent drinking, which could affect the study results. This national study is scheduled for release in early fall of 2006.

Co-authors of the article are Jennifer Gibson, Dr. Sonya Dal Cin, and Dr. James Sargent, all from Dartmouth Medical School’s Norris Cotton Cancer Center.