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High-density of alcohol outlets and advertising affect youth drinking

June 12, 2019

June 12, 2019 -- Alcohol use among Tanzanian youth is rising and the high density of alcohol selling outlets and alcohol advertisements coupled with low enforcement of minimum drinking age laws are likely facilitating this uptick, according to a study by the Columbia University Mailman School of Public Health and Muhimbili University of Health and Allied Sciences. The volume of alcohol advertising that youth encounter in Tanzania is increasing as competition among global and local alcohol producers intensifies. Results of a new study that sought to map the influence of the alcohol environment on adolescent drinking in Tanzania are published in the journal Health and Place.

"The high density of alcohol-selling venues in the areas we investigated makes alcohol readily available to youth," said Marni Sommer, DrPH, RN, associate professor of Sociomedical Sciences at Columbia Mailman School, and senior author

Based on earlier data from cities in northern Tanzania, a majority of youth - 64 percent--can easily purchase alcohol. Among secondary school students, 37 percent reported seeing alcohol advertisements almost daily in the last 30 days.

The two-year study of the structural and environmental context of adolescent alcohol use and alcohol-related risky sexual behavior in urban Tanzania involved weeks of participatory activities with adolescents, in-depth interviews with adolescents and adults, and the mapping of alcohol outlets and advertising which revealed a high density of alcohol-selling outlets around most of the study sites. Density was particularly high around schools and youth centers in the lower income communities.

Participants viewed the number of alcohol outlets in their communities as problematic and recommended limiting the number of alcohol sellers within a given area. "Many adolescents described how constantly seeing alcohol as they go about their daily activities serves as a form of temptation, reminding them of the availability of alcohol and their easy access to it," said Mobolaji Ibitoye, MPH, doctoral candidate in Sociomedical Sciences, and first author.

Specifically, the youth recommended that alcohol not be sold near schools and in residential areas as their presence in such settings increased the temptation to drink; others recommended better enforcement of minimum drinking age laws to prohibit alcohol use among youth under 18 years of age.

Many study participants also endorsed the use of economic policies including taxation to reduce adolescents' access to alcohol. "Participants believed that affordability was a key driver of adolescent alcohol use," noted Ibitoye.

Strong national efforts that regulate all forms of alcohol advertising and marketing in Tanzania will counter aggressive marketing campaigns that target adolescents and normalize drinking, noted the researchers. "We also urge that more research be conducted on the effect of other forms of alcohol promotion on adolescents, such as through social media and promotional concerts," said Sommer.

Given that influencing alcohol outlet density and advertising are often beyond the control of consumers, the World Health Organization has recommended the use of structural interventions to reduce alcohol uptake and use. "Our study participants concur that instead of focusing on individual behaviors and consumption patterns, community zoning to restrict the number of alcohol-selling outlets per area have the potential to reduce alcohol use among adolescents in Tanzania," commented Sommer.

"This study brought to light important insights by showing, from the adolescents' perspective, the effect that environmental alcohol cues have on their drinking or intentions to drink," observed Ibitoye."Our findings underscore the urgency for a comprehensive alcohol policy that addresses availability, advertising and pricing of alcoholic beverages - as well as regulations that are enforced - in order to help create an environment that constrains adolescent alcohol use on a population level."
Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit

Columbia University's Mailman School of Public Health

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