Quantifying Children's Non-Supermarket Exposure to Alcohol Marketing via Product Packaging Using Wearable Cameras.

Objective: The aim of this research was to quantify children's exposure to alcohol marketing via product packaging using wearable cameras, observing sociodemographic differences and contextual features of exposure. Method: In Wellington, New Zealand, 167 children (ages 11-13; 53% girls) wore wearable cameras for 4 consecutive days. The cameras automatically captured images approximately every 7 seconds. Image data (n = 700,000 images) were coded through content analysis to determine the extent of children's exposure to alcohol marketing via product packaging. Negative binomial regression models were used to calculate rates of exposure per day and to examine differences between groups. Results: Children were exposed to alcohol marketing via product packaging 7.7 times per day. on average. Product packaging contained limited health information and lacked delining features that could provide visual cues to children to differentiate alcohol from other commodities. No statistically significant differences by sociodemographic characteristics were detected. Conclusions: Children are frequently exposed to alcohol marketing via product packaging. Such exposure normalizes alcohol in children's environments and fails to send accurate information to children about the health risks associated with alcohol consumption. Mandatory labeling on alcohol product packaging, including prominent health warnings (text, pictorial, and graphic), or plain packaging, provides governments an opportunity to substantially reduce children's overall exposure to alcohol marketing and potentially increase children's awareness of the risks associated with alcohol consumption.