Difficult but necessary conversations ‐ the case for advance care planning

TO THE EDITOR: The alcohol industry invests in “responsible drinking” advertisements purportedly designed to meet corporate social responsibility objectives. Analysts have proposed that such advertising is used to avoid alcohol control measures and in effect constitutes alcohol promotion.1-4 The Australian alcohol industry organisation DrinkWise recently launched an online video advertisement, “How to drink properly”, which has been seen by tens of thousands of viewers. To investigate young drinkers’ responses, we conducted a qualitative study with 40 Western Australian drinkers aged 18–21 years. A research agency recruited the sample members from among young people listed in its large database, who were sent an invitation email to ascertain whether they drank alcohol. Eligible respondents were then sent an email in March 2014 containing an internet link to the video and an open-ended request to “Let us know your reactions to this video”. The participants responded by reply email. Data were analysed using NVivo 10 (QSR International). The responses were coded according to attitudinal (eg, like/dislike the ad) and behavioural intentions variables. The study was approved by the Curtin University Human Research Ethics Committee. Around two-thirds of respondents reported liking the ad, describing it as “cool”, “classy” and “clever”. It was viewed as specifi cally targeting their age group: “The message was clearly targeting younger drinkers, perhaps in their teens and 20s”; “You can tell it is solely focused on the younger demographic”; and “It seemed as though it was talking to me and my friends, rather than the whole community”. Reasons given for this perception included creative elements (cartoon format, humour, swearing) and recognition of heavy drinking practices: “It accepts that people drink and get ‘shitfaced’, as the ad says”. Some noted that the ad stimulated desire: “It immediately encouraged me to drink”. Overall for this sample, the takeout message was that drinking is a normal part of life with distinct advantages if undertaken at “appropriate” levels. No respondents nominated the number of drinks required to achieve this level. Some commented that they were aware of the need to avoid excessive consumption, but that it is diffi cult to stop once drinking has commenced. There was no demonstrated understanding of the National Health and Medical Research Council guidelines, which note that young people up to the age of 25 “are at particular risk of harm from alcohol consumption”.5 Our study fi ndings suggest that through its “responsible drinking” advertising, DrinkWise instead risks effectively promoting alcohol consumption to 18–21-year-olds. Of considerable concern is that people aged under 18 are also highly likely to be exposed to this advertisement, given its online placement.