Promotion of alcohol on Twitter

To the Editor: The president of the Australian Medical Association (AMA) recently expressed concern about the use of social media by alcohol companies,1 and one Facebook study found “tens of thousands of alcohol-related Pages, Applications, Events, and Groups”.2 Twitter provides another social media channel to promote alcohol, particularly to young adults, the heaviest users of Twitter. Although Australian research is limited, United States data show that 26% of people aged 18–29 years use Twitter, almost double the rate of those aged 30–49 years (14%).3 Given the strong association between alcohol advertising and consumption,4 such promotion is likely to increase the public health costs associated with excessive alcohol consumption.

We investigated alcohol promotion in 6 months of tweets by the seven most valuable global alcohol brands5 (Box). While these accounts have a relatively modest number of followers worldwide (the highest being 58 777 followers of Heineken), their tweets are forwarded (or “retweeted”) to reach a wider audience. For example, Budweiser sent 286 tweets to its 15 043 followers, but its messages were retweeted 13 523 times. Thus, tweets by alcohol companies can reach a much larger secondary audience, including (but not limited to) Twitter users in Australia.

Every alcohol brand also made extensive use of popular hashtags (searchable keywords that signal a tweet-topic). After excluding brand-related hashtags, the hashtags most commonly used by brands included examples related to popular topics like sport, social events, and follow Friday (#ff), a widely used method of making recommendations on Twitter. The use of such popular hashtags increases the likelihood that tweets will be viewed by the wider audience that searches for content on those hashtags, potentially including individuals aged under 18 years.

The use of popular hashtags by alcohol companies is reminiscent of tobacco companies’ past practices of associating their brands with positive themes. Although social media will be difficult to regulate, we might learn from the 2003 World Health Organization Framework Convention on Tobacco Control, which has seen tobacco promotion banned in 168 nations.6 That Framework’s trajectory suggests research, public pressure, political will, and international cooperation are needed to reduce widespread alcohol promotion and the associated public health costs. The AMA is thus to be applauded for directing public attention to the use of social media by alcohol companies.