Alcohol Advertising and Violence

Published:January 20, 2020DOI:


      Numerous studies have found associations between alcohol outlet density and violence, but it is unknown whether alcohol advertisements visible outside outlets are also associated with violent crime. Baltimore City, MD enacted restrictions on retail alcohol establishment advertising practices as of June 5, 2017. This study examines the association between alcohol advertisements visible outside off-premise alcohol outlets and violent crime before this restriction.


      Outlet observations (n=683) were conducted in summer 2015, and violent crime data (n=24,085) were from June 5, 2015, through June 4, 2017. The number of violent crimes per square mile within 1,000 feet of outlets was summed using kernel density estimation. In 2018–2019, authors used mixed models with a Simes–Benjamini–Hochberg correction for multiple testing.


      Roughly half (47%, n=267) of the outlets with complete data (n=572) had alcohol advertisements visible from the exterior. Outlets with alcohol advertisements had 15% more violent crimes per square mile within 1,000 feet (=1.15, 95% CI=1.07, 1.25, q<0.001) after adjusting for neighborhood context. All associations between alcohol advertisements and specific types of violent crime were significant, with the association strongest for homicides (=1.28, 95% CI=1.13, 1.46, q<0.001). There was no association between cigarette advertisements and violent crime (eB=1.08, 95% CI=0.92, 1.26, q=0.43).


      Alcohol advertisements visible outside off-premise outlets were associated with increased violent crime over and above the association between the outlets themselves and violent crime. Reducing alcohol advertising visible from the street may decrease risk of violent crime that is associated with alcohol outlets.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. CDC. Alcohol-related disease impact (ARDI) application. Published 2015. Accessed December 21, 2016.

        • Norström T
        Alcohol and homicide in the United States: is the link dependent on wetness?.
        Drug Alcohol Rev. 2011; 30: 458-465
        • Ramstedt M
        Population drinking and homicide in Australia: a time series analysis of the period 1950–2003.
        Drug Alcohol Rev. 2011; 30: 466-472
        • Felitti VJ
        • Anda RF
        • Nordenberg D
        • et al.
        Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study.
        Am J Prev Med. 1998; 14: 245-258
        • Campbell CA
        • Hahn RA
        • Elder R
        • et al.
        The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms.
        Am J Prev Med. 2009; 37: 556-569
        • Madensen TD
        • Eck JE
        Violence in bars: exploring the impact of place manager decision-making.
        Crime Prev Commun Saf. 2008; 10: 111-125
        • Amanuel H
        • Morojele N
        • London L
        The health and social impacts of easy access to alcohol and exposure to alcohol advertisements among women of childbearing age in urban and rural South Africa.
        J Stud Alcohol Drugs. 2017; 79: 302-308
        • Parker RN
        • McCaffree K
        • Alaniz M
        • Cartmill R
        Sexual violence, alcohol, and advertising.
        in: Parker RN McCaffree KJ Alcohol and Violence: the Nature of the Relationship and the Promise of Prevention. Lexington Books, Lanham, MD2013: 39-60
        • Beaudette J
        Overview of the U.S. Beverage alcohol market, trends & market entry conditions.
        Beverage Alcohol Community Symposium, November 12, 2015
        • Anderson P
        • de Bruijn A
        • Angus K
        • Gordon R
        • Hastings G
        Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies.
        Alcohol Alcohol. 2009; 44: 229-243
        • Jernigan D
        • Noel J
        • Landon J
        • Thornton N
        • Lobstein T
        Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008.
        Addiction. 2017; 112: 7-20
        • Tomlinson MF
        • Brown M
        • Hoaken PNS
        Recreational drug use and human aggressive behavior: a comprehensive review since 2003.
        Aggress Violent Behav. 2016; 27: 9-29
        • Wagenaar AC
        • Salois MJ
        • Komro KA
        Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies.
        Addiction. 2009; 104: 179-190
        • Quigley BM
        • Leonard KE
        • Collins RL
        Characteristics of violent bars and bar patrons.
        J Stud Alcohol. 2003; 64: 765-772
        • Sheats KJ
        • Irving SM
        • Mercy JA
        • et al.
        Violence-related disparities experienced by black youth and young adults: opportunities for prevention.
        Am J Prev Med. 2018; 55: 462-469
        • Romley JA
        • Cohen D
        • Ringel J
        • Sturm R
        Alcohol and environmental justice: the density of liquor stores and bars in urban neighborhoods in the United States.
        J Stud Alcohol Drugs. 2007; 68: 48-55
        • LaVeist TA
        • Wallace Jr, JM
        Health risk and inequitable distribution of liquor stores in African American neighborhood.
        Soc Sci Med. 2000; 51: 613-617
        • Morrison C
        • Gruenewald PJ
        • Ponicki WR
        Race, ethnicity, and exposure to alcohol outlets.
        J Stud Alcohol Drugs. 2016; 77: 68-76
        • Substance abuse and Mental Health Administration
        Results from the 2017 National Survey on Drug Use and Health: detailed tables.
        Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Rockville, MDPublished September 7, 2018
        • Sherk A
        • Stockwell T
        • Chikritzhs T
        • et al.
        Alcohol consumption and the physical availability of take-away alcohol: systematic reviews and meta-analyses of the days and hours of sale and outlet density.
        J Stud Alcohol Drugs. 2018; 79: 58-67
        • Trangenstein PJ
        • Curriero FC
        • Jennings JM
        • et al.
        Methods for evaluating the association between alcohol outlet density and violent crime.
        Alcohol Clin Exp Res. 2019; 43: 1714-1726
      2. Byrne K. TransForm Baltimore Implementation. At Baltimore Good Neighbors Coalition Meeting on November 14, 2017, Baltimore City, MD.

      3. Department of Planning. Transform Baltimore: Baltimore's new zoning code. Published 2018. Accessed August 15, 2018.

      4. Federal Bureau of Investigation. Violent crime. Crime in the United States. Published 2016. Accessed February 21, 2017.

        • Salbach NM
        • O'Brien KK
        • Brooks D
        • et al.
        Reference values for standardized tests of walking speed and distance: a systematic review.
        Gait Posture. 2015; 41: 341-360
        • Gussler-Burkhardt NL
        • Giancola PR
        A further examination of gender differences in alcohol-related aggression.
        J Stud Alcohol. 2005; 66: 413-422
        • Ross CE
        • Mirowsky J
        Neighborhood disadvantage, disorder, and health.
        J Health Soc Behav. 2001; 42: 258-276
        • Getis A
        • Ord JK
        The analysis of spatial association by use of distance statistics.
        Geogr Anal. 1992; 24: 189-206
        • Newson RB
        Frequentist q-values for multiple-test procedures.
        STATA J. 2010; 10: 568-584
      5. R Core Team. R: A language and environment for statistical computing. v 3.5.2 ed. Vienna, Austria: R Foundation for Statistical Computing; 2018.

      6. U.S. Census Bureau. American Fact Finder. Washington, DC; 2018.

        • Alaniz ML
        Alcohol availability and targeted advertising in racial/ethnic minority communities.
        Alcohol Health Res World. 1998; 22: 286-289