Normalizing Alcohol Consumption among Youth: Role of Peers, Media, and Access to Alcohol in Mumbai

Background: Evidence suggests a link between alcohol marketing, advertisements, and underage drinking. Despite India having prohibitive alcohol policies including a ban on advertising, there has been an increase in underage drinking. Purpose: We explore young peoples’ experiences of alcohol in Mumbai and their drinking behavior. We also explore how young underage people are exposed to alcohol marketing and advertisements and how they access alcohol. Methods. We conducted a descriptive mixed methods study using Geographical Information System (GIS) mapping and participatory action research method called photo voice. Seven young people aged 18-24 participated in photo voice. Participants took photographs of their experiences of alcohol. The photographs informed the discussion at the photo voice workshops. We used GIS to map the proximity of alcohol outlets to educational institutions in Mumbai. Results: We found several interconnected factors that explain how young people perceive alcohol and how these factors contribute to the ‘normalization’ of alcohol. These include family influence, peer and media influence, gender norms, and access to alcohol. Despite being below the legal drinking age in the state, participants reported drinking underage. Using GIS we found that alcohol was available and accessible in proximity of colleges. Conclusion: This study highlights that despite restrictive alcohol policies, young people are exposed to alcohol marketing in multiple ways and is accessible and available to them. The consumption of alcohol is socially normalized and sanctioned through media, family and peer influences. It is necessary to reconsider current alcohol policies in India and design programs that address underage drinking.