Performing solidarity? A scoping review of alcohol marketing to sexual and gender minorities

Abstract

Background

Harmful alcohol use is more prevalent among sexual and gender minorities (SGMs) than their cisgender/heterosexual counterparts. The reasons for this are complex, incorporating alcohol’s normalization and availability in social settings, its importance to identity construction, and drinking to cope with stigma and discrimination. However, commercial determinants have been underexplored, particularly how alcohol is marketed to SGM communities.

Methods

Scoping review methodology was employed. Searches were conducted in MEDLINE, Web of Science, Google Scholar, CINAHL, ASSIA, PsycInfo, and PubMed. Grey literature was located through organizational websites. Following screening and data extraction, literature was synthesized thematically.

Results

Fourteen articles were included. Findings exposed a complex web of alcohol marketing targeting SGMs on multiple fronts. Traditional advertising media was augmented by the opportunities digital marketing affords. Venue-based marketing on the commercial scene exploited the industry’s domination of community spaces, and the dearth of alcohol-free alternatives. Further, appropriation of SGM iconography, and sponsorship of SGM events, positioned the industry as an ally, forging public-facing personae of solidarity and acceptance.

Conclusion

Multifaceted marketing of alcohol saturates SGM communities, entrenching understandings of its ubiquity and importance. Further work is needed to describe and quantify the impact of these strategies on alcohol use within SGM communities.

Keywords:

• Alcohol
• lGBTQ+
• marketing
• public health

1. Introduction

Alcohol is a marketable intoxicant associated with health, societal, and economic harms (Babor et al., 2023). Importantly, alcohol-related harms are not experienced equally within societies, with some groups at greater risk than others. This includes those who identify within the sexual and gender minority (SGM) umbrella, a catch-all term for people who are anything other than cisgender and/or heterosexual. It is well established that harmful alcohol use is more prevalent among SGMs than their cisgender/heterosexual counterparts (Hughes et al., 2020; King et al., 2008; Meads et al., 2023), with significant variations evident within the SGM assemblage. For example, Hughes et al. (2016) reported greater differences in alcohol use among sexual minority women compared to heterosexual women, than in sexual minority men compared to heterosexual men, and a recent review described higher overall prevalence of alcohol use among bisexual people compared to either their heterosexual or lesbian/gay counterparts (Shokoohi et al., 2022).

Research suggests SGM people experience increased alcohol-related harms due to the interplay between alcohol’s normalization and availability within SGM social settings, its importance to identity construction, and use to cope with stigma and discrimination (Hughes et al., 2016; MacLean et al., 2019; McNair et al., 2016). However, a focus on the individual detracts from the role of broader determinants of health, particularly the commercial activities of the alcohol industry. Global retail sales of alcohol are estimated to be worth over 1.5 trillion US dollars a year, and ‘Big Alcohol’ invests heavily in protecting profits by actively marketing its wares (Jernigan & Ross, 2020).

Alcohol marketing is a broad concept that embraces diverse activities and approaches designed to promote brands, increase sales, and recruit new drinkers (Institute of Alcohol Studies, 2020). These approaches are collectively defined as the marketing mix, a decades-old concept traditionally comprising the ‘four Ps’ of product, price, place, and promotion (McCarthy & Perreault, 1990). In brief, strategies under each category include packaging and flavor (product), discounts and offers (price), retail location (place) and advertising and sponsorship (promotion) (Institute of Alcohol Studies, 2020). Over the last two decades, the traditional marketing mix has been augmented by the reach that digital media affords. Digital media has created a new kind of marketing actor, unbound by space, time or geographic borders, and able to profile and pursue through the use of data analytics (Carah & Brodmerkel, 2021; Lyons et al., 2023).

The relationship between exposure to alcohol marketing and alcohol use behaviors has been repeatedly demonstrated, with higher exposure to marketing positively associated with alcohol use initiation, increased consumption, and increased ‘binge’ or hazardous drinking (Alhabash et al., 2022; Finan et al., 2020; Jernigan et al., 2017; Noel et al., 2020). While much of this work has focused exclusively on adolescents and younger adults to date (Critchlow & Moodie, 2021), the practice of actively targeting specific groups of consumers is not limited to this demographic. For example, strategies for alcohol marketing toward women have recently been described, exposing the limitations of existing regulatory systems (Atkinson et al., 2019). It is vital that marketing approaches to SGMs are similarly examined, as they have potential to perpetuate and increase existing health inequalities between SGMs and cisgender/heterosexual consumers, as well as within the SGM umbrella. In this article, we ask how do alcohol companies target gender and sexually diverse communities?

2. Materials and methods

A scoping review methodology was selected for its strength in encompassing diverse literature from heterogeneous sources. Scoping reviews align with addressing broader research questions by mapping the nature and range of evidence available, and are particularly useful when key concepts (in this case ‘alcohol marketing’ and ‘sexual and gender minorities’) are difficult to delineate (Cacchione, 2016). The Joanna Briggs Institute (JBI) framework for undertaking a scoping review guided the approach, consistent with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review (PRISMA-ScR) guidelines (JBI, 2015; Tricco et al., 2018). The objectives, inclusion criteria, and methods were specified in advance and documented in a publicly accessible protocol (Whiteley et al., 2022). No ethical approval was required.

2.1. Eligibility criteria

Our population of interest was SGMs, including, but not limited to, those who identify as lesbian, gay, bisexual, transgender, or queer (also termed LGBTQ+). The key concept of alcohol marketing included the range of strategies falling within the ‘four Ps’ marketing mix, in addition to digital media approaches. Publications that conflated alcohol marketing with other substances (e.g. tobacco) were excluded if no separate discussion of alcohol was made. No geographic restrictions were applied, although only literature published in English was included. Alcohol marketing to SGMs is not a recent phenomenon (Elliott, 2011), and articles published between 1980 and November 2022 were eligible for inclusion. The earlier date was agreed during discussion with our experienced project advisory group. The review considered primary research, case reports, peer-reviewed editorials/scholarly writing, book chapters, preprints, reports, and theses if they fulfilled the inclusion criteria, aligning with the scoping review remit of mapping the body of existing evidence (JBI, 2015).

2.2. Search strategy

A comprehensive search strategy was informed by a pilot search of Web of Science. The text within titles and abstracts of articles focused on alcohol marketing and/or SGM were used to develop key search terms. DW performed the pilot searching, with the developing strategy considered by the whole study team and then the study advisory group. Searches were initially conducted in MEDLINE, Web of Science, Google Scholar, and CINAHL. ASSIA, PsycInfo, and PubMed were subsequently added to expand the scope after comparatively limited results. Grey literature was located through the World Health Organisation (WHO), European Union, Scottish Government, Kings Fund, Scottish Health Action on Alcohol Problems, and Alcohol Focus Scotland websites. The index term ‘sexual and gender minorities’ was used for our target population, in addition to keywords ‘LGB*,’ ‘lesbian,’ ‘gay,’ ‘bisexual, ‘transgender, ‘queer, ‘sexual minorit*,’ ‘homosexual,’ and ‘rainbow.’ For the concept, the index terms ‘marketing,’ ‘social marketing,’ ‘direct-to-consumer advertising,’ and ‘social media’ were employed, alongside keywords ‘market*,’ ‘advert*,’ ‘promo*,’ ‘brand*,’ ‘sponsor*,’ ‘washing,’ ‘commercial*,’ ‘social media,’ ‘digital,’ ‘internet,’ ‘Facebook,’ ‘Twitter,’ ‘Insta*,’ ‘TikTok,’ and ‘social network*.’ Results for population and concept were combined with the search terms ‘alcohol drinking,’ ‘alcohol*,’ and ‘drink*.’ The reference lists of all included articles were screened for additional publications, and literature that cited included articles was checked using Google Scholar. The list of included articles was reviewed by the study advisory group, and other key experts in the field, who could offer no further literature fitting the inclusion criteria. Searches were conducted in November 2022.

2.3. Screening and data extraction

All identified citations were collated in RefWorks (ProQuest LLC) and duplicates removed. Titles and abstracts were screened independently by DRH and DW, full-text retrieved for potentially relevant sources, and independently screened again. Disagreements at any stage were resolved through discussion between reviewers, where consensus was reached in all cases. Data were extracted by DRH using a data extraction tool developed from the JBI template, following piloting by DRH and DW using the same paper. The extraction tool included country of origin, type of article, primary focus/aims, participants and methodology (if applicable), alongside key findings/messages, and conclusions. DW checked 50% of data extracted as the process progressed. The data extraction tool was modified to accommodate the range of article types included in the review. Critical appraisal of quality was not undertaken, in line with recognized guidance for scoping reviews (JBI, 2020).

2.4. Analysis and presentation of results

In addition to a tabular presentation of results, our research question demanded a narrative response to explore the breadth of literature included and offer insight into targeted marketing practices. As such, thematic synthesis was employed to produce the discussion (Thomas & Harden, 2008). Relevant sections of text from each included article were coded inductively by DW to capture any discussion of alcohol marketing to SGM people. The codes were then reviewed for similarities, grouping initial codes into descriptive themes. Descriptive themes were reviewed by DRH to ensure they remained grounded in the data, prior to further amalgamation and interpretation into three analytical themes. Analytical themes were reviewed by the study team for coherence. Coding and theme development were supported by NVivo version 12 (QSR International) software.

3. Results

3.1. Summary of studies

Figure 1 demonstrates the search results. In total, 7259 citations were found. After duplicate removal and abstract screening, 59 records were sought for full text retrieval. Following further screening and exclusions, 14 articles were included in the final review. Included articles comprised seven primary research studies, three reports, three peer-reviewed scholarly essays, and one book chapter. Two of the primary studies employed subsets of data from included reports. Alcohol marketing to SGMs was not always the primary focus of included articles; therefore, relevant content could be limited. Publications spanned 28 years from 1994 to 2022, and all originated in one of three countries: New Zealand, the United Kingdom, and the United States of America. Details of included articles are summarized in Table 1. Our thematic synthesis produced three distinct, but interrelated themes, illustrating the breadth of marketing practices that target SGM communities.

Figure 1. Prisma flow diagram adapted from Page et al. (2021).

Table 1. Summary of included articles.

Citation	Type	Country	Primary focus/aims	Study participants	Methods
Adams et al. (2007)	Book chapter	New Zealand	To explore the public health implications of alcohol marketing to gay men	N/A	Not stated
Adams et al. (2019)	Report: qualitative descriptive research design	New Zealand	To identify social, cultural and political influences on alcohol consumption among ‘rainbow’ New Zealanders	131 participants incorporating a diverse range of ‘rainbow people.’ Age 16–70+, range of ethnicities in addition to gender and sexual identities. Includes both current alcohol drinkers and these in recovery	24 focus groups in six NZ cities between February and May 2018. Inductive thematic analysis with member checking practices
Adams et al. (2022)	Primary research: qualitative design (subset of data from 2019 report)	New Zealand	To explore understandings of the ways in which alcohol operates as a commercial determinant of health for ‘rainbow’ communities	131 participants incorporating a diverse range of ‘rainbow people.’ Age 16–70+, range of ethnicities in addition to gender and sexual identities. Includes both current alcohol drinkers and those in recovery	24 focus groups in six NZ cities between February and May 2018. Inductive thematic analysis with member checking practices
Atkinson et al. (2022)	Primary research: mixed methods	United Kingdom	To explore the extent and nature of gendered alcohol marketing to women on social media	Marketing posts of 20 alcohol brands on Facebook and Instagram over an 18-month period	Quantitative content analysis and qualitative thematic analysis of posts between January 2019 and June 2020
Belt et al. (2014)	Primary research: quantitative design	USA	To explore the nature and extent of corporate alcohol sponsorship of organisations and events in the USA	75 alcohol brands identified as having the highest consumption among underage drinkers in the USA	Systematic internet search for brand-specific sponsorship in the USA between 2010 and 2013
Cerezo et al. (2021)	Primary research: qualitative design	USA	To examine the ways sexual minority women experienced changes in social media use, including alcohol-related content, during COVID-19	28 participants currently at college, and self-identifying as sexual minority women who drink an average of one of more days per week	Pre- and post-COVID lockdown focus groups. Concept mapping and theme generation
Drabble (2000)	Peer-reviewed scholarly essay (review)	USA	To discuss alcohol, tobacco and pharmaceutical targeted marketing to LGBT communities, and the need for reasonable guidelines for sponsorship and donations	N/A	Not stated
Emslie et al. (2015)	Report: qualitative exploratory study	Scotland	To explore the social context of drinking among LGBT people in Scotland	33 participants incorporating a range of gender and sexual identities, 18–52 years old. All report drinking alcohol, with six classed as hazardous or harmful drinkers	Seven focus groups between 2014 and 2105 with participants who knew each other. Thematic analysis
Emslie et al. (2017)	Primary research: qualitative design (subset of data from 2015 report)	Scotland	To explore how drinking practices are important to identity construction for LGBT people	33 participants incorporating a range of gender and sexual identities, 18–52 years old. All report drinking alcohol, with six classed as hazardous or harmful drinkers	Seven focus groups between 2014 and 2105 with participants who knew each other. Thematic analysis
Felner et al. (2020)	Primary research: qualitative design	USA	To examine LGBTQ substance use initiation, escalation and use in adolescence and adulthood vis-à-vis their LGBTQ identities	59 LGBTQ young adults (aged 21–34) already enrolled in an ongoing longitudinal cohort study, who met the criteria for a probable substance use disorder	In-depth semi-structured interviews conducted in 2015. Thematic analysis
Pega and MacEwan (2010)	Report: scoping exercise combining literature review, policy analysis and qualitative methods	New Zealand	To scope evidence related to the reduction of alcohol-related harms amongst takatāpui, lesbian, gay, and bisexual (TLGB) communities	10 members of TLGB community organisations, 10 providers of alcohol prevention and treatment services, and four alcohol policy-makers	Literature and policy review. Focus groups and interviews (dates not given). Methods of analysis not stated
Penaloza and Wardlaw (1996)	Peer-reviewed scholarly essay (review)	USA	To critically analyse targeted marketing practices and their impact on ‘gays and lesbians’	N/A	Not stated
Rahn (1994)	Peer-reviewed scholarly essay (review)	USA	To discuss methods of alcohol marketing to gay men	N/A	Not stated
Spivey et al. (2018)	Primary research: quantitative design	USA	To assess Pride event policies about tobacco and alcohol in the USA	100 Pride events in the 100 most populous cities in the USA between 2016 and 2017	Systematic search of Pride event websites and contacting organisers

3.2. Moving with the times: from print to social media

In socially progressive countries, such as New Zealand, the United Kingdom, and the United States, increasing socio-political awareness and acceptance of gender and sexual diversity nurtured commercial ambitions to tap into this under-exploited market. Opportunities to harness the spending power of gender and sexually diverse people (commonly known as the ‘pink dollar’ or ‘pink pound’) were buoyed by sociocultural change, reducing fears of products being stigmatized by association, and lessening commercial barriers to attracting queer consumers (Adams et al., 2007; Penaloza & Wardlaw, 1996).

The historical importance of print media for accessing this market was clear. Print media has offered direct access to SGM communities for over 40 years, with alcohol advertising appearing in both local and national lesbian and gay publications (Adams et al., 2007; Drabble, 2000). Speculative discussion within the literature considered whether advertising in ‘niche’ magazines could also exert intentional or unwitting influence over editorial control, limiting focus on the detrimental impacts of substance use more broadly:

A San Diego community assessment found high rates of alcohol ads…in local lesbian and gay publications but little coverage of alcohol and drug problems. (Drabble, 2000, p.12)

The focused nature of print media made it a preferred early vehicle for alcohol advertising to SGM communities. However, the expansion of cable, public broadcasting and on-demand television soon enhanced its ability to engage specific audiences. Alcohol adverts on gay television channels, and sponsorship and collaboration with programs aimed specifically at SGM viewers subsequently appeared and proliferated (Adams et al., 2007; Atkinson et al., 2022; Belt et al., 2014).

The timespan of included literature allowed insight into how ‘traditional’ marketing techniques have been augmented by new opportunities created by the digital age. Early internet promotions included ‘viral emails’ and pop-up adverts on SGM community websites, while bars and clubs slowly developed their online presence (Adams et al., 2007, 2019). However, the rapid growth of social media expanded marketing possibilities for alcohol, integrating brand connectivity into private and public life. Curiously, there was limited visibility of overt targeting of SGM on social media within the literature, although examples of brands using posts to celebrate Pride, and align to SGM campaigns were evident (Atkinson et al., 2022). The success of these strategies was unclear, however, as literature evaluating the impact of such approaches was absent, and desensitization to online advertising was also reported:

I feel like I haven’t really seen any at all. But that’s not because they aren’t there. I feel like because, you know, I spend a lot of time online. Obviously, you’re over saturated with ads, with everything. I feel like I’ve learned, and adapted to filter everything out… (Adams et al., 2019, p.26)

However, social media allowed for more subtle and oblique promotional techniques. The importance of user-generated content threaded through the literature, placing alcohol within the heart of SGM life. Alcohol content on social media normalized a culture of heavy drinking, with popular apps used to post photos of nights out, ‘check-in’ to venues, or showcase social drinking (Cerezo et al., 2021; Emslie et al., 2015). Social media became a performative space for SGM, used to curate public-facing personae often enmeshed in alcohol. The arrival of COVID lockdowns/shelter-in-place orders amplified this type of content, further normalizing excessive drinking at home. While clearly not unique to SGM communities, their embrace of lockdown drinking was evidenced within the literature, as one sexual minority women explained:

There’s more encouragement for drinking, I believe…besides the ads…there’s also all the quarantine games and stuff, the drinking games that are happening, or having a Zoom cocktail hour kind of thing. (Cerezo et al., 2021, p.571)

The utilization of a global pandemic to influence drinking behaviors exemplified the industry’s ability to seize emerging opportunities and rapidly move with the times.

3.3. Exploiting the scene/seen

The commercial ‘scene’ was a dominant focus within the literature. The scene was constructed as a historical safe space, having long offered a focal point and social hub for gay and broader SGM communities (Adams et al., 2007, 2022). The bars and clubs that predominate the scene were influential centers of identity construction, enabling interaction and offering valuable sanctuaries of support (Adams et al., 2007, 2019, 2022; Emslie et al., 2015). However, despite the social importance of these spaces, they were also recognized for their role in the normalization of alcohol use among SGM groups (Adams et al., 2007, 2022; Felner et al., 2020). The paradox of the ‘safe space’ simultaneously causing harms was repeatedly acknowledged (Felner et al., 2020; Pega & MacEwan, 2010).

While alcohol promotion within pubs and clubs is not unique to SGM venues, the significance of the scene to SGM communities intensified the worth of venue-based marketing. Drinks promotions were common, with specific brands or type of drink, such as shots and alcopops commonly incentivized (Adams et al., 2022; Emslie et al., 2017). In addition, existing products were rebranded, or new products created, to appeal specifically to scene-going consumers (Adams et al., 2007; Emslie et al., 2015, 2017). While some venue-based promotions appeared relatively passive, such as two-for-one deals and cheaper refills (Adams et al., 2019; Drabble, 2000; Rahn, 1994), there were also more dynamic marketing strategies evident. For example, bar-based competitions with alcohol-related prizes encouraged active participation in promotions (Adams et al., 2019), while moving alcohol closer to the consumer, often via visibly sexualized staff, was also observed:

They have guys maybe walking about with kind of trays, like half naked with shots. It’s like kind of sexualisation in a sense…going up to groups of people to try and sell their shots, but at the same time they’re just in their wee kinda panties…it’s just really trying to kinda get you to, get you drunker. (Emslie et al., 2015, p.12)

Enticement to drink more in already alcohol-saturated environments were common, with calls for more responsible hospitality documented over the years (Drabble, 2000; Pega & MacEwan, 2010). The scene also presented something of a captive market, as opportunities for socializing without alcohol were repeatedly positioned as relatively rare (Adams et al., 2019; Drabble, 2000; Felner et al., 2020; Pega & MacEwan, 2010). The paucity of alcohol-free community spaces for SGM created an environment of restricted choice:

I would say a lot of the social activities that are geared towards camaraderie in the gay and lesbian community often surround and involve drinking…if you want to go dancing or to socialise or seek that queer space, it’s always in a bar. (Felner et al., 2020, p.116)

In addition to capitalizing on the centrality of the commercial gay scene, the industry also exploited the ‘seen’ elements of SGM culture to commercial advantage. Historical adverts aimed at gay male consumers employed images of stereotypically attractive men, naked male torsos and known gay celebrities to endorse their wares (Adams et al., 2007). Such visual cues often relied on cliched understandings of who gay men were, drawing on tropes of extravagance, campness and hypersexuality. In addition, the adoption of colloquial language (e.g. ‘queen’) was also employed, alongside sexual humor and innuendo. However, such stereotypical perceptions did not always land well with the target market (Adams et al., 2007), and could be perceived as parochial and outdated.

The rainbow flag was also appropriated by multiple alcohol brands within both advertisements, and as part of product packaging, commodifying a powerful symbol of the fight for SGM equality since the late 1970s (Adams et al., 2022; Atkinson et al., 2022). Reported testimonials suggested such strategies could sometimes reap their intended rewards:

I bought a Rainbow bottle of vodka because the bottle had a rainbow on it. (Adams et al., 2022, p.4)

3.4. Performing solidarity

The sponsorship of Pride events by the alcohol industry was repeatedly emphasized within the literature, particularly in North America (Adams et al., 2007; Belt et al., 2014; Spivey et al., 2018). The visibility of on-site alcohol promotions, banners, and branding at Pride embedded perceptions of normative substance use, saturating these culturally important spaces with messages about the centrality of alcohol to SGM celebrations (Adams et al., 2007; Felner et al., 2020; Emslie et al., 2017; Spivey et al., 2018). While Pride was the most ubiquitous, a broad range of SGM events also attracted alcohol industry attention including sporting events and ski weeks, as well as smaller provincial festivals and parties (Adams et al., 2007, 2019, 2022; Drabble, 2000). Such funding was often framed as enabling, supporting the ongoing survival of these social and cultural celebrations. However, a perceived dearth of other funding options and substance-free community spaces bred fiscal reliance on the industry, ensuring alcohol promotion remained contingent to event success (Adams et al., 2007; Pega & MacEwan, 2010; Rahn, 1994).

The sponsorship of these events also presented opportunities for alcohol brands to convey camaraderie with the community, positioning themselves as allies of SGM causes. Such sponsorship was complemented by patronage of gay and lesbian organizations and charities, engendering brand loyalty though displays of strategic benevolence (Adams et al., 2007; Atkinson et al., 2019; Drabble, 2000; Rahn, 1994). For example, Absolut vodka was an early sponsor of Pride festivals throughout North America, donated money to HIV/AIDS organizations and was a long-term commercial sponsor of the Gay and Lesbian Alliance Against Defamation (GLAAD) in the United States (Adams et al., 2007; Belt et al., 2014; Drabble, 2000; Rahn, 1994). While ostensibly philanthropic, perceptions of the motivations behind such compassionate corporate identities revealed diverging narratives.

For some, alcohol industry alignment to SGM causes demonstrated a positive societal movement towards inclusion and acceptance of SGM people (Adams et al., 2007, 2019, 2022; Emslie et al., 2015; Penaloza & Wardlaw, 1996). Accommodating SGMs in the marketplace provided a sense of legitimacy and recognition, ‘detoxifying’ beleaguered communities that often felt marginalized and vilified:

…whether you kind of see that as actually being quite a positive thing, that a company would welcome your business. It doesn’t seem quite so long ago when to be LGBT still seemed like something that was quite toxic and it would hurt you… (Emslie et al., 2015, p.12)

However, the value of altruistic intentions was commonly weighed against an understanding of commercial gains. Primary research revealed an uncomfortable balancing act between the benefits of alcohol company endorsement and the inherent health harms of increased consumption (Adams et al., 2019, 2022; Emslie et al., 2015). Allegiances to SGM causes were framed as rainbow- or pink-washing; a cynical use of SGMs to manufacture a corporate image that only notionally endorsed progressive liberal values (Adams et al., 2019; Atkinson et al., 2019).

Well, it’s just like pink-washing isn’t it, it’s just like using people’s identity to sell a product and get you to buy into both capitalism and harmful behaviours. (Adams et al., 2019, p.25)

In this view, SGM were commodified, with performative altruism the marketing key that gained access to their lucrative ‘pink dollar’ (Adams et al., 2019, 2022; Penaloza & Wardlaw, 1996). This strategy was exemplified by Coors Brewing Company, who actively supported Pride festivals and donated to GLAAD while the Coors family funded one of the United States largest homophobic right-wing religious conservative think tanks (Drabble, 2000). A show of solidarity, rather than solidarity itself, was often all that was required.

4. Discussion

This scoping review has drawn together published academic literature exploring the targeted marketing of alcohol to SGM communities. Our findings reveal a limited but diverse body of work, firmly located in countries with greater societal acceptance of SGM people (Flores, 2021). Such acceptance derives from the enfranchisement of SGM communities, hard won through identity-based civil and political rights movements broadly centered within Western Europe, the Americas and Oceania. The resulting visibility, recognition and relative empowerment of SGMs within these societies positioned them as viable targets for focused marketing by commercial industries (Chasin, 2000). As such, while this is notionally a global review, findings should be considered within the socially liberal contexts in which they were produced.

The findings expose a complex web of alcohol marketing strategies, targeting SGM people on multiple fronts. The reach of traditional print and television advertising has been extended by the algorithmic nature of digital marketing, identifying, and pursuing chosen targets through the temporo-spatial permeability of social media’s borders (Carah & Brodmerkel, 2021; Lyons et al., 2023). Strategies for venue-based marketing on the commercial scene encompass the full marketing mix, exploiting Big Alcohol’s domination of community spaces for people who are gender and sexually diverse. Further, the appropriation of SGM imagery by alcohol brands, and the sponsorship of SGM events and organizations serves to position the industry as an ally, forging public-facing personae of solidarity and acceptance, potentially also strengthening its reputation with other self-identified ‘allies.’ Such multifaceted marketing saturates SGM communities, entrenching the normalization of alcohol’s ubiquity. However, robust data is lacking on the impact such strategies have on drinking practices of SGM people, which is vital to evidence recommendations for regulation and policy. As Critchlow and Moodie (2021) argue, the limited studies that offer insight into the effect of marketing on adults are often focused on advertising alone, and seldom reflect consumer-level indicators of harm such as progression in drinking frequency and level. Further research with an emphasis on the impact of all marketing forms on the drinking behaviors of SGM people is required.

Regulation on the scale and extent of alcohol marketing has been identified as a cost-effective public health measure to help tackle alcohol-related harms (WHO, 2017). However, execution of such measures remains challenging. While some countries have implemented statutory alcohol marketing restrictions, others remain constrained by the adoption of self-regulatory codes which focus primarily on the content of advertisements, and have been critiqued for their vagueness and ambiguity (Hastings et al., 2010; Noel et al., 2017). The effectiveness of self-regulation is also questionable, with its reactive nature and few meaningful sanctions restricting its ability to protect consumers and vulnerable groups (Boniface et al., 2023). Statutory regulatory efforts are also commonly impeded by vociferous challenge from the alcohol industry, and their practice of testing the boundaries of enforceable restrictions (Purves et al., 2022). For example, in Ireland, attempts to ban alcohol advertising in sport have been undermined by the substitution of zero-alcohol variants with similar branding to ‘regular strength’ counterparts (so-called alibi marketing) (Critchlow & Purves, 2023). Of note, data surrounding ‘no and low’ alcohol variants in SGM marketing were absent from this review, and are an important area of further work. Regulating the marketing of alcohol to SGM communities cannot be considered in isolation, and must acknowledge the accumulated burden of exposure experienced by individuals whose gender and/or sexuality is only one facet of identity. Recognition of the intersectional nature of identity is imperative, as people who are gender and/or sexually diverse may also be exposed to targeted marketing focused on their age, class or ethnicity (Sudhinaraset et al., 2016). As such, partial restrictions on marketing to SGM communities may have limited impact, and strategies that deliver a comprehensive ban on alcohol marketing should be the ambition for effective public health (Babor et al., 2023).

The sponsorship of SGM events, and the assertion that alcohol industry patronage remains contingent to survival demands further examination. In Scotland, similar arguments have been voiced about the financial ramifications of banning alcohol advertising in football (soccer), despite only 6% of Scottish Premiership sponsors being alcohol-related (Graham, 2023). Creating a narrative of fiscal reliance serves the industry well, positioning them as integral to maintaining the status quo. This argument also pervades within academic spheres. For example, a recent review by Meads et al. (2023) focused on the prevalence of alcohol use among SGMs in the UK. They speculated that, while reducing targeted alcohol advertising may be of benefit, the reduction in sponsorship revenue may reduce SGM community events, increase loneliness, and ultimately, increase alcohol consumption. The review was funded by The Drinkaware Trust (2023), a body supported by donations from UK alcohol producers, retailers, supermarkets and venues. To date, there is no evidence to suggest that restricting alcohol marketing to SGMs would drive such an increase in consumption.

Big Alcohol is not the only health-demoting industry targeting SGMs, and many parallels can be drawn with the tobacco industry. As with alcohol, a higher prevalence of smoking and tobacco use are frequently reported among SGM communities (Carvalho et al., 2023; Li et al., 2021), with Big Tobacco employing familiar marketing strategies. Tobacco products have been depicted as a normalized part of life in advertisements aimed at SGM consumers; the rainbow motif has been employed as a surrogate for solidarity; and Pride events have long been the loci of intensive tobacco industry activity (Acosta-Deprez et al., 2021; Hendlin et al., 2023). SGM people also report greater exposure to tobacco-related content on social media than their cisgender/heterosexual counterparts (Emory et al., 2019). Importantly, the tobacco industry has swiftly adapted to tightening legislation on cigarette promotion, encouraging the use of other tobacco products among SGM communities, such as e-cigarettes (Rahmandar & Gribben, 2022) and smokeless products (i.e. snus) (Hendlin et al., 2023). Such adaptation by a health-demoting industry emphasizes the importance of statutory, comprehensive and unambiguous bans on all types of alcohol marketing if rates of harmful alcohol use among SGM communities are to be addressed.

There are strengths and limitations to this review. While our search was comprehensive, there is the possibility relevant literature may have been missed due to database selection or exclusion of non-English language publications. While older literature tended to focus on gay men and lesbians, most articles embraced an expansive understanding of SGM identities. Primary research reported transgender and nonbinary participants, and a range of sexual identities including those specific to Pacific Islander cultures in New Zealand (fa’afafine and takatāpui). Such representation offers broad insight into alcohol marketing to SGM communities as a whole, but limits more nuanced exploration of how specific identities are considered, targeted and used by the industry.

A limited and disparate body of literature demonstrates a complex web of targeted alcohol marketing that saturates SGM communities. Such comprehensive strategies contribute to the normalization of alcohol’s importance for people who are gender and sexually diverse. Further work is needed to describe and quantify the impact of these marketing strategies on alcohol use within SGM communities, in order to evidence robust recommendations for restriction and statutory regulation.

Acknowledgments

Huge thanks to the members of our advisory group; Dr Amanda Atkinson, Mr David Barbour, Prof. Laurie Drabble and Prof. Tonda Hughes. The advisory group combined academics within the field of sexual and gender minority drinking, with third sector expertise from the UK. The group were consulted on project focus, search strategies, and reviewed our provisional findings. Our thanks also to Dr Jeffrey Adams and Prof. Antonia Lyons for their helpful suggestions during our literature search.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by a small grant from the Institute of Alcohol Studies [21-239].