The liquor cabinet in David Jernigan's office is fully stocked—mostly with flavored, fruity, carbonated and pink-labeled–adult beverages.
Maybe it's a surprise to find this stash in the office of a public health professor, but his liquor bottles are all part of Jernigan's work. He tracks alcohol advertising.
"We've seen a shift in the culture of women's drinking and there's a big marketing piece of that," said Jernigan, director of the Center on Alcohol Marketing and Youth at Johns Hopkins University.
Excessive drinking is much more common among men, but last year the Centers for Disease Control and Prevention made the point that binge drinking among women is an under-recognized problem.
Jernigan and his team followed-up with an infographic on the health consequences of problem drinking, but he says education messages are overwhelmed by the weight of marketing claims such as: "It's a smart drink and, of course, it's a diet beer."
Jernigan says the push to get women to drink more began in the late 1990s with the launch of a new category of liquor he calls "alcopops" or "beer with training wheels."
"The industry at the time said they were for entry-level drinkers and people who don't like the taste of beer: read–young women," Jernigan said.
"I have to look for the canary in the coal mine," he said. "We look at the UK for example, where this started happening in the early 90s, not the late 90s. Twenty years later, the UK has an epidemic of liver sclerosis and liver cancer among women in their 20s. The cancer doctors in the UK are blown away they; have never seen anything like this."
Female bodies break down alcohol differently and that makes women more vulnerable to alcohol-related health risks.
"This is a product that's responsible for 15 percent of breast cancer cases," Jernigan said. "If you drink alcohol heavily over an extended period of time—you hurt your heart—and you will die of alcohol-related heart disease," Jernigan said.
"That's why we are pulling the alarm lever, if the level of marketing gets to the same intensities as it is for men–because of the biological differences–the harms will be greater for women than they are for men," Jernigan said.
Lisa Hawkins is vice president of public affairs at the Distilled Spirits Council.
"It's perfectly reasonable and appropriate for our companies to be able to develop and responsibly market products that appeal to women's tastes and lifestyle choices," Hawkins said.
"I think it's sexist to say, or at the very least an exaggeration to say, that women are victimized by this marketing," said Julie Gunlock, director of the Culture of Alarmism project at the Independent Women's Forum.
Her group is on the lookout for overblown and "agenda-driven" headlines about women's health and habits.
"That often leads to government regulation," Gunlock said. "We're trying to hit back and remind women that we live in really good times and things aren't as scary as they appear to be."
Women aren't so gullible, she said, that when a liquor marketer puts a high-heel on a wine bottle suddenly women can't resist. There has been lots of handwringing lately about brands such as MommyJuice and Skinnygirl but Gunlocks says there's been very little discussion about the millions of women who consume alcohol responsibly.
"We are not becoming this population of boozed-up moms, we just aren't. This just isn't happening, and yet the narrative out there is that it is," she said.
Among women age 26 and older, 2.6 percent would be considered heavy drinkers in 2011. That proportion was 2.2 percent in 2002, according to the government's National Survey on Drug Use and Health. The proportion of same-age male heavy drinkers was 9.1 percent in 2011, down from 10 percent in 2002.
Monitoring alcohol marketing
Jernigan finds lots of ads aimed at women that he believes are a problem. In one Belvedere Vodka ad, a woman appears to be on her knees and is re-applying her lipstick in the reflection of a belt buckle.
"The code says marketing materials should not contain any lewd or indecent images or language," Jernigan said. "It doesn't take a lot of imagination to figure out what could have led to this particular scene."
In 2008, the Distilled Spirits Code Review Board considered a complaint about the Belvedere ad. "Not found in bad taste" was among the board's conclusions.
While Jernigan's list of objections is long, there doesn't seem to be much of a consumer outcry. In all of 2013, there were just two complaints reviewed by the Distilled Spirits Council.
The Beer Institute has a similar process for complaints about marketing. Vice President of Communications Chris Thorne says the system works well, especially when it comes to concerns about images that would suggest excessive or irresponsible drinking.
"We don't want anybody to misuse our product, we don't want anybody to be binge drinking," Thorne said. "We have put tons of efforts and programs in place to prevent it."
In March the Federal Trade Commission issued its newest report after examining the advertising practices of the alcohol industry. The committee was focused on concerns about alcohol ads that can be viewed by underage people.
The report ends with a list of recommendations to make alcohol marketing less accessible to youth.
Thorne's conclusion: "It found very few issues to complain about. We see that as a demonstration that brewers in this country—they care, they listen and they follow the ad code."
Distilled Spirits Council spokeswoman Lisa Hawkins says when it comes to youth, the news is good.
"Among underage girls, the government data shows that underage and binge drinking among 9th to12th graders has continued its long term decline and many measures are at historic lows," said Lisa Hawkins.
While many people associate college with risky drinking and underage drinking, that's not the norm on every campus.
The College Alcohol Study found that at some schools, four out of five students were heavy drinkers, while at others colleges, hardly any students were heavy drinkers, said Toben Nelson, an associate professor of epidemiology and community health at the University of Minnesota.
A school's drinking culture, the social and marketing environment, as well as community policies really matter, Nelson said.