"This study shows that promotional items are related to early onset drinking, and I think the responsible thing to do would be for these industries to quit distributing them," said Dr. James D. Sargent, of the Dartmouth-Hitchcock Medical Center and co-author of the study. Sargent noted that similar tobacco-branded items were banned under the nationwide settlement agreement with the tobacco industry in 1998.

The study involved 2,400 middle-school youth ages 9-15 in Vermont and New Hampshire.

Sargent and colleagues noted that the alcohol industry in the U.S. spends in excess of $1 billion for advertising and marketing, including production of items like baseball hats, backpacks, and t-shirts that appeal to underage youth.

The study results were presented at the annual meeting of the Pediatric Academic Societies in Washington, D.C.

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