New Report Warns: Viral Smoking Imagery Could Undermine Youth Prevention Gains

Truth Initiative’s seventh annual “While You Were Streaming” report exposes the ongoing presence of tobacco in top shows, movies, and music videos

As youth e-cigarette use declines to the lowest in a decade — a hard-won public health victory — a new trend in pop culture threatens to reverse that progress. Smoking is once again being glamorized across entertainment and social media, with viral images of celebrities like Charli XCX and Jeremy Allen White lighting up. Truth Initiative’s seventh annual While You Were Streaming report finds that smoking depictions in movies surged by 70% in 2023, and the number of movies depicting tobacco increased for the first time since 2020 — all while research shows that exposure to such imagery can triple a young person’s odds of starting to vape nicotine.

The report, titled “Lights, Camera, Addiction: How Persistent On-Screen Tobacco Imagery Continues to Fuel Nicotine Addiction Among Young Audiences,” reveals that seven of the top 15 shows most popular among 15- to 24-year-olds in 2023 displayed tobacco. All but one of those shows have appeared in previous reports, including animated series like “The Simpsons,” “Family Guy,” and “American Dad,” underscoring how tobacco imagery remains a persistent problem. 

The picture is even worse on the big screen, with the number of movies depicting tobacco increasing for the first time since 2020. And while the number of chart-topping songs featuring tobacco in music videos decreased from 2022, nearly one in four still included tobacco and collectively reached nearly five billion views on YouTube as of October 2024.

The report comes at a moment when teen vaping has dropped to its lowest levels in a decade, an encouraging sign of progress. Yet data show that 20% of young adults are still at risk of a lifetime of nicotine addiction. 

The consequences of youth nicotine use are well documented: Nicotine can harm the developing adolescent brain, and nicotine addiction can increase stress and intensify symptoms of depression and anxiety. These risks are especially troubling amid the youth mental health crisis, as the latest CDC Youth Risk Behavior Survey shows teen mental health has declined over the past decade. 

“While youth vaping is down, on-screen tobacco imagery threatens to undo that progress,” said Dr. Jessica Rath, Senior Vice President, Truth Initiative Schroeder Institute. “Young people deserve content and on-screen resources that support their well-being — not imagery that makes them more likely to start smoking or vaping.”

Widespread tobacco imagery, often portrayed as edgy, rebellious, or cool, risks normalizing nicotine use and slowing the current positive momentum in prevention. In 2023 alone, nearly 17 million young people were exposed to streaming shows that featured tobacco. Research from Truth Initiative shows that the more young people see tobacco imagery while binge-watching, the more likely they are to report intentions to vape or smoke in the future.

• Popular shows continue to repeat harmful patterns: Though the number of tobacco depictions in the most popular shows among young people decreased by 72% (from 890 in 2022 to 252 in 2023), some popular shows that have typically featured heavy tobacco content, such as “Stranger Things,” “Euphoria,” and “Dahmer – Monster: The Jeffrey Dahmer Story,” did not air seasons in 2023. New seasons of these shows either aired in 2024 or are in the works.
• Binge-watched content remains saturated: The proportion of binge-watched streaming shows containing tobacco imagery increased from 64% in 2022 to 70% in 2023. Binge-watched shows that increased their tobacco content include “American Dad,” “Law & Order SVU,” “Never Have I Ever,” “South Park,” and “SpongeBob SquarePants.”
• Anime ascends in popularity and tobacco depictions: Two of this year’s most binge-watched shows containing tobacco are anime adaptations of manga, Japanese comics or graphic novels. “Jujutsu Kaisen,” with 181 depictions, contained the most tobacco incidents of any binge-watched show this year. “Demon Slayer” also appeared on the list with two depictions.
• Animated shows remain a consistent offender: Five out of six animated shows in the top 15 contained tobacco imagery, totaling 238 depictions. All are repeat offenders. According to Ypulse’s 2022 Media Consumption Report, animated shows are more popular with Gen Z than with any other demographic. “The Simpsons” contained the most tobacco depictions among the top 15 shows.

After years of declines, tobacco imagery is once again on the rise in popular films. It’s been more than a decade since the U.S. Surgeon General concluded in 2012 that young people exposed to tobacco imagery in movies are significantly more likely to start smoking. Multiple studies have established that this response is also dose-dependent — meaning the more frequently young audiences see tobacco use on-screen, the more likely they are to initiate it themselves. 

• Movie progress goes up in smoke: Of the top films released in 2023, 41% contained tobacco, compared to 35% in 2022. The six percentage point increase in the proportion of films to portray tobacco marks the first time this figure has increased in three years. The number of tobacco depictions in movies also increased by 70%, with films averaging 14 tobacco incidents in 2023, up from about 10 in 2022.
• Award-winning films are part of the problem: Eight of the 10 films nominated for Best Picture at the 2025 Academy Awards contained tobacco. Among them: "Anora," "A Complete Unknown," and "Emilia Pérez," all of which feature young stars, including Timothée Chalamet and Selena Gomez, smoking on screen.
• Legacy films show higher rates of exposure: “Legacy films,” older films re-released in theaters and films that depict prominent historical figures using tobacco, accounted for nearly one in four tobacco incidents and averaged 54 depictions per PG-13-rated film, compared to just six in contemporary PG-13 titles.

The influence doesn’t stop at shows and films. Tobacco imagery also appears in music videos — a format with massive reach and appeal among young audiences.

• Fewer music videos featured tobacco — but reach remained high. In 2023, 23% of the year’s top Billboard songs included tobacco in their music videos, down from 28% in 2022. The 212 depictions — fewer than half the 462 in 2022 — appeared in videos by major recording artists including SZA, Travis Scott, and Sabrina Carpenter. 

“The data are clear - tobacco imagery on screen causes tobacco initiation among youth and young adults. The entertainment industry has a choice. It can help protect an entire generation or continue to expose them to harmful images that make nicotine addiction more likely,” Rath said. “Decision makers at all levels including policy, entertainment executives such as leaders of streaming platforms and broadcast networks, showrunners, directors, writers, actors, and music artists, have a role to play to help protect young people from a lifetime of addiction.”

Truth Initiative calls for a comprehensive set of actions and policies to mitigate the harm of depicting tobacco onscreen, such as:

• Adopt and disclose anti-tobacco policies: Studios should implement clear rules restricting tobacco in youth-rated content — and make them public. Studios not part of the Motion Picture Association (MPA) released 74% of tobacco-heavy films in 2023 and remain top offenders.
• Raise awareness among influencers and creators: Public health groups should educate parents, young people, and industry decision makers — including directors, writers, and actors — about how on-screen tobacco drives youth nicotine addiction. Influencers can amplify this message.
• Engage creators directly: Truth Initiative has worked with Hollywood Health and Society to understand creators’ perspectives and encourage removal of tobacco content at the script stage.
• Support actors in saying no: Actors can include “no tobacco” clauses or request tobacco riders to limit harmful depictions. Showrunners should recognize their influence and prioritize health over outdated visual tropes.
• Enforce existing laws: Studios must certify that no compensation was exchanged for tobacco depictions and ensure content with smoking does not qualify for tax incentives — as required by federal law since 2009.

To read the full report and list of entertainment industry recommendations, as well as for research methodology, visit truthinitiative.org.