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Research finds tobacco imagery on TV and streaming shows drives youth vaping

Young people with high exposure to tobacco images in television shows were three times as likely to start vaping compared to peers with no exposure, according to landmark Truth Initiative research that is the first to establish the link. The research was featured in the third annual Truth Initiative report covering the pervasive re-normalization of tobacco images in streaming, broadcast and cable shows most popular among youth and young adults, “Straight to Vape: Pervasive tobacco imagery in popular shows poses new threat, making youth more prone to e-cigarette use.”

While smoking in movies has long been found to lead to cigarette use, this research is the first to show the link between exposure to tobacco content in episodic content on streaming, broadcast and cable platforms and subsequent tobacco use among young people. The research, published in Preventive Medicine, found that exposure to tobacco imagery through episodic programming can triple a young person’s odds of starting to vape.

Other key findings include:

  • Higher exposure to tobacco on shows led to greater odds of subsequent vaping initiation — a concerning finding in the age of binge-watching and as streaming consumption rises, especially during the COVID-19 pandemic. In the first month of stay-at-home orders, in March 2020, the U.S. audience for streaming channels grew by 50-60%, with children and teen viewers growing by nearly two-thirds, according to Nielsen tracking.
  • Younger age was also linked with increased likelihood of starting to use e-cigarettes.
  • Young people were also more likely to begin vaping if they lived in the Northeast compared to the West, lived with a combustible tobacco or e-cigarette user, were higher sensation-seeking, and had greater anxiety.
  • Tobacco imagery in episodic content was not linked with smoking initiation. Given the epidemic levels of youth vaping, the researchers hypothesize that young people may be modeling observed smoking behavior on screen but replacing a cigarette with the more popular, socially acceptable e-cigarette. Other factors were, however, tied to increased smoking initiation, including African American race compared with white race, lower parental education, living with a tobacco user, higher sensation seeking, and greater anxiety.

The conclusions are based on a nationally representative sample of 4,604 youth and young adults between ages 15 and 24 who had never previously used e-cigarettes or any other tobacco product. Researchers asked participants how often they watched a selection of nine shows previously identified in Truth Initiative research as representing programs with high, low and no amounts of tobacco imagery. These programs included “Big Bang Theory”, “Daredevil”, “Once Upon a Time”, “American Horror Story”, “Modern Family”, ‘Fuller House”, “Orange is the New Black”, “The Walking Dead”, and “Stranger Things” and surveys were conducted between February and May 2018. A year later, researchers asked about tobacco product use.

With a clear link between tobacco imagery and youth vaping, it is more important than ever that all broadcast and streaming platforms implement strong policies designed to protect youth from exposure to tobacco depictions on screens, whether those screens are laptops, phones or TV.