Media Exposure and Tobacco, Illicit Drugs, and Alcohol Use Among Children and Adolescents: A Systematic Review

ABSTRACT

The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies examining media content, 95% found a statistically significant association between increased media exposure and negative outcomes. Similarly, of the 12 studies evaluating the quantity of media exposure, 67% reported an association with a negative outcome. Overall, all 17 of the identified longitudinal studies supported a causal association between media exposure and negative outcomes over time. The evidence was strongest for links between media exposure and tobacco use; it was moderate for illicit drug use and alcohol use. Substantial variability in methodological rigor across studies and expanding definitions of media exposure contribute to persistent gaps in the knowledge base.

KEYWORDS:

• Adolescents
• children
• health
• media
• television

Acknowledgments

Financial support for this project was provided by Common Sense Media and The Department of Clinical Bioethics, National Institutes of Health. No form of payment was given to anyone to produce the manuscript.

The authors thank the following: Research Librarian: Jan Glover; Research Assistants: Lisa Anamasi, Martin Andersen, Jennifer Ferris, Lindsey Greene, Nanlesta Pilgrim, and Daina Barauskas; administrative support: Josephine Onofrio; and original manuscript review: George Rutherford, MD.

Notes

^a Media content = analysis of the substance of the media exposure, e.g., music videos.

^b Media quantity = analysis of the amount of the media exposure, e.g., number of hours of TV viewed daily.

^c One study found media exposure was associated with a negative behavior outcome in Whites and no association with behavior outcome in Blacks.