Young people with high exposure to tobacco imagery are three times as likely to start vaping compared to their peers with no exposure, a report from the Truth Initiative finds.

The report, While You Were Streaming: Tobacco’s Starring Role—the fifth annual study by the anti-tobacco nonprofit of onscreen media including television, movies, and streaming services—warns that 25 million young people in the United States are at increasing risk for developing tobacco habits, noting that more than 2.5 million high school and middle school students in the U.S. used e-cigarettes in 2022, with 46 percent of high schoolers who vape doing so almost daily.

In 2021, of the 15 most popular streaming shows among 15- to 24-year-olds, 60 percent contained depictions of tobacco, with total instances of tobacco use among the top shows increasing to 425 compared to 390 in 2020. A University of Chicago study cited in the report found that 47 percent of 106 rated films in 2021 featured 2,381 instances of tobacco imagery—more than double the 1,000 incidents of tobacco imagery in 71 films from 2020. The report also noted that among music videos for top Billboard songs in 2021, depictions of tobacco use were viewed more than two billion times. Moreover, the report noted that binge-watching of older shows with heavy tobacco imagery blunts what little progress is being made toward curbing depictions of tobacco, and that shows with intense tobacco content enjoy tremendous popularity for years after their original airing.

“The proliferation of tobacco imagery in entertainment content is particularly alarming when you consider how…years of scientific research show that nicotine can amplify feelings of anxiety and depression while increasing stress, but so many young people are seeing tobacco depictions and turn to e-cigarettes to cope with stress,” said Truth Initiative president Robin Koval. “As the entertainment industry claims to be concerned with the very real youth mental health crisis facing our nation, we encourage content creators and distributors to partner with us to tackle the portrayal of tobacco use on their platforms.”

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