Background Our objective was to assess whether exposure to tobacco in video games is associated with smoking among adolescent gamers from Argentina.
Methods Cross-sectional data were analysed from students in public and private middle schools in Argentina. Tobacco content in video games was estimated using previously validated methods and adolescents’ tobacco exposure was assessed by multiplying tobacco content in the top three video games they play by the hours played per day. The primary outcome was current smoking. Multilevel logistic regression models adjusted for clustering within schools, regressing current smoking on tobacco exposure in video games (ie, none, low, high) after controlling for age, sex, parental education, parenting style, parental rules about the use of video games, rebelliousness, sensation seeking and ‘technophilia’.
Results Of the 3114 students who participated, 92% of boys (1685/1802) and 56% of girls (737/1312) played video games and were included in the analytical sample. The prevalence of smoking was 13.8% among boys and 22.0% among girls; 74.5% of boys played video games more than 1 hour per day compared with 47.7% of girls. High exposure to tobacco content in video games compared with no exposure was independently associated with current smoking among girls (OR 1.78; 95% CI 1.02 to 3.09) but not among boys (OR 0.98; 95% CI 0.64 to 1.51).
Conclusions Greater exposure to tobacco content in video games was associated with higher likelihood of smoking among Argentine girls who play video games, suggesting the need for policies that limit these exposures.
- low/middle income country
- advertising and promotion
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Contributors RM, JT and AP conceived and designed the study. LP and NC collected data and helped with the implementation. AP conducted the statistical analysis. RM, AP and JT drafted the manuscript. JDS and SF critically reviewed the article. All authors approved the final manuscript.
Funding This work was supported by US Department of Health and Human Services, National Institutes of Health and Fogarty International Center (R01 TW009274 and R01 TW010652).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Centro de Educacion Médica e Investigación Clínica (CEMIC).
Provenance and peer review Not commissioned; externally peer reviewed.