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Content analysis of tobacco in episodic programming popular among youth and young adults
  1. Jessica Miller Rath1,2,
  2. Morgane Bennett1,3,
  3. Donna Vallone1,2,4,
  4. Elizabeth C Hair1,2
  1. 1Schroeder Institute, Truth Initiative, Washington, DC, USA
  2. 2Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC, United States
  4. 4Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, United States
  1. Correspondence to Dr Jessica Miller Rath, Schroeder Institute, Truth Initiative, Washington, DC 20001, USA; jrath{at}


Background While evidence exists supporting a causal relationship between exposure to tobacco content in movies and youth smoking, research is limited on the prevalence and impact of tobacco content in episodic programming aired on television (TV) and online streaming platforms. The purpose of this study was to analyse episodic programming popular among young people to estimate the prevalence of tobacco imagery.

Methods An online survey of participants aged 15–24 years (n=750) recruited from an existing panel was used to gauge viewership of episodic programming aired on Netflix, broadcast TV and cable TV. Two trained coders independently watched the entire 2015/2016 and 2016/2017 seasons of 14 programmes aired on a streaming platform, Netflix, and across broadcast and cable TV. The coding scheme was based on existing methods which involve documenting both the type of tobacco product featured and, if applicable, user information.

Results Eighty-six per cent of Netflix programmes and 86% of broadcast and cable TV programmes had at least one occurrence of tobacco. Netflix programmes had more total occurrences (n=1185) compared with the broadcast or cable programmes (n=482). Most of the tobacco occurrences included cigarettes being actively used by a character.

Conclusions Given the high prevalence of tobacco use found in these entertainment channels, the level of exposure to tobacco use among youth and young adults is very concerning and is serving to circumvent the restrictions of tobacco advertising on broadcast TV. Further research is needed to understand the influence of this exposure on smoking behaviour.

  • media
  • prevention
  • priority/special populations

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  • Contributors JMR, MB and ECH designed the study. MB coordinated the data collection and performed the analysis. JMR, ECH and DV contributed to the writing and revisions of the manuscript.

  • Funding This study was funded by Truth Initiative.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.