PT - JOURNAL ARTICLE AU - Monika Arora AU - Gaurang P Nazar AU - Aastha Chugh AU - Tina Rawal AU - Surbhi Shrivastava AU - Praveen Sinha AU - Vineet Gill Munish AU - Fikru Tesfaye Tullu AU - Kerstin Schotte AU - Jonathan R Polansky AU - Stanton Glantz TI - Tobacco imagery in on-demand streaming content popular among adolescents and young adults in India: implications for global tobacco control AID - 10.1136/tobaccocontrol-2019-055360 DP - 2020 Apr 08 TA - Tobacco Control PG - tobaccocontrol-2019-055360 4099 - http://tobaccocontrol.bmj.com/content/early/2020/03/09/tobaccocontrol-2019-055360.short 4100 - http://tobaccocontrol.bmj.com/content/early/2020/03/09/tobaccocontrol-2019-055360.full AB - Background India implemented tobacco-free film and TV rules (Rules) to protect adolescents and young adults from tobacco exposure.Objective To assess tobacco imagery in online series popular among adolescents and young adults.Methods Ten popular online series on streaming platforms were identified after discussions with participants (aged 15–24 years) in New Delhi, and content-coded for tobacco imagery following the Breathe California protocol. Incidents of tobacco use and brand appearances in each series episode were counted, and compliance with Indian Rules was recorded.Results 188 episodes across 10 series on Netflix and Amazon Prime Video were coded. Seven series were rated age 16+, two were 18+ and one was 13+. The median number of tobacco incidents per episode in foreign productions was as follows: Amazon’s ‘The Marvellous Mrs Maisel’ (87.5, IQR 62.0–116.0) and Netflix’s ‘The Crown’ (29.0, 18.0–36.0) were higher than Indian productions: Netflix’s ‘Sacred Games’ (9.0, 0.5–14.5) and Amazon’s ‘Mirzapur’ (7.0, 4.0–11.0) (p=0.84). Tobacco incidents per hour ranged from 0 (Bodyguard, Riverdale, 13 Reasons Why) to 106.1 (The Marvellous Mrs Maisel). Seven of 10 series had tobacco imagery and none were compliant with the Rules.Conclusion Contrary to Section 5 of India’s Cigarettes and Other Tobacco Products Act, its Rules are not being complied with by the streaming platforms. US-produced streaming media contains more tobacco incidents than Indian-produced media. There is an urgent need for better enforcement of existing Rules on streaming platforms in India, and modernisation of the WHO Framework Convention on Tobacco Control, Article 13 guidelines to account for new streaming platforms to protect youth from tobacco imagery globally.