Adolescents’ exposure to tobacco & alcohol content in YouTube music videos.
Jo Cranwell1, Rachael Murray1, Sarah Lewis1, Jo Leonardi-Bee1, Martin Dockrell2 & John Britton1
UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham UK1 and Public Health England, London UK2
To quantify tobacco and alcohol content, including branding, in popular contemporary YouTube music videos;
and measure adolescent exposure to such content. Design Ten-second interval content analysis of alcohol, tobacco or
electronic cigarette imagery in all UK Top 40 YouTube music videos during a 12-week period in 2013/14; on-line national
survey of adolescent viewing of the 32most popular high-content videos. Setting Great Britain. Participants A total of
2068 adolescents aged 11–18 years who completed an on-line survey. Measurements Occurrence of alcohol, tobacco
and electronic cigarette use, implied use, paraphernalia or branding in music videos and proportions and estimated numbers
of adolescents who had watched sampled videos. Findings Alcohol imagery appeared in 45% [95% confidence interval
(CI)=33–51%] of all videos, tobacco in 22% (95% CI=13–27%) and electronic cigarettes in 2% (95% CI=0–4%).
Alcohol branding appeared in 7% (95% CI=2–11%) of videos, tobacco branding in 4% (95% CI=0–7%) and electronic
cigarettes in 1% (95% CI=0–3%). The most frequently observed alcohol, tobacco and electronic cigarette brands were,
respectively, Absolut Tune, Marlboro and E-Lites. At least one of the 32 most popular music videos containing alcohol
or tobacco content had been seen by 81% (95% CI=79%, 83%) of adolescents surveyed, and of these 87% (95%
CI=85%, 89%) had re-watched at least one video. The average number of videos seen was 7.1 (95% CI=6.8, 7.4). Girls
were more likely to watch and also re-watch the videos than boys, P<0.001. Conclusions Popular YouTube music
videoswatched by a large number of British adolescents, particularly girls, include significant tobacco and alcohol content,
Adolescent exposure, alcohol, music videos, new media, tobacco, YouTube.
Harmful consumption of alcohol causes a global total of 2.5 million deaths , and tobacco smoking 6 million deaths , each year.
In the United Kingdom alcohol and tobacco consumption cause, respectively, 7000  and 100 000 deaths , and together cost the UK National Health Service (NHS) at least £5.4 billion [3,5,6] annually. Preventing this morbidity and mortality is a clear public health priority.
Because most smokers start smoking during adolescence [7,8], and initiating alcohol consumption at a young age is a strong risk factor for dependence in later life , it is crucial to identify avoidable risk factors for tobacco or alcohol use in this period of development. There is now strong evidence that adolescent exposure to paid-for advertising and other alcohol or tobacco media imagery in the media increase subsequent alcohol [10–15] and tobacco use [16–21]. Media exposure includes films and television programmes, in which both tobacco [22–26] and alcohol [13,26–31] imagery are common. Further, social media have provided tobacco companies with new opportunities to promote their products  and generate favourable attitudes towards tobacco, including intention to smoke, in young nonsmokers . In the 1990s and early 2000s televised music videos included significant alcohol and tobacco content [34–36]. However, music videos are now viewed predominantly via on-line channels such as YouTube, and are another potentially important source of exposure.YouTube dominates the music video-sharing market in the United Kingdom, was the fourth most popular UK website in 2011 , and is particularly popular among 12–17-year-olds . In 2014 the site attracted more than 1 billion unique users , approximately five times more than in 2006 .
In April 2011 music videos accounted for 30% of the top 10 most viewed channels , and in 2007 YouTube videos were reported qualitatively to contain extensive and easily accessible tobacco imagery . To quantify contemporary exposure we have therefore analysed alcohol and tobacco content in YouTube music videos of the 110 most popular songs in UK music charts during the 12-week period from 3November to 19 January 2014. We have also used a British (GB) nationally representative on-line survey administered to 11–18-year-olds between 21March and 1April 2014 to measure reported viewing of 32 of the most popular videos containing either tobacco or alcohol imagery.
© 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. Addiction
REPORT doi:10.1111/add.12835 This is an open access article under the
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