New research released today by Truth Initiative — the national nonprofit dedicated to making tobacco a thing of the past — reveals that 79 percent of the shows most popular with young people aged 15-24 depict smoking prominently. Tobacco use is most prevalent in on-demand digital content.

The new report, “While You Were Streaming,” illuminates a renormalization of tobacco use, especially on streaming content services such as Netflix and Hulu. Tobacco use in online streaming content is pervasive, rising and more prominent than in broadcast and cable programming. Netflix shows contained more tobacco incidents (319) than broadcast and cable television shows (139). The worst offenders, based on the number of tobacco incidents in 2016, include:

  • “Stranger Things” – 182 tobacco incidents
  • “The Walking Dead” – 94 tobacco incidents 
  • “Orange Is the New Black” – 45 tobacco incidents
  • “House of Cards” – 41 tobacco incidents

Researchers at Truth Initiative analyzed one season from select Netflix, broadcast, and cable TV series for tobacco use, drawing from a nationally sourced sample of youth and young adults to identify the 14 most popular shows in this age group. The results are surprising: among the sample shows, there were nearly 500 depictions of tobacco.

The Truth Initiative findings present an opportunity for streaming content providers to heed the lessons learned from the motion picture industry. The surgeon general has concluded that exposure to smoking in movies can cause young people to smoke. Well-documented movie research shows that youth and young adults with high exposure to tobacco imagery are twice as likely to begin smoking as those with less. In fact, 37 percent of new youth smoking initiation in the U.S. can be attributed to exposure to smoking in the movies.

This report shows that young people are seeing more smoking imagery than previously thought, due to the increasing popularity and impact of online streaming content. While traditional TV viewership among youth and young adults is on the decline, memberships to paid subscription services, such as Netflix, are on the rise. The impact of these new media is wide reaching when you consider that the more tobacco imagery young people view on screen, the more likely they are to become smokers.

“There has been a revolution in television that now encompasses a complex universe, including Hulu, Netflix and an emerging world of on-demand platforms,” said Robin Koval, CEO and president of Truth Initiative. “And, while everybody was watching, but no one was paying attention, we experienced a pervasive re-emergence of smoking across screens that is glamorizing and renormalizing a deadly habit to millions of impressionable young people. Content is the new commercial and it has to stop. This report serves as both a wake-up call and an opportunity for the streaming and television industries to understand the damage smoking imagery causes and do something about it. We look forward to working together to make it happen.”

The report also shares findings of a separate study from researchers working with the University of California, San Francisco (UCSF) who performed a content analysis of online postings and articles in an attempt to estimate the number of 2015-2016 top-ranking broadcast, cable and streaming shows that may include tobacco use. Results of these analyses indicated that 38 percent of broadcast TV shows, 22 percent of cable TV shows and 54 percent of Amazon, Netflix and Hulu shows sampled were associated with incidents of tobacco in online content.

Research also shows that advertising is a key factor in youth tobacco use and that young people are particularly susceptible to influence from smoking images. Almost all smokers (99 percent) start by age 26. In the U.S., nearly nine out of 10 adult smokers start smoking by age 18. While tobacco companies can no longer advertise on TV, the depiction of tobacco use on screen serves as free advertising for tobacco companies and a way to recruit the “replacement smokers” needed to make up for the 1,300 people who die each day from tobacco-related disease. This content is seeping through popular culture in ways never seen before, and initial data suggest an emerging threat to a new generation of young Americans.

There are common sense measures that can help protect impressionable viewers from repeated tobacco imagery:

  • Conduct additional research on tobacco in TV  
  • Monitor streaming platforms more closely 

  • Enforce stricter parental guideline ratings that include tobacco use 

  • Work in partnership with creators and distributors to ensure future content does not include tobacco imagery
  • Change state film production subsidy policies to provide tax and other incentives for productions that do not promote tobacco use

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