Broad tobacco searches on YouTube lead users to pro-tobacco content

YouTube is one of the most widely used social media platforms, and one where users often search for information on health-related topics. According to a Truth Initiative study published in Digital Health, the ways people commonly seek information on YouTube may lead health information seekers to pro-tobacco content.

Key takeaways from this study:

• Most tobacco videos surfaced by common tobacco-related searches are pro-tobacco. About 65% of videos returned by the most common tobacco and nicotine-related searches on YouTube were pro-tobacco, with most of the videos in the sample coming from individual users rather than organizations. A few viral videos, like a "vape tricks" clip and a "cigar ash fail," drew tens of millions of views. 
• Only specific and unambiguous health related searches lead to quality content. Just 5 of 118 videos returned by health-seeking searches were pro-tobacco. Health institutions such as hospitals, universities, and government agencies made up 39% of these videos, compared with about 4% for pro-tobacco searches and 16% for ambiguous ones. Top health-related videos included ASAP Science, TED-Ed, and a CDC "Tips from Former Smokers" video.
• Vague searches lead to a pro-tobacco environment. Broad terms like "vape," "nicotine pouch," and "Zyn" returned about twice as many pro-tobacco videos as anti-tobacco ones, and the authors classified most common searches (87%) as ambiguous or pro-tobacco rather than health-seeking. The few pro-tobacco videos in the health-seeking group promoted nicotine's supposed cognitive benefits, a claim that could appeal to young people.

Better search algorithms and platform design could help users find trustworthy health information

Beyond content moderation and media literacy, the authors suggest improving the wayfinding infrastructure of search and recommendations. Ideas include clearer signals from credible institutions, prompts to help ambiguous searchers refine their search, and targeted cessation messaging alongside pro-tobacco content.