Is Youth Smoking Linked to Television?
Despite bans on television tobacco advertising, TV viewers are constantly confronted with tobacco products and smokers. In music videos, smokers are portrayed as attractive, successful, and influential. Logos, billboards, and banners for cigarettes are prominent on televised sporting events. Even characters in G-rated films can be found smoking. Researchers have been wondering: could television be to blame?
Smoking is the leading preventable cause of death in the United States. The earlier in life smoking begins, the greater the risk of disease. Because of this, a majority of efforts to reduce smoking have been aimed at youth.
Study Investigates TV Viewing and Initiation of Smoking
Due to the prevalence of smoking on television, researchers set out to determine if youth with greater exposure to television viewing were more apt to start smoking. These results were published in the journal Pediatrics.
Researchers from the Center for Child Health Outcomes at Children’s Hospital and Health Center in San Diego, California studied data on 592 youths (aged 10-15) from the National Longitudinal Survey of Youth, Child Cohort (NLSY). Specifically, they examined the association between television viewing in 1990 and smoking initiation from 1990 to 1992.
The researchers assessed the following behaviors:
- Initiation of smoking, from self-reported smoking behavior
- Television viewing, based on an average of youth and parental reports on the NLSY
Factors Controlled in the Study
The following factors, gathered at baseline, were controlled in the study:
Social, economic, and demographic characteristics:
- Ethnic background
- Household poverty
- Marital status of parents
- Number of children in the household
- Measured intelligence, based on the Armed Forces Qualification Test in 1986
- Baseline child aptitude test scores, measured by the Peabody Individual Achievement Test for math and reading and the Peabody Picture Vocabulary Test
Among the youth in the study, smoking rates increased from 4.8% in 1990 to 12.3% in 1992. After controlling for baseline factors, researchers found an increasing association between duration of TV viewing and likelihood of taking up smoking. Compared to children who watched less than 2 hours of TV per day, children who watched more than:
- 2 to 3 hours of TV per day were 2.0 times more likely to begin smoking;
- 3 to 4 hours of TV per day were 3.2 times more likely to begin smoking;
- 4 to 5 hours of TV per day were 5.2 times more likely to begin smoking;
- 5 hours of TV per day were 6.0 times more likely to begin smoking.
The researchers also found that among the youth in the study:
- African-Americans and Hispanic Americans were less likely to initiate smoking than youth who were white.
- Those who lived in a household where their mother was married were half as likely to begin smoking compared with those whose mother was not married.
- Those whose families lived in poverty were more likely to begin smoking than those who lived above the poverty line.
Is There Really a Link?
The results of the study suggest that the more television youth watch, the more likely they are to begin smoking. However, the study has major limitations because it did not look at the type of television programs the youth were watching. It could be that television viewing, irrespective of its programming or commercials, predicts tobacco use in children. Also, since the researchers did not take into account the effects of peer smoking, the study results do not directly support the conclusion that decreasing the time spent watching television will reduce the initiation of smoking in youth.
The researchers suggest that youth who spend significant amounts of time watching television may be missing out on activities that help guard against high-risk behaviors. Studies have found that youth who bond to family and school are less likely to engage in behaviors that could harm their health. Television watching decreases the time youth spend interacting with their parents and thus may reduce family bonding. This may be one factor that plays a role in the relationship between television viewing time and smoking initiation.
Experts Recommend Limiting Youth TV Viewing
Because television provides frequent positive portrayals of smoking, many researchers feel that it indirectly promotes tobacco use among children. Despite the limitations of the current study, it is certainly reasonable to limit the duration of television viewing in an effort to reduce the incidence of smoking and other high-risk behaviors among youth. The American Academy of Pediatrics recommends limiting youth television viewing to no more than two hours per day.
American Academy of Pediatrics
Centers for Disease Control and Prevention
Canadian Public Health
The College of Canadian Family Physicians
American Academy of Pediatrics website. Available at: http://www.aap.org .
Gidwani PP, Sobol A, DeJong W, et al. Television viewing and initiation of smoking among youth. Pediatrics . 2002;110:505-508.
Gutschoven K, Van den buick J. Television viewing and smoking volume in adolescent smokers: a cross-sectional study. Prev Med. 2004;39:1093-1098.
Gutschoven K, Van den Buick J. Television viewing and age at smoking initiation: does a relationship exist beween higher levels of television viewing and earlier onset of smoking? Nicotine Tob Res. 2005;7:381-385.
7/26/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Centers for Disease Control and Prevention (CDC). Cigarette use among high school students - United States, 1991-2009. MMWR Morb Mortal Wkly Rep. 2010;59(26):797-801.
Last reviewed May 2009 by ]]> Rosalyn Carson-DeWitt, MD ]]>
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