Adolescents' exposure to tobacco and alcohol content in YouTube music videos

Aims 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 32 most 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 videos watched by a large number of British adolescents, particularly girls, include significant tobacco and alcohol content, including branding.