Tobacco continues to play a starring role on screen – fueling youth e-cigarette public health crisis in the process


(BPT) - Tobacco’s Starring Role,Truth Initiative’s fifth annual “While You Were Streaming” study of the most popular 2021 onscreen entertainment among 15- to 24-year-olds released on March 7 has found that this content continued to normalize and glamorize tobacco usage which research shows drives youth vaping initiation. The report identified that 25 million young people were exposed to tobacco imagery by top streaming shows, with a separate 25 million through box office movies. The report also analyzed chart-topping music videos featuring tobacco depictions, which were collectively viewed over 2 billion times on YouTube.

As youth vaping persists with over 2.5 million middle and high school students using e-cigarettes, research shows on-screen exposure to smoking imagery makes young people three times more likely to start vaping nicotine. Even more concerning is that tobacco is often depicted as a stress reliever, which sends a particularly harmful message in the wake of youth depression and anxiety rates spiking in recent years resulting in the Surgeon General issuing a youth mental health crisis advisory. Nicotine can amplify feelings of anxiety and depression while increasing stress, establishing a worrisome link to the growing youth mental health crisis.

“Images have influence, and by giving highly addictive nicotine products a starring role, entertainment platforms and celebrities alike are serving as unpaid spokespeople for the tobacco industry whether they realize it or not, with tremendous consequences for young audiences nationwide,” said Robin Koval, CEO and President of Truth Initiative. “With youth tobacco use on the rise, and the youth e-cigarette crisis continuing to be a serious public health threat, the entertainment industry can play a major role in changing this picture to protect our nation’s youth and not be complicit with the tobacco industry in addicting a new generation to nicotine.”

Tobacco Imagery is Pervasive

Across the 15 shows most popular with young people in 2021, 60% contained depictions of tobacco, a persistently high and unchanged number from 2020. Showtime ousted Netflix as the top offender, becoming the platform with the most tobacco imagery, largely due to “Shameless” characters. Netflix stayed on the list in second place, however, despite their 2019 pledge to eliminate depictions in youth-rated shows.

Animated cartoon shows, even those created for the youth audience, continued to feature tobacco imagery. Netflix cartoon comedy “Big Mouth,” Fox’s “Simpsons” and “Family Guy” and Adult Swim’s “Rick and Morty” were repeat tobacco offenders in this year’s list.

Onscreen tobacco use was also common among the year’s top movies. According to an analysis by NORC at the University of Chicago, nearly half (47%) of top 2021 films contained tobacco imagery, exposing an estimated 25 million youth and young adults. Youth-rated movies contained, on average, 30 tobacco depictions per film. The PG-rated “The Girl Who Believes in Miracles” and 17 films rated PG-13 or under contained depictions of tobacco, with several nominated for major industry awards. And while the report focuses on 2021 movies, this year’s Academy Award nominees make clear the issue continues to persist. Nine out of 10 Best Picture nominees contain tobacco imagery, including the PG-13 rated “Elvis,” “The Fabelmans,” “Top Gun: Maverick,” and “Women Talking.”

Music videos were another platform for youth exposure to tobacco and often portrayed tobacco use as edgy, glamorous and cool. Although there was a decrease in the total number of tobacco depictions in Billboard songs, 2021 music videos still exposed many to tobacco imagery as they were viewed on YouTube more than 2 billion times. Top 2021 Billboard songs with accompanying music videos featuring tobacco were headlined by major recording artists such as Silk Sonic, Farruko, Elle King and Miranda Lambert, and The Weeknd.

Tobacco Imagery Harms Adolescent Mental Health

Nicotine can harm adolescent mental health. As the true scale of youth mental health needs comes into focus, celebrities and other public figures have a responsibility to model healthy behaviors. Instead, watching celebrities smoke and vape in influential movies, shows and music videos normalizes these unhealthy behaviors and creates unwitting tobacco spokespeople out of public figures.

“The proliferation of tobacco imagery in entertainment content is particularly alarming when you consider how frequently smoking and vaping are portrayed as a stress reliever when we know the exact opposite is true,” said Koval. “Years of scientific research show that nicotine can amplify feelings of anxiety and depression while increasing stress, but so many young people are seeing tobacco depictions and turn to e-cigarettes to cope with stress. As the entertainment industry claims to be concerned with the very real youth mental health crisis facing our nation, we encourage content creators and distributors to partner with us to tackle the portrayal of tobacco use on their platforms, especially given the established connection between nicotine use and mental health.”

Truth Initiative provides support and resources for young people to quit e-cigarettes with This is Quitting, a free and anonymous text message quit vaping program for teens and young adults from truth that now serves more than 550,000 young people. A randomized clinical trial found that young adults aged 18-24 who used This is Quitting had nearly 40% higher odds of quitting compared to a control group. Teens and young adults can text “DITCHVAPE” to 88709 to get immediate help to quit. Resources for parents of young people who vape are available for free at

The pervasiveness of onscreen tobacco imagery is a symptom of a larger issue with the normalization and glamorization of smoking and vaping in entertainment media and pop culture. The entertainment industry should not be complicit with the tobacco industry in helping addict a new generation of young people to nicotine. They have the power, and the facts about the impact of smoking and vaping imagery on youth, to change the picture for good.