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.