Tobacco Use Widespread in Video Games Played By Youth

Theoretical Background and research questions/hypothesis:  American teens aged 13 to 18 are exposed to an average of nearly nine hours of entertainment media in a day. Playing video games ranks as the second favorite media activity for teens, and 56 percent of teens play video, computer or mobile games on any given day. Issues such as violence in video games have long been debated, but what is the impact of other health-related behaviors, such as smoking, that are prevalent and often glamorized in video games played by youth? Truth Initiative wanted to better understand the  role smoking imagery might play in influencing smoking initiation.

Methods:  In 2016, Truth Initiative reviewed the available existing research on tobacco use in video games and commissioned interviews with 351 teens aged 15 to 17, 91 percent of which reported playing video games at least one day per week. Truth Initiative also surveyed parents and guardians about their awareness of smoking in video games targeted to and played by teens. The survey showed that 93 percent of parents were unaware  of a 2015 University of California, San Francisco (UCSF)  study which verified tobacco content in 42 percent of the video games that participants reported playing; however, only 8 percent of these games had received tobacco warnings from the Entertainment Software Rating Board (ESRB).

Results:  Our research found that: 

• Tobacco use is prevalent in video games played by youth.
• Tobacco use in video games is viewed as making characters “tougher,” “grittier” or “cooler.”
• More than three-quarters of the teens said they would play games despite the characters using tobacco.
• Over half of teens said they would not recommend a game with tobacco use to a younger sibling or family member, suggesting that they realize the harm tobacco imagery in video games could cause.
• When parents were made aware of the UCSF study, more than 65 percent reported that they would not consciously buy their child or someone else’s child a video game that features characters smoking or includes tobacco content.

Conclusions:  Tobacco use in video games is likely to promote youth smoking and video game content descriptors often fail to mention tobacco use, making it difficult for parents and guardians to be aware of the issue. The depiction of tobacco use in games serves, in effect as both free advertising for tobacco companies and a way to recruit the “replacement smokers” they need to make up for the 1200 people who die each day from a tobacco related disease.

Implications for research and/or practice:  While more research is needed on the question of tobacco use in video games and youth behavior, this research serves as the  foundation for an emerging conversation on the issue and offers insights for others to consider when addressing the health impact of behaviors portrayed in media popular with young people. This presentation will discuss the research, practice, policy and communication issues Truth Initiative confronted in this project and its lessons learned.