New Research From Truth Initiative® Illustrates Dramatic Increase In Smoking Imagery In Shows Popular With Young People

A new report released today by Truth Initiative, the national nonprofit dedicated to making tobacco use a thing of the past, reveals 92% of the shows most popular with young people aged 15 to 24 years old depict smoking prominently. The organization first reported on the issue in 2018 with the groundbreaking report While You Were Streaming that found 79% of the shows popular with youth contained images of tobacco. Approximately 28 million young people have witnessed tobacco use based on the estimated viewership of the 13 shows studied in this year’s report. According to the surgeon general, youth with more exposure to tobacco in movies are twice as likely to begin smoking compared to those with less exposure.

The 2019 report, While You Were Streaming: Smoking on Demand, A Surge in Tobacco Imagery is Putting Youth at Risk details a dramatic increase in the amount of smoking across broadcast and streaming shows. When compared to the 2018 report, tobacco depictions increased by 176% overall and by 379% in youth-rated programs with more than 200 tobacco incidents observed in programs rated TV-Y7 and TV-PG. For the second year in a row, Netflix, the most commonly watched streaming service among 15-24 year olds topped the list. The streaming network nearly tripled the number of tobacco incidents (866) compared with the prior year (299).

The report is released as millions of teens prepare to watch the season three premiere of “Stranger Things,” which, for the second year in a row, is the worst offender. The show had a 44% increase in smoking from season one (182) to season two (262) and in its first two seasons, tobacco was depicted in every episode. Other returning shows to the 2019 list include:

  • “Unbreakable Kimmy Schmidt” – 292 tobacco depictions (up from 9 depictions)  
  • “Orange is the New Black” – 233 tobacco depictions (up from 45 depictions)
  • “House of Cards” – 54 tobacco depictions (up from 41 depictions)

But the proliferation of tobacco imagery is not limited to Netflix. Main characters in Amazon’s award-winning “The Marvelous Mrs. Maisel” and Hulu’s “Gap Year” also smoke. Tobacco incidences on broadcast and cable programming have dramatically increased this year as well showing nearly two and a half times (150%) more tobacco imagery than in 2018. Top 2019 offenders on network TV, broadcast and cable include:

  • Once Upon a Time – 97 tobacco depictions (up from 0 depictions)
  • American Horror Story – 88 tobacco depictions (up from 15 depictions)
  • Modern Family – 79 tobacco depictions (up from 20 depictions)

“Content has become the new tobacco commercial,” said Robin Koval, CEO and president of Truth Initiative. “We’re seeing a pervasive re-emergence of smoking imagery across screens that is glamorizing and renormalizing a deadly addiction and putting young people squarely in the crosshairs of the tobacco industry. Streaming, broadcast and cable companies are giving the tobacco industry free advertising and young people are paying the price. This report is a call to action to creators, producers, policy makers and the public to change the channel and take smoking out of the picture.” 

Peer-reviewed studies estimate 37% of new youth smoking initiation in the U.S. can be attributed to exposure to smoking in movies. With almost all smokers starting to smoke by age 26, streaming services are essentially giving Big Tobacco free advertising to recruit new youth smokers to replace the nearly 1,300 people who die each day from tobacco-related diseases.

With 61% of young adults reporting online streaming as their primary way of viewing episodic content, this year’s report underscores the critical need to put reasonable guidelines into practice to help safeguard today’s youth. Truth Initiative calls on the public health community, states and TV and streaming producers and creators to adopt the following common-sense measures to help protect impressionable viewers from repeated tobacco imagery:  

  • States can change their film production subsidy policies to provide tax and other incentives for productions that do not promote tobacco use.
  • Enforce stricter parental guideline ratings that include tobacco use.
  • Call on content creators and distributors to ensure future content does not include tobacco imagery.
  • Age-appropriate, anti-tobacco messages should air before and during any programs that include tobacco.
  • Conduct additional research on the connection between tobacco in television and streaming shows.

Furthermore, producers of video content, regardless of platform, should adopt the following policy principals:

  • In future productions, commit to no tobacco depictions (including e-cigarettes) in youth-rated content (i.e. TV-14, PG-13 or below) unless:
    • the depiction unambiguously reflects the dangers and consequences of tobacco use, or
    • the depiction represents the tobacco use of an actual person, as in a biographical drama or documentary.
  • Clearly mark previously produced material with tobacco descriptors so parents can appropriately evaluate content.
  • Include anti-smoking advertising before previously produced material with youth ratings and tobacco depictions.
  • Certify that no tobacco product placement appears in any future production (including consideration paid to producers/actors/etc.).

In addition to this report, through its Tobacco In Pop Culture effort, Truth Initiative exposes tobacco imagery on screens and in pop culture — including TV, streaming, video games, movies and social media — to help inform about the dangers of the entertainment industry’s normalization of smoking and underscore the need for actionable solutions. For research, resources and more information, please visit

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