It looks cool on TV – media portrayals of substance use

Kids’ attitudes around substance use are influenced very early on by media portrayals of substance use. The positive associations formed at this young age may be predisposing to early substance use with a concomitant increase in problematic use. Being aware of this pervasive influence is an important first step to countering its ill effects.


The early stages of substance use are strongly influenced by environmental risk factors.  Digital media now surpasses traditional marketing for most adolescents and young adults, and in this context, social media placements are overtaking overt advertisements and media product placements. Although the influence of advertising has been studied mostly for tobacco and alcohol, the conclusions from these studies can be extended to other forms of substance use and other types of portrayals, such as that seen in peer-to-peer exposure through social media. A review of the current research on how media and marketing affect substance use behavior in teen and young adults may help make recommendations regarding evolving social media exposure to substance use.


This study is a descriptive review of the state of research on the effects of substance use portrayals in marketing and media, focused on tobacco, alcohol, e-cigarette and cannabis content during the pre-adolescent, adolescent and young adult years.


Multiple studies have shown a robust association between media exposure and youth tobacco use.

One of the summarized studies suggested that exposure to marketing and media double the odds of becoming a tobacco user. Another epidemiological review concluded that there is a causal link between exposure to tobacco promotion and initiation of tobacco use (using the criteria for determining causality, the Hill criteria).

Exposure to favorable media portrayals of drinking promotes youth drinking. This is particularly true of alcohol advertisements more so than portrayals of drinking in television or film (see systematic review).  Adolescents encounter on average three alcohol advertisements per day with greatest exposure amongst African American and Hispanic youth. Exposure to e-cigarette portrayals is associated with increased e-cigarette use in middle and high school students, in a dose-dependent manner.  E-cigarette advertising is further complicated by health claims.

Social networking sites are important new outlets for digital marketing. 

Marketing can be customized to youth using social media algorithms that predict brand preference based on venues frequented or friends’ use (leading in turn to user-generated marketing).


Possible mechanisms for the success of advertising in initiating youth substance use: 

  1. Media portrayals of one’s identified peer group using substances in appealing settings then influences the initiation of substance use by associating substance use with that identified peer group.(drawing from social identity theory).
  2. Exposure and learning is biased towards the beneficial effects of substance use since there is not an equivalent amount of media portraying the downsides of substance use/misuse (consistent with social learning).
  3. Advertising exerts measurable effects on both explicit and implicit attitudes towards substance use. By forming positive associations between substance use and desirable social situations, the automatic (implicit) response to substance use is more likely to be positive, regardless of what the more measured (explicit) attitudes towards substance use are.


Possible moderators between advertising and increased use: Impulsivity enhances intent to use after media portrayals of substance use.  Other mediators include baseline substance use, brand familiarity, and the extent to which the youth enjoy the media advertisements.

In summary, there is robust data suggesting that media portrayals of both alcohol and cigarette smoking influence and increase rates of teen and young adult consumption of both alcohol and tobacco.  These findings are likely applicable to the newer social media platforms as well as to a broader array of substances.


Media portrayals of substances such as cigarettes and alcohol are likely leading to positive associations between substance use and social standing/inclusion/desirability.  Countering this influence needs to start early as many of these positive associations are created as early as elementary school and precede and possibly promote youth substance use.

  1. This is a review of the literature about media influences, a field in which most studies have been conducted with regards to smoking. There are various alcohol related studies included but virtually no cannabis-related studies.
  2. Illicit substances are not included given the lack of legal advertising for these substances.
  3. The authors at times combine paid advertisements/product placements with social media dissemination (peer-to-peer advertising). The latter is more complicated socially and is increasing in importance in parallel to the decreases in traditional advertising.


  • For individuals & families seeking recovery: Parent-child discussions about media portrayals of substance use are a potential means of limiting the influence of advertising.  In addition, there is research supporting parental monitoring and clear boundary setting regarding substance use decreases substance use initiation.  Parental involvement is particularly important during elementary and middle school years and may influence children’s attitudes towards substances, before peer influences become predominant.
  • For scientists: Identifying interventions that target the implicit and explicit associations that youth have about different forms of substance use (informed by media portrayals as early as elementary school) could lead to the development of preventive interventions that precede the onset of substance use. Designing interventions that are informed by research on perceptions, behaviors and implicit bias would be an important scientific/public policy collaboration to effectively change attitudes towards substance misuse (given that many of the broadly disseminated public media campaigns are not informed by behavioral research).  There is also an urgent need to study the effects of digital marketing, both as delivered by the companies, as well as by peers, in the form of “viral marketing campaigns”.
  • For policy makers: The most effective approaches to prevention of health risk involve systemic changes that do not require individuals to make active choices.  Thus, regulation of industry-promoted media content would limit exposure of youth to substance use portrayals.  The Master Settlement Agreement imposed on tobacco companies banning paid tobacco media product placements could serve as a model for cannabis and alcohol advertising.  Another approach might include launching counter advertisement campaigns that portray the risks of substance use.  The challenge of this approach is to make the counter advertisements as appealing as the portrayals they are countering.
  • For treatment professionals and treatment systems: Training in media literacy skills helps reduce the initiation of substance use in elementary school participants. This type of media literacy training may also be relevant to those in early recovery to decrease the triggering of urges promoted by advertising and media portrayals of substance use.  It is currently not used routinely in substance use treatment programs and thus represents an under-utilized strategy to prevent relapse.


Jackson, K. M., Janssen, T., & Gabrielli, J. (2018). Media/marketing influences on adolescent and young adult substance abuse. Current addiction reports5, 146-157.