The influence of commercial marketing on the health behaviors of children has been studied for many years.  Approaches to mitigate the related risks have included policies that restrict such marketing and voluntary, industry-led initiatives.  However, some companies continue to market unhealthy products to children and important questions remain about its characteristics and effects.

Purpose: The intent of this research was to describe adolescents’ self-reported screen-based media use and consequential exposure to unhealthy food and beverage ads across six high and upper-middle income countries including Australia, Canada, Chile, Mexico, United Kingdom and the US.

Methods:  Data were collected from the 2019 cohort of the International Food Policy Study Youth Survey. The final analytical sample for the results described herein was 9,171 adolescents between the ages of 10 and 17 years (including 1,603 from the US).  Depending on the country, the survey was administered in English, Spanish and/or French. The survey questions can be found here.

Results: The results indicated that the average amount of time reportedly spent in front of various screens ranged from 7.6 to 10.2 hrs/day on weekdays and 8.9 to 11.2 hrs/day on weekend days.  Among the US sample specifically, this included time on:

  • YouTube (2.2 to 2.4 hrs/day)
  • TV shows, series or movies (2.4-2.7 hrs/day)
  • Games (2.2 to 2.5 hrs/day)
  • Social media (1.6-17 hrs/day)
  • Websites (1.3 to 1.4 hrs/day)

Across all countries, a high proportion of participants were using at least one social media platform (77%-87%).  The most popular were Instagram (52%-68%, Facebook (27%-60%) and Snapchat (28%-52%).

Self-reported exposure to ads for unhealthy foods and drinks within the past 30 days was common with television (43%-69%), websites or social media (27%-60%), and video or computer games (10%-17%) reported most often. Daily exposure to ads for sugary drinks and fast food was also common (25% and 34%).   One notable difference among the countries was the relative high percent of the US sample that reported daily exposure to fast food ads (44%).

Study strengths and limitations:  The sample, while large and international, was obtained using non-probability methods.  The survey instrument was comprehensive and standardized across all countries.   Use of screen-based media and exposure to ads was self-reported and retrospective.  The resulting estimates are useful for comparisons but likely imprecise due to recall errors and participants’ inability to recognize all forms of marketing.

Implications for your practice:  Teens are spending a significant amount of time viewing screens and while doing so, they are exposed to ads and other marketing tactics that may undermine parents’ efforts to encourage healthy behaviors.  By stressing the importance of limiting screen-based activities with your young patients and their parents, you can help families achieve a healthy and balanced use of this technology.  This may result in more quality family time to enjoy other activities together.

Original citation:  Demers-Potvin, E, White, M, Kent, MP, Nieto, C, White, CM, Zheng, X, Hammond, D, & Vanderlee, L. Adolescents’ media usage and self-reported exposure to advertising across six countries:  Implications for less healthy food and beverage marketing. BMJ Open 2022, e058913. doi:10.1136/bmjopen 2021-058913.

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