PERVASIVE TOBACCO IMAGERY IN POPULAR SHOWS POSES

STRAIGHT

TO VAPE

PERVASIVE TOBACCO IMAGERY

IN POPULAR SHOWS POSES NEW

THREAT, MAKING YOUTH MORE

PRONE TO E-CIGARETTE USE

WHILE YOU WERE STREAMING 2020

August 2020

WHILE YOU WERE STREAMING 2020

The resurgence of tobacco imagery in episodic content – where it is often

portrayed as a normal social behavior and as glamorous, rebellious and

edgy — poses a new threat to young people. A groundbreaking new Truth

Initiative study ﬁnds that youth and young adults with high exposure to

popular streaming and TV shows containing tobacco images are three

times more likely to start vaping compared to their peers with no

exposure. This new research comes as young people’s favorite shows

continue to prominently feature tobacco, according to the latest Truth

Initiative analysis, and as the popularity of streaming grows even more

rapidly amid the COVID-19 pandemic with many young people spending

more time at home. With youth e-cigarette use already at epidemic

levels, it is clear that tobacco content on the small screen is a growing

and urgent health risk for young Americans.

While a robust body of research has directly linked tobacco imagery

in movies to increased smoking among young people, the new Truth

Initiative study is the ﬁrst to establish a link between smoking imagery

and e-cigarette use, ﬁnding that exposure to tobacco imagery through

episodic programming can triple a young person’s odds of starting

to vape. The research also found that the higher the exposure, the

greater the odds of subsequent vaping initiation — a concerning ﬁnding

in the age of binge-watching — and that younger age was also linked

with increased likelihood of starting to use e-cigarettes. Published in

Preventive Medicine, the nationally representative study used a sample

of 4,604 youth and young adults between ages 15-24 who had never

previously used e-cigarettes or any other tobacco product.

This new vaping evidence adds urgency to an issue Truth Initiative ﬁrst

reported on with its landmark 2018 study, “While You Were Streaming:

Tobacco Use Sees a Renormalization in On-Demand Digital Content,

Diluting Progress in Broadcast & Theaters,” that sounded the alarm

on the pervasive re-normalization of tobacco images in streaming,

broadcast and cable shows most popular among youth and young

adults. The follow-up report in 2019, “While You Were Streaming:

Smoking on Demand,” found that the picture had gotten worse with

streaming platforms like Netﬂix continuing to feature massive amounts

of tobacco imagery. Smoking on the small screen had gone from

common to nearly unavoidable, as popular programs like “Stranger

Things,” “Orange Is the New Black” and “Modern Family” increasingly

show images of tobacco and portray characters who smoke.

The alarming data connecting tobacco imagery with vaping behavior

directly build on prior

While You Were Streaming

reports. Researchers

asked participants how often they watched a selection of nine shows

previously identiﬁed as representing programs with high, low and no

amounts of tobacco imagery. These programs included “Big Bang

Theory”, “Daredevil”, “Once Upon a Time”, “American Horror Story”,

“Modern Family”, ‘Fuller House”, “Orange is the New Black”, “The

With youth e-cigarette

use already at epidemic

levels, it is clear that

tobacco content on the

small screen is a growing

and urgent health risk

for young Americans.

August 2020

WHILE YOU WERE STREAMING 2020

Walking Dead”, and “Stranger Things” and surveys were conducted

between February and May 2018. A year later, researchers asked about

tobacco product use. The subsequent ﬁnding — that high exposure to

tobacco imagery through episodic programming triples a young person’s

odds of starting to vape — underscores that tobacco imagery in video

content continues to put young people at risk.

Compounding the threat: tobacco imagery continues to appear

prominently in young people’s favorite shows. In this 2020 report,

“Straight to Vape: Pervasive Tobacco Imagery in Popular Shows Poses

New Threat, Making Youth More Prone to E-Cigarette Use,” Truth

Initiative ﬁnds nearly three-quarters — 73% — of the top 15 most popular

programs with 15- to 24-year-olds feature characters who smoke or

depict tobacco products, effectively exposing more than 27 million

young people to tobacco in 2019. The top offender from Truth Initiative’s

two previous reports, hit Netﬂix show “Stranger Things,” topped the list

again with four times as many depictions of tobacco in its latest season

compared to its ﬁrst season. Seven of the shows analyzed were rated TV-G

or TV-PG, and instances of tobacco depictions nearly doubled in youth-

rated shows between the 2018 and 2019 seasons. This preponderance

of tobacco in episodic content is part of an overall problem with the

renormalization and glamorization of tobacco in entertainment media and

pop culture – recent research has also reported an increase in tobacco

imagery in top-grossing movies.

As the youth vaping epidemic drives overall youth tobacco use to

levels unseen in nearly two decades, it is no surprise that the evidence

shows that tobacco imagery in entertainment increases youth and

young adult e-cigarette use. Vaping is the dominant type of tobacco

use today among young people and is often the ﬁrst tobacco product

tried. Youth e-cigarette use has skyrocketed in recent years, doubling

among high school students, from 11.7% in 2017 to 27.5% in 2019;

and tripling among middle school students from 3.3% to 10.5%. On

top of growing evidence that e-cigarettes harm lung and heart health,

young people who use e-cigarettes are four times more likely to start

smoking cigarettes than their peers who do not vape. Nicotine in all

forms is harmful to developing brains: younger users are more likely

to become addicted, have more difﬁculty quitting and may be at higher

risk for addiction to other substances in the future. Tobacco use is also

putting youth at higher risk during the COVID-19 public health crisis:

new research shows that smoking or vaping may increase the risk of

needing intensive care or even dying from COVID-19.

“Truth Initiative has been sounding the alarm on the resurgence and

renormalization of tobacco imagery on the small screen and its negative

impact on youth for years. These new data deﬁnitively linking tobacco

imagery in episodic programing to youth vaping initiation both validates

and escalates our concerns. Put simply, the more tobacco use a young

Exposure to tobacco

imagery through

episodic programming

triples a young person’s

odds of starting to vape.

August 2020

WHILE YOU WERE STREAMING 2020

person sees in shows, the more likely they are to start vaping,” said

Robin Koval, CEO and President of Truth Initiative. “We feel an increased

sense of urgency knowing that tobacco content is directly fueling the

youth vaping epidemic. As Big Tobacco reinvents itself with electronic

products that put a new generation of young people at risk for nicotine

addiction, the entertainment industry should not be complicit and

must do more. It’s critical to know where tobacco content exists and to

implement policies that can limit ongoing tobacco exposure.”

The Truth Initiative study published in Preventive Medicine and its main ﬁnding that

young viewers who watch more tobacco-containing shows have over three times

the odds of subsequent vaping reﬂects major shifts in both the media and tobacco

product landscapes.

Many previous studies have clearly linked tobacco depictions in movies with

youth smoking, prompting the Surgeon General to issue a report in 2012 stating

conclusively that exposure to onscreen smoking in movies causes young people to

start smoking. This new Truth Initiative study highlights a shift in the inﬂuence of

tobacco imagery that follows trends in product usage. Even while most on-screen

depictions still feature cigarettes and smoking, the behavior it fuels among young

people is toward e-cigarettes. This result makes sense given the current culture

– after years of progress to decrease the smoking rate, cigarettes have now been

replaced by e-cigarettes among youth as socially acceptable and the ﬁrst tobacco

products tried. Young people may be imitating the behavior of smoking, but with the

more popular product among their generation.

While the media landscape and types of tobacco products have changed over the

years, the inﬂuence of tobacco in pop culture on young people has not. Concerns,

however, have grown more urgent given the youth e-cigarette epidemic and the

increased health threats posed by the COVID-19 pandemic.

It’s all about the vape:

the new frontier of smoking

August 2020

WHILE YOU WERE STREAMING 2020

COVID-19 HELPS PAVE WAY TO MORE TOBACCO

EXPOSURE

The COVID-19 pandemic has contributed to a set of precarious

conditions for youth exposure to tobacco use in media. The closure

of schools and the cancellation of many youth engagement activities

have given many young people more free time to consume content.

In the ﬁrst month of stay-at-home orders, in March 2020, the U.S.

audience for streaming channels grew by 50-60%, with children

and teen viewers growing by nearly two-thirds, according to Nielsen

tracking. This adds up to millions of young eyeballs on shows that

feature the use of tobacco, which in turn makes them three times

more likely to try vaping.

The pandemic accelerated an already rapid ascent in streaming,

which has gained popularity in recent years as new platforms

proliferate and provide more content for viewers. In 2019, U.S. media

and entertainment companies spent over $120 billion on original

content. Netﬂix alone increased its original content by more than

50% in 2019, releasing 371 original TV shows and movies in the U.S.

Streaming now accounts for nearly 20% of television consumption

for most Americans, almost doubling its 2018 market share. And the

percentage of youth reporting that their most-watched shows aired on

streaming platforms rose from 29% in 2018 to 84% in 2019.

Streaming now accounts for nearly 20%

of television consumption for most

Americans, almost doubling its 2018

market share.

August 2020

WHILE YOU WERE STREAMING 2020

FREQUENT DEPICTIONS OF TOBACCO IN

POPULAR SHOWS

As young people spend more time streaming their favorite shows,

those programs remain likely to include some type of tobacco

product.

Following the ﬁrst two Truth Initiative reports that uncovered the

pervasiveness of tobacco imagery in popular shows, the latest

analysis ﬁnds that a majority of shows still contain tobacco. An

analysis of the top 15 programs among 15- to 24-year-olds from

2018 and 2019 ﬁnds that tobacco continues to regularly appear

onscreen, with 73% featuring characters who smoke or depicting

tobacco products.

The use of e-cigarettes in shows is rising and often depicted as

cool and sexy. Among the top shows popular with young people,

depictions of e-cigarette use increased in 2019. In 2018, there

were 16 instances of e-cigarettes in three top shows: “Big Mouth”

(6), “Family Guy” (6) and “Fuller House” (4). Five shows featured 22

e-cigarette instances in 2019, including “Big Mouth” (11), “On My

Block” (6), “Black Mirror” (3), “You” (1) and “Black-ish” (1). Almost

all (98.9%) vaping instances across 2019 shows analyzed by Truth

Initiative featured characters actively using products either in their

hands or mouths.

Truth Initiative survey results also found that an estimated 2.5

million youth and young adults, including over 400,000 youth ages

13-17, watched season one of HBO’s “Euphoria,” which had 67

incidences of e-cigarette use across eight episodes.

While e-cigarettes are creeping into popular shows, cigarette

imagery still dominates the screen. Season 3 of “Stranger

Things” included 721 tobacco incidences in its latest season

— quadrupling the instances of tobacco imagery in the show’s

ﬁrst season. “Shameless” was at the top of the list in 2018

with 226 depictions of tobacco. “The Simpsons,” “Family Guy,”

and “Big Mouth” each had over 50 tobacco incidences in their

respective 2018 seasons and “Orange is the New Black” —

another repeat offender from previous reports — had 38. The

“End of the F***king World” had 1,000+ tobacco images in a

single “powerwall” scene (large display of tobacco products)

that featured hundreds of cigarette packs and individual tobacco

products. (See charts on page 7 for a complete list of tobacco

incidences in the top 15 shows*).

Though not among young

people’s favorite shows, some

programs have highlighted the

negative health consequences

of e-cigarette use, including

storylines about vape-related

lung injuries on “Grey’s Anatomy,”

“New Amsterdam,” “Upload” and

“Chicago Med.” Grey’s Anatomy,

for example, contained no tobacco

imagery at all and also featured a

story with a 17-year-old swimmer

whose lungs resembled those of a

60-year-old smoker due to vaping.

The impact of possible anti-vaping

messages embedded within

episodic programming is unclear

but should be studied to best

discourage tobacco use.

Bright Spots:

Some shows

demonstrate the

harmful effects

of vaping

August 2020

WHILE YOU WERE STREAMING 2020

Not only do many shows contain tobacco, but they also feature it

repeatedly. Over 50% of 2019 shows that included tobacco depictions

featured it in more than half of all episodes. “Shameless” featured

tobacco content in every single episode in 2018 and almost all 2019

episodes of “Sex Education” and “Stranger Things” contained tobacco,

with 88% and 75% of episodes, respectively, depicting tobacco use.

Figure 1. Percent of Episodes with Tobacco

in Top 2019 Shows

13 Reasons Why

A Series of

Unfortunate Events

The End of the

F***ing World

Black Mirror

Orange is the

New Black

You

On My Block

Lucifer

Big Mouth

Stranger Things

Sex Education

88%

75%

73%

60%

40%

38%

33%

13%

10%

Figure 2. Percentage of Episodes with Tobacco

in Top 2018 Shows

NCIS

Riverdale

Fuller House

Criminal Minds

Law & Order

SVU

Family Guy

Walking Dead

Orange is the

New Black

Big Mouth

Simpsons

Shameless

100%

62%

60%

31%

25%

20%

17%

Over 50% of 2019 shows that included tobacco depictions

featured it in more than half of all episodes.

August 2020

WHILE YOU WERE STREAMING 2020

Figure 3. Total Incidences of Tobacco

in Top 2019 shows

Black Mirror

The End of the

F***ing World

A Series of

Unfortunate Events

13 Reasons Why

You

Orange is the

New Black

On My Block

Lucifer

Sex Education

Big Mouth

Stranger Things

721

130

Figure 4. Total Incidences of Tobacco

in 2018 shows

NCIS

Fuller House

Riverdale

Law & Order

SVU

Criminal Minds

Orange is the

New Black

Walking Dead

Big Mouth

Family Guy

Simpsons

Shameless

226

Tobacco incidences appeared even in streaming shows designed for

general audiences (TV-G) and for younger viewers to watch with their

parents (TV-PG). Seven of the shows analyzed for this report were rated

TV-G or TV-PG and tobacco depictions in these shows nearly doubled

from 576 incidences in 2018 to 1,156 in 2019. TV Parental Guidelines do

not currently treat tobacco as an explicit rating factor, making it more

challenging for parents to help their children avoid content that makes

them more likely to smoke or vape.

Seven of the shows analyzed for this report were rated

TV-G or TV-PG and tobacco depictions in these shows

doubled from 576 incidences in 2018 to 1,156 in 2019.

August 2020

WHILE YOU WERE STREAMING 2020

HOW RESEARCHERS SELECTED AND ANALYZED SHOWS

Truth Initiative researchers surveyed over 2,000 young people (ages 15-24) to identify the most

popular shows among young people in 2018 and 2019.*

Top 2018 shows among ages 15-24,

by popularity**

• Family Guy, Season 16 (FOX)

• Simpsons, Season 29 (FOX)

• Walking Dead, Season 8 (AMC)

• Bob’s Burger, Season 8 (FOX)

• Big Bang Theory, Season 11 (CBS)

• Criminal Minds, Season 13 (CBS)

• Modern Family, Season 9 (ABC)

• Law and Order: SVU, Season 19 (NBC)

• Big Mouth, Season 2 (Netﬂix)

• NCIS, Season 15 (CBS)

• 13 Reasons Why, Season 2 (Netﬂix)

• Orange is the New Black, Season 6 (Netﬂix)

• Riverdale, Season 2 (CW)

• Shameless, Season 8 (Showtime)

• Fuller House, Season 4 (Netﬂix)

Top 2019 shows among ages 15-24,

by popularity**

• Stranger Things (Netﬂix)

• 13 Reasons Why (Netﬂix)

• The Big Bang Theory (CBS)

• Big Mouth (Netﬂix)

• Orange is the New Black (Netﬂix)

• You (Netﬂix)

• On My Block (Netﬂix)

• Lucifer (Netﬂix)

• Fuller House (Netﬂix)

• The End of the F***ing World (Netﬂix)

• A Series of Unfortunate Events (Netﬂix)

• Black Mirror (Netﬂix)

• The Mandalorian (Disney+)

• High School Musical: The Series (Disney+)

• Sex Education (Netﬂix)

Reviewing shows for tobacco:

Researchers viewed more than 700 episodes and 400 hours of programming to document tobacco

depictions. Each image of a cigarette pack or individual product was counted as a separate incident —

even if multiple packs or products were shown in the same scene. Researchers coded 415 episodes

from the top 2018 shows and 305 episodes from the top 2019 shows for the presence of tobacco.

*Shows that aired new episodes as of January of each year were included in the survey

**Top shows were identiﬁed by Truth Initiative surveys. Researchers used Nielsen viewership data for the target age group to

determine which cable and broadcast shows to include in the survey. For streaming platforms, researchers identiﬁed scripted,

original shows that demonstrated youth appeal and cross-referenced the selections with social media and news articles. In total,

more than 150 shows per year were included in the surveys. The top 15 shows differ in 2018 and 2019 because some did not air

each year and some gained popularity over time.

August 2020

WHILE YOU WERE STREAMING 2020

A MULTI-PLATFORM PROBLEM: TOBACCO

IMAGERY IN ENTERTAINMENT AND POP CULTURE

Broadcast/cable TV and streaming networks are not the only

entertainment platforms littered with tobacco imagery. The big screen

is a big part of the problem as well. Researchers at the University of

California, San Francisco released a report earlier this year showing

that tobacco incidences in movies in 2019 were the highest in more

than a decade. More than half of top-grossing ﬁlms released in 2019

depicted tobacco use, resulting in 23.7 billion in-theater tobacco

impressions alone — which doesn’t include exposures from at-home

movie viewing. Unfortunately, youth-rated ﬁlms are not exempt from

this inﬂuential imagery, and in fact, the amount of tobacco content has

risen in youth-rated movies by 63% since 2015 alone.

Peer-reviewed studies estimate 37% of new youth smoking initiation

in the U.S. can be attributed to exposure to smoking in movies.

According to the U.S. Surgeon General, exposure to tobacco use on

screen causes young people to smoke. The CDC predicts that this will

lead to more than 6 million new youth smokers, a third of whom will

die from tobacco-related diseases.

While cigarettes are the primary form of tobacco imagery on the

big screen, the presence of e-cigarettes in movies has skyrocketed

too. Among top-grossing movies released in 2019, there were

116 e-cigarette incidences, which is more than half of the total

e-cigarette depictions in history (204 total incidences). E-cigarettes

were ﬁrst documented to appear on screen in 2010 and while movies

with e-cigarettes from major studios are mostly R-rated, the same

is not true for independent movies that show vaping — most of those

movies receive youth-appropriate ratings.

Other types of entertainment media geared toward young people

often portray tobacco as well. Tobacco imagery is widespread in

video games played by youth and 93.5% of popular video games that

contain tobacco images portray its use in a positive or neutral light,

according to previous Truth Initiative research. Popular music videos

are also sources of tobacco content. For example, a 2020 music video

for #1 Billboard song “Blinding Lights” from The Weeknd repeatedly

shows the singer smoking a cigarette. The e-cigarette KandyPen was

featured in DJ Khaled’s video “I’m the One,” a collaboration with Justin

Bieber, Quavo of Migos, Chance the Rapper, and Lil Wayne. The video,

which has more than 1.4 billion views on YouTube, features bikini-clad

models vaping KandyPens.

Peer-reviewed studies

estimate 37% of new

youth smoking initiation

in the U.S. can be

attributed to exposure

to smoking in movies.

August 2020

WHILE YOU WERE STREAMING 2020

With this constant bombardment of tobacco use in entertainment—

alongside an overwhelming increase in total viewership — Big

Tobacco has more opportunities to ensnare youth into a lifetime

of tobacco use. With a clear link between tobacco imagery and

youth vaping, it is more important than ever that all content

providers implement strong policies designed to protect youth

from exposure to tobacco depictions on screens — from laptops to

phones and from TVs to movie screens.

PROTECTING YOUNG PEOPLE FROM TOBACCO

IMAGERY

Tobacco use continues to appear on the small screen at an alarming

rate, leading to potentially deadly consequences. With a clear

link between viewing tobacco imagery on shows and subsequent

e-cigarette use and combustible tobacco use among young people,

the stakes have never been higher. Similar to the link between

movies and cigarette smoking initiation, the more tobacco imagery

young people see, the more likely it is that they will vape and begin a

trajectory to nicotine addiction and other tobacco use.

Media companies have taken some steps aimed at reducing tobacco

imagery in shows but more must be done. Following the publication

of our 2019 report, Netﬂix announced in 2019 that it would eliminate

tobacco in youth-rated programming (rated TV-14 or below) going

forward and that it plans to cut back on depictions across the

board. The streaming giant determined that 190+ of its original TV

series contained tobacco content, and added a smoking warning

label at the beginning of certain programs. These moves, however,

aren’t nearly enough. The company’s pledge has many loopholes

and inconsistencies, including a caveat for creative vision and an

exemption for existing shows, and a formal policy remains to be

seen. An example of the weakness in this policy is illustrated by

Netﬂix’s newly acquired series

Cobra Kai (not rated)

, which includes

blatant smoking and cigarette brand display.

Other online streaming services must address the problems on

their platforms as well. For example, few provide viewers with

consistent information about tobacco content. Smokefree Movies

at the University of California, San Francisco reviewed popular U.S.

streaming services and found that three streaming services do

not display reasons for ﬁlm and TV ratings with video content, and

six other services only show reasons for TV ratings after the user

begins playing the movie/TV show.

They also found that none of the

streaming services inform users that smoking on screen harms

young viewers.

Tobacco use continues

to appear on the small

screen at an alarming rate,

leading to potentially

deadly consequences.

August 2020

WHILE YOU WERE STREAMING 2020

The National Association of Attorneys General has also expressed

concerns about tobacco imagery in streaming content. In August 2019,

the organization sent letters to major U.S. streaming services to urge the

industry to implement measures to protect young people from tobacco

imagery. The letters, which 43 state and territory attorneys general

signed, were sent to Amazon.com, Apple, AT&T, CBS Corporation,

Comcast Corporation, Discovery, The Walt Disney Company, Google,

Netﬂix, Sony, Lionsgate, Viacom and Walmart.

To help halt the vaping epidemic in its tracks, Truth Initiative calls for a

comprehensive set of policies to curb tobacco incidences on screen that

increase the likelihood that young people will start vaping. They include:

Ratings system – Designating new titles with smoking as TV-MA —

designed for adults and unsuitable for those 17 and under — could

reduce young people’s exposure to tobacco. TV Parental Guidelines,

which do not currently treat tobacco as an explicit rating factor,

would provide more clarity and information for parents who seek to

limit the tobacco content their children consume.

Anti-tobacco and anti-vaping ads – Anti-tobacco messages have

been enormously successful in reducing tobacco use rates and

should be deployed before and during shows that feature tobacco

imagery. These messages should include speciﬁc anti-smoking

and anti-vaping messages that demonstrate the harmful effects of

this increasingly popular tobacco product.

Tobacco payoffs – Big Tobacco has an overt interest in the continued

presence of tobacco on TV. It is essential to ensure that no parties

or persons involved with a production received anything of value in

exchange for including smoking or vaping depictions in a show.

State public subsidy policies – Shows with tobacco depictions

should not be eligible for local production subsidies, including tax

breaks and other incentives. States can change their production

subsidy policies to provide tax and other incentives for only those

productions that do not promote tobacco use.

Education and outreach – Many creatives in the entertainment

industry do not realize the potentially deadly effects that tobacco

content can have on youth and young adults. It is important to

educate directors, writers and producers about the importance of

keeping tobacco out of their shows.

Ongoing research – More information is available about the

harmful effects of tobacco imagery than ever before, yet there is

more to be learned. A rigorous and ongoing monitoring of tobacco

imagery, including how it is portrayed and who is watching, is

needed. Especially, with e-cigarette depictions on the rise, it is

critical to document and understand the impact of streaming on

youth culture and the many ways that it can impact youth health.

More information

is available about

the harmful effects

of tobacco imagery than

ever before, yet there is

more to be learned.

August 2020

WHILE YOU WERE STREAMING 2020

Today’s youth are using tobacco products, especially e-cigarettes, at

unprecedented levels. Frequent tobacco imagery in the most popular

entertainment among youth threatens to not only normalize tobacco

use but can actually lead young people to start vaping. Network and

streaming channels alike must implement measures to curb tobacco

depictions before another generation loses millions to the harmful

effects of tobacco use. But with strong policies and an intentional

reduction in tobacco incidences throughout the entertainment

industry, we have the opportunity to improve youth health outcomes

and make smoking, vaping and nicotine use a thing of the past.

Network and streaming channels alike

must implement measures to curb tobacco

depictions before another generation loses

millions to the harmful effects of tobacco use.

August 2020

WHILE YOU WERE STREAMING 2020

900 G Street, NW

Fourth Floor

Washington, DC 20001

202.454.5555

truthinitiative.org

truthinitiative

REFERENCES

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org/10.1016/j.ypmed.2020.106169

2 Truth Initiative. While You Were Streaming. 2018

3 Truth Initiative. While You Were Streaming: Smoking on Demand. 2019

4 Fuhrer B. Streaming TV Update: Key Trends During COVID. ARF Virtual Town Hall Series: The

ARF. 2020. https://thearf.org/category/articles/what-behaviors-will-stay-after-the-crisis-

passes/.

5 Polansky J. R, Glantz Stanton A. “What is Hollywood Hiding?” UCSF: Center for Tobacco

Control Research and Education. 2020. https://escholarship.org/uc/item/3pw661mg

6 Adams Sally H., et al. “Medical Vulnerability of Young Adults to Severe COVID-19 Illness—Data

From the National Health Interview Survey.” Journal of Adolescent Health. 2020. ISSN 1054-

139X. https://doi.org/10.1016/j.jadohealth.2020.06.025

7 Wang TW, Gentzke AS, Creamer MR, et al. “Tobacco Product Use and Associated Factors

Among Middle and High School Students—United States, 2019.”

MMWR Surveill Summ

2019;68(No. SS-12):1–22. DOI: http://dx.doi.org/10.15585/mmwr.ss6812a1

* Shows that had zero depictions or incidences of tobacco are unlisted in the chart.