Social media use and adolescent health-risk behaviours in young people: a systematic review and meta-analysis

Purba, A. K., Thomson, R. M. , Henery, P. M., Pearce, A. , Henderson, M. and Katikireddi, S. V. (2023) Social media use and adolescent health-risk behaviours in young people: a systematic review and meta-analysis. British Medical Journal, 383, e073552. (doi: 10.1136/bmj-2022-073552) (PMID:38030217) (PMCID:PMC10685288)

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Objectives: To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years). Design: Systematic review and meta-analysis. Data sources: EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic, PsyArXiv, medRxiv, and Google Scholar (1 January 1997 to 6 June 2022). Methods: Health risk behaviours were defined as use of alcohol, drugs, tobacco, electronic nicotine delivery systems, unhealthy dietary behaviour, inadequate physical activity, gambling, and anti-social, sexual risk, and multiple risk behaviours. Included studies reported a social media variable (ie, time spent, frequency of use, exposure to health risk behaviour content, or other social media activities) and one or more relevant outcomes. Screening and risk of bias assessments were completed independently by two reviewers. Synthesis without meta-analysis based on effect direction and random-effects meta-analyses was used. Effect modification was explored using meta-regression and stratification. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: Of 17 077 studies screened, 126 were included (73 included in meta-analyses). The final sample included 1 431 534 adolescents (mean age 15.0 years). Synthesis without meta-analysis indicated harmful associations between social media and all health risk behaviours in most included studies, except inadequate physical activity where beneficial associations were reported in 63.6% of studies. Frequent (v infrequent) social media use was associated with increased alcohol consumption (odds ratio 1.48 (95% confidence interval 1.35 to 1.62); n=383 068), drug use (1.28 (1.05 to 1.56); n=117 646), tobacco use (1.85, 1.49 to 2.30; n=424 326), sexual risk behaviours (1.77 (1.48 to 2.12); n=47 280), anti-social behaviour (1.73 (1.44 to 2.06); n=54 993), multiple risk behaviours (1.75 (1.30 to 2.35); n=43 571), and gambling (2.84 (2.04 to 3.97); n=26 537). Exposure to content showcasing health risk behaviours on social media (v no exposure) was associated with increased odds of use of electronic nicotine delivery systems (1.73 (1.34 to 2.23); n=721 322), unhealthy dietary behaviours (2.48 (2.08 to 2.97); n=9892), and alcohol consumption (2.43 (1.25 to 4.71); n=14 731). For alcohol consumption, stronger associations were identified for exposure to user generated content (3.21 (2.37 to 4.33)) versus marketer generated content (2.12 (1.06 to 4.24)). For time spent on social media, use for at least 2 h per day (v <2 h) increased odds of alcohol consumption (2.12 (1.53 to 2.95); n=12 390). GRADE certainty was moderate for unhealthy dietary behaviour, low for alcohol use, and very low for other investigated outcomes. Conclusions: Social media use is associated with adverse health risk behaviours in young people, but further high quality research is needed to establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful. Study registration: PROSPERO, CRD42020179766.

Item Type:Articles
Additional Information:This work was supported by the Medical Research Council (MC_UU_00022/2), Chief Scientist Office (SPHSU17), an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02) and the Wellcome Trust (218105/Z/19/Z, 205412/Z/16/Z).
Keywords:Adolescents, health risk behaviours, social media, social networking sites.
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and PURBA, Amrit and Thomson, Dr Rachel and Pearce, Dr Anna
Authors: Purba, A. K., Thomson, R. M., Henery, P. M., Pearce, A., Henderson, M., and Katikireddi, S. V.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:British Medical Journal
Publisher:BMJ Publishing Group
ISSN (Online):0959-8138
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in British Medical Journal 383:e073552
Publisher Policy:Reproduced under a Creative Commons License

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