Key points are not available for this paper at this time.
I believe television is going to be the test of the modern world, and that in this new opportunity to see beyond the range of our vision we shall discover either a new and unbearable disturbance of the general peace or a saving radiance in the sky. We shall stand or fall by television. —Author E. B. White1Television and other media represent one of the most important and underrecognized influences on children and adolescents' health and behavior in the 1990s. Their impact should be eliciting serious concern, not just from parents and educators but from physicians, public health advocates, and politicians as well (Fig 1). Although objections to various programming and advertising practices can exist on common sense, philosophical, aesthetic, humanistic, or public health grounds without strict scientific data, 2 increasing numbers of studies document that a serious problem exists. By time criteria alone, television represents the predominant medium. Young people average 16 to 17 hours of viewing weekly, beginning as early as age 2. 3 When video game and videocassette usage are added, some teenagers may spend as many as 35 to 55 hours in front of the television set. 4 More families own a television set than a telephone. 5However, other media are important as well. Adolescents can spend nearly equal amounts of time listening to the radio, although music is used frequently as an accompaniment to other activities. 4, 6 More than half of all 15- to 16-year-olds had seen the majority of the most popular, recent R-rated movies in one study. 7 In a separate study, 92% of males and 84% of females had seen or read Playboy or Playgirl by age 15. 8Finally, playing video games has become a favorite pastime of children and adolescents and now represents a 7 billion per year industry. 9 One survey of nearly 400 seventh- and eighth-grade students found that teens average 2 to 4 hours per week playing such games. 10 Although not much data are available about young people's use of new technology such as the Internet, there is every reason to believe that “surfing the Net” will prove popular as well. Indeed, in one recent national survey 89% of teenagers reported using a computer, 61% “surfed the Net, ” and 14% reported seeing something that they did not want their parents to know about. 11 By 1996, nearly five million youths had used the Internet or an on-line service from school or home. 12Media exert a significant displacement effect—2 to 3 hours per day spent watching television or playing video games means less physical activity, reading, and interaction with friends—but such data do not speak to cause-and-effect concerns. Likewise, content analyses can only demonstrate what the average child or adolescent will view. Even so, such analyses are disturbing when they reveal what the average American child or teenager is exposed to annually. Young people view an estimated 10 000 acts of violence each year. 13 Most recently, the National Television Violence Study examined nearly 10 000 hours of television programming throughout 3 years and found that 61% contains violence, with children's programming being the most violent (Fig 2). 14–16 In addition, 26% of violent interactions involved the use of guns. 16 During the 3 years of the study, none of the key indicators of violence in the media changed, despite widespread public concern. 14–16 A recent comprehensive analysis of rock music videos of all genres demonstrated that 22. 4% of all Music Television videos portrayed overt violence, 20% of all rap videos contained violence, and weapon carrying was depicted in 25% of all Music Television videos. 17 Attractive role models are the aggressors in more than 80% of violent music videos. 18Each year, teenagers view nearly 15 000 sexual references, innuendoes, and jokes, of which <170 will deal with abstinence, birth control, sexually transmitted diseases, or pregnancy. 19The so-called family hour of prime time television (8 to 9pm) contains more than 8 sexual incidents per hour, more than four times as much as in 1976. 20 Nearly one-third of family hour shows contain sexual references, and the incidence of vulgar language is increasing dramatically as well. 21 The Internet offers unparalleled access to hard-core pornography with just a few keystrokes. 22A recent content analysis found that alcohol, tobacco, or illicit drugs are present in 70% of prime time network dramatic programs, 38 out of 40 top-grossing movies, and half of all music videos. 23 In another recent study, one-fourth of all Music Television videos contained alcohol or tobacco use. 24Several studies document that smoking is making a comeback in Hollywood movies: a 1994 study of the 62 top-grossing films from 1960 to 1990 found that levels of smoking remained constant despite decreases in real-life and that lead characters were far more likely to smoke on screen (65%) than their real-life counterparts with similar demographic characteristics. 25, 26 Similarly, an American Lung Association study of 133 movies released in 1994 to 1995 found that 77% depicted tobacco use. 27In addition to programming, young people view ∼20 000 commercials each year, of which nearly 2000 are for beer and wine. 28For every “just say no” or “know when to say when” public service announcement, teens will view 25 to 50 beer and wine advertisements. 29 Alcohol and tobacco advertisers are becoming an increasing commercial presence on the Internet as well, with more than 35 alcoholic beverages represented, homepages devoted to smoking, a Budweiser on-line radio network, interactive games, free giveaways, brand spokescharacters, and specially designed chat rooms. 12 Altogether, tobacco manufacturers spend 6 billion per year, and alcohol manufacturers 2 billion per year in all media, trying to entice young people into “just saying yes. ”30, 31Data like these are alarming, but are the media actually responsible for episodes of child aggression, teen homicides, and increased rates of teenage drug use and sexual activity? 32Or, as the entertainment industry maintains, do the media merely mirror an increasingly violent, drug-oriented, and sexualized society? A close examination of the available data are essential. The research is voluminous and very clear on the relationship between media violence and real-life aggression: a cause-and-effect relationship exists. 33–38 Such research involves detailed cross-sectional studies, 39–43 naturalistic studies, 44, 45 longitudinal studies, 46–50 and several meta-analyses. 51–54 Two government reports, the 1972 Surgeon General's Report55 and the 1982 National Institute of Mental Health56 report affirmed this conclusion after examining all available data. The latter stated unequivocally: 56After 10 more years of research, the consensus among most of the research community is that violence on television does lead to aggressive behavior by children and teenagers who watch the programs. This conclusion is based on laboratory experiments and on field studies. Not all children become aggressive, of course, but the correlations between violence and aggression are positive. In magnitude, television violence is as strongly correlated with aggressive behavior as any other behavioral variable that has been measured (authors' italics). The research question has moved from asking whether or not there is an effect to seeking explanations for the effect. Taken together, the research data are persuasive that high levels of television viewing are causally related to aggressive behavior and the acceptance of aggressive attitudes. 57 The correlations found are stable throughout time, place, and demographics. 13, 34 Added to this is the now-sizable body of research demonstrating that the more adolescents are exposed to violence or are victims of violence in their homes or communities, the more likely they are to use violence or carry weapons themselves. 58–61 Clearly, the witnessing of violence is an important determinant of violent behavior; and media violence represents the witnessing of violence vicariously, on the television or movie screen. As long ago as the 1960s, laboratory experiments by Bandura et al62 established that young children are liable to imitate what they see on the television screen, particularly if the behavior is performed by an attractive role model and is either rewarded or goes unpunished (Bandura's social learning theory). Several longitudinal correlational studies have tracked children or adults for a period of up to 30 years and found that viewing media violence at young ages (8 years and younger) is a significant risk factor for adolescent or adult aggressive behavior or even criminal violence. 43, 4548–50, 63 Researchers have concluded that children learn their attitudes about violence at a very young age and, once learned, the attitudes tend to be life-long. 64American media are also rife with portrayals of justified violence (eg, the “good guy” beating up the “bad guy”), which research shows is the single strongest positive reinforcer for young people. 30, 65 Not only can media violence facilitate aggressive or antisocial behavior, it may also desensitize viewers to future violence and can also increase viewers' perception that they are living in a mean and dangerous world. 36, 66 The problem is that the entertainment industry does not want to admit the connection any more than the tobacco industry will acknowledge the cause-and-effect relationship between cigarette smoking and lung cancer. 63Media violence is not the sole cause of violence in society. Poverty, racism, inadequate parenting, the dissolution of the American family, individual psychologic differences all may have far more impact. Studies have found that child abuse, sexual abuse, witnessing domestic violence, or witnessing community violence may all play a key role in determining who will become violent. 58–6167–70But the use of violence to achieve goals or to settle conflicts is, in fact, learned behavior. Such learning occurs in social groups such as the family, peer groups, and gangs. Television and other media may function as a super peer in this respect. 32How much do media contribute to real-life violence? When 22 separate estimates of effect size were collated from various surveys, the size of the effect for media violence was estimated to be 5% to 15%. 30, 35 Given all the factors contributing to violence, to be able to isolate media violence as one factor is significant. Homicide and suicide are the second and third leading causes of death among adolescents, and guns contribute significantly to both. 71 What links adolescent homicides to American media is the glamorization of guns, which represent 26% of all violent interactions on television (Table 1). 16, 36 Although there are no specific data linking viewing gunplay in the media with actual gun-related offenses in real life, the connection seems logical, at least to one television critic: 72On average, a violent crime is committed (in the US) every 17 seconds. The entertainment industry alone cannot be blamed for this, any more than guns alone, and not the people who pull their triggers, can be blamed for gun-related deaths; however the connections are inescapable. If there were fewer guns, fewer people would be shot to death; if there were fewer violent images, fewer people might be moved to seek violent the data are not nearly as clear for determining what relationship between early sexual and a of sexualized Although there are more than studies linking media violence to real-life violence, there are only studies demonstrating any connection between media with high sexual content and in sexual behavior or for sexual activity, be from the violence if children and teenagers can learn aggressive behavior, they be able to learn sexual behavior as In addition, the to have the teenage in the world, despite the that American teenagers are not sexual in numbers than their This is an important that to the of a that even with early sexual birth is a as data the media represent an important and of sexual for teenagers (Table the high be from several a of access to birth control, a of about birth in a of sexual in the media, and an of in the media about and the use of birth that the billion of advertising that tobacco and alcohol manufacturers every year to the American public has a significant impact on adolescents' and attitudes about smoking and and may their actual as well. studies a but positive to relationship between and addition, advertising seems to episodes in contribute to and long as years the National a report on the of advertising on which is clear from the available that television does has demonstrated that children to and learn from and that advertising is at least in positive attitudes and the for viewers to be the most recent studies document that children and adolescents who are exposed to amounts of tobacco or alcohol advertising are more likely either to use or to use such This as well, billion a year is a of to to advertising if it does not people to Such advertising is in (Table is strongest cigarette advertising and In one study, children as young as years were as likely to as the for the and to with cigarette In addition, there is a positive between advertising and brand (Table for cigarette advertising have also been to the content of and cigarette popular with teens are more likely to in with high A study found that one-third of teens cigarette and these teens were four times more likely to be Most a recent longitudinal study found that an estimated one-third of all adolescent smoking be causally related to tobacco alcohol, the correlations far have been only of the that alcohol advertising and problem by young the does not the that advertising a it seems that advertising is a contributing factor that and related to a than a one leading media violence, scientific is What is if the entertainment industry will do in to these public health and determining if such can be with media is that all other will the and of these correlations new data are the impact on sexual behavior in sexual content sexual activity, use of sexual The will longitudinal correlational studies can be some recent research that there may be in teenagers view the on their family and other Such may have for sexual portrayals and their impact on research content analyses of violence, and drug use in television programming, movies, and rock music a longitudinal study of the effect of violent video and games on children's attitudes and behavior; a longitudinal study of the impact of rock music on adolescents' and behavior; and studies of children and teenagers use the addition, although the relationship between advertising and is now well what is is to the of advertising does not able to the that advertising making it less as a teenagers be to in the with the tobacco which a on characters in have an impact on young studies are body of now that to the of the media to children's and adolescents' and, their behavior as well. American media contribute more to health than to positive or but it does not have to this are from the children view media to more and public health to the media to the frequently that if parents do not like what their children there is an on the television set or the that if the the media were they would not have to about their impact. In fact, groups are parents do to which media their children but the entertainment industry also to for the health of what they parents do not the media their children or adolescents are exposed to with any or Not only do parents frequently the of hours that their but also they the shows that they view (Fig In addition, one-fourth of more than one-third of and more than half of have television in their (Fig Two surveys, a of nearly found that less than half of parents report television with their is to be an for of television an watching a with a child and it with or as a and a media (Table one recent survey found that of children or teenagers watch something Music when they are alone than when viewing with their these parents are very about the of more than all other Given the of hours that children spend in front of the television these other media that less significant may be important television movies and videos as one to by the American of based on a of all available data to parents the public health of media on it is that health this new on their young and for who children or adolescents should learn to a media (Table when seeing with a of aggressive behavior or school parents can be using media from a of (Table In addition, can as role models by using television and videocassette in their for programming are important community for television and parents can also for media by to national Hollywood the and the also be in the television industry to birth advertising and the entertainment industry to their of violence and to responsible role of health that is for numbers of public service to the of tobacco and alcohol that young people the most of per to to it is to not only in but also in of public service can an more of a the problem and Such are when other are (eg, public service and on smoking in public One aggressive in demonstrated a smoking after 4 years when radio and television were with a public service are used by the very they are to (eg, when to say parents and health to in media use of media for a social or public to be to public on health not tobacco manufacturers have long by the about smoking as an of individual Similarly, the National Association has the of by that the to own a despite the that no has a as a of the guns as a would have a public health the and of guns is to less than the and of involves industry practices than trying to by to be is one of the few that a media media for nearly every from has media for and high school and and all have far more than the A of groups (Table have and that can be used in a of but school to more time and to what they view as programs. in the of children and adolescents public health such as early sexual violence, and drug such on a new research is the of media programs. several have been that such can what they set out to One in to attitudes about television violence among and third as well as their own levels of aggressive behavior as by their recent has been to to and video games also be used for the was the in the to have it is in any clear public American television was established and to the by in The to that that the public the which are to the to the (authors' italics). of the to violent content and of programming for and the have an increasingly aggressive role the The 1990 Television to some and programming for to like as children will be like in the by the of with the Television and by high levels of media the of 1996, which into the 1990 Television by for and beginning in 3 hours of programming per The also that all television beginning in contain a that be by parents to out media which or will be the a one that the will have to with public groups, the television industry a set of that Association of movie exist with this several studies that parents a more not the are not specific and the impact of violent or sexual is content to the a with an for sexual content may contain violence at a but is not a for violent parents may be to in the for violence, even although research shows that this represents some of the most programming for young studies document that children and young teenagers are the more adult the to the entertainment industry of several are available that would television and other media for children and is in the in only per for public the and increased the for own of programming individual to to to and to 17 on television is in be used to these If the future will to at least 5% to of be for programming for young might also for media programs. In a of research is would be the of about media and has now been 15 years the government of all available research to that Such that and as in the public health to media for young once there is no between the and common public health exist in at least children and adolescents the advertising of and alcoholic such advertising represents commercial than free it is not the The is to advertising that is or and tobacco and alcohol advertising that advertising may be more than an would tobacco advertising seen by children or teenagers to by would tobacco advertising at children and, more would and which in the has more than half of the 6 billion that tobacco spend on One significant to a on alcohol advertising might be the of Two either equal amounts of public service that would the of or that be to so-called that the only but do not the that the might Such have been by the the Surgeon the American of and the American it is that the or of public service will the levels of commercial alcohol manufacturers to seems far more not increased seems to be the in children and adolescents from the Although that 3 hours of programming per week is such an seems inadequate their free use of public television and should be to at least hour per day of programming for The is among in not any such young people and will using the of to and other will have to be to young people from dangerous chat and other on the A recent has this with from technology and Internet the entertainment industry problem with the of their the research and most parents would American media are the most violent and sexually in the and have to more and Indeed, the industry is to to such as as being or as family but that any programming can have children view television and movies as the real world, with real adults and it is a that is rife with violence, and smoking, and a of and frequently from the industry is that it is merely people what they there is significant to the of more than of violent programs, the other of without The had a and Similarly, a movie industry study found that movies were times more likely to million than R-rated public document that as many as 80% of adults believe that entertainment violence is to is is a in from one of to one of for the and of young The American public is to teenagers for their early sexual activity, or violent behavior; these are learning important behavioral from the media that programs, even increased can only is no for an and significant in the violence when guns are the and the smoking and being at American children and adolescents (Table the entertainment industry to acknowledge their to the public health may be but the is beginning to and teenagers a for entertainment but they also represent the and only of adults in American society. they far than what they are being exposed to
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Victor C. Strasburger
Edward Donnerstein
PEDIATRICS
University of New Mexico
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Strasburger et al. (Fri,) studied this question.
www.synapsesocial.com/papers/6a10402196ccf4328060085b — DOI: https://doi.org/10.1542/peds.103.1.129