Recall of Netflix Scripted Content Known to Contain E-Cigarette-Related Imagery is Associated with Susceptibility to Use E-Cigarettes Among Young Adults.

Abstract

INTRODUCTION Netflix pledged to avoid depictions of e-cigarette use in scripted series and movies rated TV-14 or below. However, this policy did not extend to young adults, many of whom are below the legal tobacco purchasing age. This study examined the association between recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and susceptibility to use e-cigarettes among never users. MATERIALS AND METHODS A non-probability representative sample of young adults (ages 18-24; N = 1500) living in California were recruited to complete an online survey assessing their recall of Netflix scripted series and movies previously identified to contain e-cigarette imagery and e-cigarette-related behaviors. Adjusted and weighted logistic regression analyses were used among participants who had never used e-cigarettes (n = 967). RESULTS Among participants who had never used e-cigarettes, 68.1% (n = 659/967) recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, including 66.4% (n = 192/289) of participants under the legal tobacco purchasing age. Participants who recalled viewing at least one Netflix scripted series or movie previously identified to contain e-cigarette imagery, compared with those who did not, had greater odds of reporting susceptibility to use e-cigarettes among never users (AOR = 1.65, 95% CI = 1.20-2.25). CONCLUSIONS Young adults living in California recalled Netflix scripted series or movies previously identified to contain e-cigarette imagery. Such recall was associated with susceptibility to use e-cigarettes among never users. These findings should motivate prevention programmers to design tobacco-related digital media literacy interventions for young adults.