By Lisa Rapaport

(Reuters Health) – Roughly half of popular hip-hop music videos feature smoking, vaping and marijuana use, with displays of tobacco products and drugs becoming increasingly common, a new study suggests.

Hip-hop is the leading music genre in the U.S. Its fan base includes a large proportion of adolescents and young adults of all racial and ethnic groups. Seeing popular and influential artists use tobacco and drugs or favor certain brands may lead more young people to try smoking and vaping and also decrease their perception of the associated health risks, researchers note in JAMA Internal Medicine.

“The use of tobacco and marijuana in music videos by popular hip hop artists can reach millions of children,” said study leader Kristin Knutzen of the Dartmouth Institute for Health Policy & Clinical Practice in Lebanon, New Hampshire.

“Children may then emulate the behavior of these celebrity music artists,” Knutzen said by email.

Knutzen’s team analyzed videos for top-50 songs on Billboard magazine’s weekly ranking of Hot R&B/Hip-Hop Songs from 2013 to 2017. Over that period, the proportion of leading hip-hop videos featuring smoking and vaping of tobacco and marijuana rose from 40 percent to 51 percent.

Brands became more prominent during the study period, too.

None of the videos showed branded combustible products in 2013. By 2017, about 10 percent of smoking displays involved brand-name cigarettes.

With vaping, 25 percent of displays featured brand name products at the start of the study. This surged to 88 percent by the end of the study.

Displays of smoking and vaping were also more common in the most popular videos.

Smoking and vaping were depicted in 42 percent of the least popular videos in the study, with from 8,700 to 19 million views.

Half of the most popular videos – with 112 million to 4 billion views – showed vaping and smoking.

One limitation of the study is that researchers lacked information on people watching the videos, making it impossible to know how many children or teens might be influenced by them.

It’s also impossible to single out hip-hop as a negative influence on young people based on this study because the researchers didn’t look at any other music genres, said Sonya Dal Cin of the University of Michigan in Ann Arbor, who wasn’t involved in the study.

“Some other genre may have more of this content, or less, or similar amounts,” Dal Cin said by email.

Even if depictions of smoking and vaping in hip-hop videos only reach some kids, the effect could still be widespread, noted Dr. Dimitri Christakis, director of the Center for Child Health, Behavior and Development at the Seattle Children’s Research Institute.

“The allure of emulating celebrities they admire is incredibly compelling,” Christakis, who wasn’t involved in the study, said by email.

If just five percent of children are more inclined to vape after watching hip-hop videos, that translates into 1.5 million additional vapes if 30 million children and teens see the videos, Christakis said.

“Parents need to be aware of what their kids are watching and listening to because it could have an impact on behavior that we know is harmful,” said William Shadel, a researcher at RAND Corporation in Pittsburgh, Pennsylvania, who wasn’t involved in the study.

Limiting screen time can help, up to a point, Shadel said by email. Parents also need to talk to children about how smoking and vaping are depicted in videos and explain health risks like cancer and lung damage in detail.

“Media literacy – or raising smart, media savvy consumers – is critically important,” Shadel said.

SOURCE: JAMA Internal Medicine, online October 15, 2018.