CAMP SUSAN CURTIS ONLINE February, 2014 | Page 17

RAY AND JAT ELECTRONIC MEDIA AND CHILDREN adolescents is exposure to sexual content in the mass media. In India, there are reports of messaging of sexual contents through mobiles among schoolgoing adolescents. MEDIA AND SMOKING Research has demonstrated a strong association between exposure to certain mass media messages and smoking in adolescents. For instance, more than half of adolescent smoking initiation has been linked to watching smoking in movies(34). Acknowledging the effects of mass media on attitudes and behavior, media literacy may teach youth to understand, analyze, and evaluate advertising and other mass media messages, enabling them to actively process media messages rather than passively remaining targets of mass media(35). India faced a lot of controversy with the ban on on-screen smoking in films and television programs. Initially, ban was imposed from January 1, 2006 and then on January 23, 2009, Delhi High Court lifted the smoking ban in films and TV (36). There is need for evidence based guidelines for such issues. Survey research results demonstrate that TV programs watched by adolescents contains high levels of sexual content, include little information about sexual risks, and are an important source of information about sex(41). Almost 75% of 15 to 17year-olds believe that sexual content on TV influences the behavior of their peers “somewhat” or “a lot.” Collins, et al.(42) reported that the amount of sexual content viewed, but not hours of television watched, was a significant one year risk factor for sexual initiation. Ashby, et al.(43) used longitudinal data to examine the relationships between amount of television viewing and parental regulation of content on sexual initiation and observed that watching television 2 or more hours per day and lack of parental regulation of television programming were each associated with increased risk of initiating sexual intercourse within a year. Peterson, et al.(44) found that co-viewing television and discussing television with parents were related to decreased sexual initiation in certain adolescents. MEDIA AND ALCOHOL DRINKING It has been shown that exposure to alcohol advertising and TV programming is associated with positive beliefs about alcohol consumption(37). Although such cross-sectional studies do not prove causation (only association), it is of interest that in a 1990 study, 56% of students in grades 5 to 12 said that alcohol advertising encourages them to drink. Findings showed that girls who had watched more hours of TV at ages 13 and 15 drank more wine and spirits at age 18 than those who had watched fewer hours of TV(38). One study suggested independent associations between marijuana and alcohol use, and media exposure. In particular, music exposure is associated with marijuana use while movie exposure is related to alcohol use(39). WHAT CAN BE DONE? Given the enormous influence that media in all forms exerts on the lives of children, it is astonishing how little parents, researchers, and policymakers have been spurred to action. First, the media needs to be recognized as a major public health issue rather than as a series of commercial endeavors in need of regulation, as they are among the most profound influences on children. This intersects with many other issues that are critically important to child health, including violence, obesity, tobacco and alcohol use, and risky sexual behaviors. Television and other media must be viewed as more than sources of evil or mere idle pleasures; their potential to enrich the lives of our children are, in fact, enormous, and that potential needs to be explored and actualized. Recently, Moreno, et al.(45) reported that a brief e-mail intervention using social networking sites shows promise in reducing sexual references in the online MEDIA AND RISK OF SEXUAL INITIATION Initiation of sexual intercourse by younger adolescents is associated with risky sexual behaviors and increased risk of multiple partners, unwanted pregnancy, sexually transmitted infections, and pelvic inflammatory disease. In the US, approximately 47% of high school students have had sexual intercourse. Of them, 7.4% report having sex before the age of 13 and 14% have had t 4 sexual partners(40). One potential but largely unexplored factor that may contribute to sexual activity among INDIAN PEDIATRICS 564 VOLUME 47__JULY 17, 2010