The media cut across virtually every major area of concern that parents and paediatricians have about adolescents — aggressive behaviour and violence, suicide, sex, drugs, obesity and eating disorders, and learning problems.2 Yet, both parents and paediatricians seem to show little understanding of the media’s impact on young people, and to take little time to try to consider the current situation — in which teenagers are inundated with messages in the media that are potentially harmful to their health. Why?

My own theory is that parents and paediatricians are just too busy raising and caring for children and adolescents to have much time to watch, listen to, or read much media themselves. Furthermore, on the list of “important things” for parents to fight with teenagers about, their media use ranks near the bottom for most. Parents may also buy into the Hollywood myth that television and movies are merely fantasy entertainment. For paediatricians, it is difficult to have time to talk about the media in a busy office visit when there are so many other, “more important” topics to cover — vaccinations, seat belts, bicycle helmets, proper nutrition.

However, the media should rank at the top of all concerns because they can have an impact on so many crucial areas of a teenager’s life, and paediatricians and parents need to realise that the media’s influence begins at a very young age. According to the first wave of the long-term Growing Up in Australia study, infants are already spending nearly 1.5 hours a day watching television, and 4–5-year-olds are spending about a third of their total play time (2.1 hours) watching television.3 In 2002, a study of more than 1000 Australians aged 10–13 years found that median screen time for this age group was up to nearly 4 hours per day (Tim Olds, Associate Professor, School of Health Sciences, University of South Australia, personal communication), and more than half of all Australian children aged 8–18 years have a television set in their own bedroom.4 The latest Kaiser Foundation study found that older children and teenagers spend more than 6 hours a day multi-tasking with a dizzying array of media, ranging from television and video games to the Internet, mobile phones and instant messaging, and iPods.5

Media violence: There are more than 1000 studies linking exposure to media violence to real-life aggressive behaviour.6-8 Media violence also leads to desensitisation and to the belief that violence is an acceptable solution to everyday problems. A recent study found an association between viewing media violence at a young age and bullying.9 In fact, the connection between media violence and real-life aggression is nearly as strong as the link between smoking and lung cancer, and stronger than the connections between lead and IQ, homework and achievement, calcium and bone mass, and exposure to asbestos and cancer.2,6 Although much of the research has been done in the United States, an Australian Psychological Association position paper in 200010 and the Royal Australasian College of Physicians in 20044 acknow-ledged the significance of media violence.

Teen suicide: Numerous studies in the US and Europe have shown a link between media coverage of suicide and subsequent increases in suicides among teens.11

Sex: Only a handful of studies have examined sexual content in the media and its impact on teenagers, but they all show that there is an impact.12 In the absence of effective sex education, the media have become one of the leading sex educators of children and teens today.12 In the most recent study of nearly 1800 teenagers, teens’ viewing of sexual content led to a doubled risk of earlier sexual initiation.13 In addition, most teenagers have been exposed to pornography online, whether intentionally or inadvertently.14,15

Drugs: Young people view as many as 2000 advertisements annually for beer on television alone in the US, and such ads do have an impact.16,17 Children and teens who view R-rated movies (designated suitable for ages 17 years and older in the US) are three times more likely to begin smoking.18

Obesity and eating disorders: Overweight and obesity are increasing at alarming rates in Australia, with a 2.5-fold rise over the past 20 years.19 Australia now has one of the highest rates of type 2 diabetes in the developed world.20 Numerous studies show that there is probably a causal connection between TV viewing and obesity,2 although the exact reasons remain unclear — might the constant barrage of junk food advertisements21 be contributing? A recent study from the Australian Divisions of General Practice found that there is an average of one junk food advertisement per commercial break in children’s television programming, and that 99% of all food advertisements during children’s TV was for junk food.22 Watching TV also correlates with unhealthy body self-image among young girls and teen girls.12,23 A recent study found a cause-and-effect relationship between the introduction of American TV programs into Fiji and the development of new eating disorders and abnormal body self-image among adolescents there.24

Learning problems: In the first study of its kind to examine this concern, researchers found that hours of television viewed per day at both ages 1 and 2 is associated with attentional problems at age 7.25

We don’t know why parents and paediatricians don’t pay more attention to the media’s influence on children and adolescents. During an office visit, how long would it take to ask two simple questions of parents?

• How much TV (and other media) does your child view each day?

• Is there a TV set in your child’s bedroom?

For children and teens who are aggressive, obese, or who are doing poorly in school, perhaps a more detailed media history could be obtained.

The recent report from the Royal Australasian College of Physicians outlines a variety of ways that paediatricians can be more attuned to this issue.4 For example, they can be far more assertive in providing counselling to parents about the impact of media on children, and encourage household rules about media use. They should avoid placing TV sets in their waiting rooms. Paediatricians should also be at the forefront of discussions with filmmakers about depicting cigarette smoking in mainstream movies.

Finally, both parents and paediatricians need to lobby governments for more funding for research into the crucial areas of how the media affect children and teens, what can be done to maximise pro-social media and protect against harmful media’s influence, better programming for young people, and more funding for media education campaigns and media education programs in schools.

TV, movies, and video games may seem like “harmless entertainment” to adults and to Hollywood, but they exert a potent influence on young people. The question is not whether children and teenagers are learning from the media; it is how much and what are they learning.