The science is well-established by now. Studies across the world consistently show that exposure to pro-tobacco imagery correlates with an increased likelihood of tobacco uptake among young adults. To counter this, the WHO established guidelines against tobacco promotion and advertisement under its Framework Convention on Tobacco Control (FCTC) in 2008.
India, a nation with half a billion people under 25, was one of the first countries to adopt these guidelines and codify them into its tobacco control laws. Under the amended Cigarettes and Other Tobacco Products Act (COTPA) 2012, all films displaying tobacco products or their use in any form must justify the need to do so to the Central Board of Film Certification. And if visuals of tobacco use are shown, films are required to display prominent anti-tobacco health warnings in the form of audio-visual disclaimers and static messages as well. If a broadcaster fails to comply, they could have their license suspended or cancelled.
These rules and penalties also apply to TV programmes broadcast in India, as well as on-demand streaming services via Section 5 of the Act.
For all their patchy implementation, early studies have shown these rules effectively create awareness of tobacco’s harm and increase users’ intention to quit. “These rules were only agreed upon because the stakeholders found public health relevance, particularly to protect children and the youth,” Monika Arora, a public health researcher at Hriday, a not-for-profit health awareness organisation in Delhi.
In a new study, Arora and her colleagues investigated if Netflix and Amazon Prime Video follow these rules as well. First, they interviewed 33 young adults from urban centres, aged 15-24 years, and shortlisted 10 series they considered popular. They are:
1. The Marvellous Mrs Maisel (Prime Video)
2. Stranger Things (Netflix)
3. Bodyguard (Netflix)
4. Riverdale (Netflix)
5. Narcos (Netflix)
6. Sacred Games (Netflix)
7. Mirzapur (Prime Video)
8. Chilling Adventures of Sabrina (Netflix)
9. 13 Reasons Why (Netflix)
10. The Crown (Netflix)
Next, they watched all 188 episodes from these ten series, and noted the number of times tobacco products and/or their use showed up in every episode.
Their findings are startling: 70% of the shows portrayed tobacco use and none of them comply with the COTPA’s regulations. No episodes in any series displayed static anti-tobacco warnings together with instances of tobacco use nor showed any audio-visual disclaimers at the beginnings or ends of such episodes.
“These rules were introduced to particularly de-glamorise tobacco use,” Arora said.
India has made incremental progress with tobacco control since implementing these rules. However, with the rise of streaming services and their seeming disregard for these regulations, “the risk exposure might again come back to where it was before these rules came in.”
There is no reason to expect that the effect of exposure to pro-tobacco imagery through streaming services would be any different from that through films, according to her. The way ahead “is for authorities to take cognisance that our national laws are being violated.”
The Wire reached out to Netflix India and Amazon Prime India, but spokespersons of the former refused to comment while the latter did not respond.
Arora and her peers’ study may be unique to India but reviews from other parts of the world have reached similar conclusions. A 2019 report by the Truth Initiative, a non-profit public health organisation in the US, found that 92% of on-demand shows they analysed contained images of tobacco. A study from the UK, also published in 2019, found 74% of episodes the authors analysed showing tobacco use. These studies both concluded that the content available on on-demand streaming services could be an important global driver of tobacco consumption.
However, the question of violations doesn’t arise as with India. “To my knowledge, India is the only country in the world that has this policy,” James Thrasher, a professor of health promotion at the University of South Carolina, said.
He added that Arora’s study highlights “a big challenge for all countries, where new media and streaming services are increasingly accessible and not too expensive.” And as new media picks up more subscribers, “it is critical that those policies” – such as COTPA – “be applied to all entertainment media production.”