@article { , title = {Alcohol and tobacco content in UK video games and their association with alcohol and tobacco use among young people}, abstract = {Aims: To determine the extent to which video games include alcohol and tobacco content and assess the association between playing them and alcohol and smoking behaviours in adolescent players. Design: Assessment of substance in the 32 UK bestselling video games of 2012/2013; online survey of adolescent playing of 17 games with substance content; content analysis of the five most popular games. Setting: Great Britain Participants: 1,094 adolescents aged 11-17 years. Measurements: Reported presence of substance content in the 32 games; estimated numbers of adolescents who had played games; self-reported substance use; semi-quantitative measures of substance content by interval coding of video game cut scenes. Findings: Non-official sources reported substance content in 17 (44\%) games but none were reported by the official Pan European Game Information (PEGI) system. Adolescents who had played at least one game were significantly more likely ever to have tried smoking (adjusted OR 2.70, 95\% CI 1.75 to 4.17) or consumed alcohol (adjusted OR 2.35, 95\% CI 1.70 to 3.23). In the five most popular game episodes of alcohol actual use, implied use and paraphernalia occurred in 31 (14\%), 81 (37\%) and 41 (19\%) intervals, respectively. Tobacco actual use, implied use and paraphernalia occurred in 32 (15\%), 27 (12 \%) and 53 (24\%) intervals, respectively. Conclusions: Alcohol and tobacco content is common in the most popular video games but not reported by the official PEGI system. Content analysis identified substantial substance content in a sample of those games. Adolescents who play these video games are more likely to have experimented with tobacco and alcohol.}, doi = {10.1089/cyber.2016.0093}, eissn = {2152-2723}, issn = {2152-2715}, issue = {7}, journal = {Cyberpsychology, Behavior and Social Networking}, pages = {426-434}, publicationstatus = {Published}, publisher = {Mary Ann Liebert}, url = {https://nottingham-repository.worktribe.com/output/800499}, volume = {19}, keyword = {Video games, Tobacco, Alcohol, Adolescent exposure, Content analysis, National survey}, year = {2016}, author = {Cranwell, J.C. and Whitamore, Kathy and Britton, John and Leonardi-Bee, Jo} }