Is Social Media as Harmful as Cigarettes?

Mental health experts offer parenting tips after the Surgeon General recommended warning labels on social platforms.

U.S. Surgeon General Vivek Murthy, M.D., doubled down on a social media advisory he issued a year ago, recommending that social media platforms be labeled as harmful to young people’s mental health. His suggestion, publicized in a June New York Times editorial, has been compared to the Surgeon General’s warning on tobacco products.

More than half of teens in the United States today spend more than four hours on social media, according to a Gallup survey. Many report checking platforms like TikTok, SnapChat and Instagram throughout the day and even throughout the night.

Today’s college students are the first generation to grow up with the prevalence of screens and social media for their entire lives.

Meanwhile, the United States is experiencing an unprecedented mental health crisis among teens that has followed a parallel trajectory to the rise of social media. A recent study shows that the amount of time kids spend on social media correlates with mental health challenges.

Researchers continue to gather evidence of how social media use affects adolescents. According to the American Psychological Association (APA), using social media is not inherently beneficial or harmful to young people. Instead, the way you use social media determines its risk level.

What is clear is that social media applications are built to give users a dose of dopamine that keeps them wanting to spend as much time on the platforms as possible. Teens, in general, aren’t as well equipped to self-regulate as adults. “Social media has an addiction type of effect so that you feel a need to constantly get notifications with that initial burst of dopamine that comes when you get a notification or a like,” says Felicia Gallucci, M.D., a psychiatrist at the University of Miami Health System.

While research continues to determine social media’s effects on mental health, many parents are concerned enough to want to set boundaries around social media and screen time.

The challenge is how to create reasonable limits without making teens feel isolated.

Dr. Gallucci and Caitlyn Fitzgerald, M.D., a child psychiatry fellow at the University of Miami Miller School of Medicine, offer social media advice to parents of teens.

What age is appropriate to join social media platforms?

Teens’ maturity varies, so it’s difficult to make a blanket rule about what age an adolescent is ready for social media. Many social apps impose an age limit of 13+ for social media use, asking new users to enter a birthday upon registering.

The APA recommends adult monitoring of social media apps, such as ongoing review, discussion and coaching around social media content and use, especially in early adolescence.

Parenting tip: Both Apple and Android offer parental control settings that allow parents to monitor what apps children access. This can keep your teen from signing up early by changing their birth year.

How much time should teens spend on social media?

Social media platforms have so many variables, making it difficult for parents to set time limits on their use. YouTube is technically a social platform, but many people use it for entertainment and even education. WhatsApp and SnapChat are some users’ most common forms of communication. And video games have a social media chat component. The way teens use social media and what platforms are popular are constantly shifting.

Social pressure is a common reason tweens and teens join a platform. If friends are on the app, your teen will want to join, too.

The American Academy of Pediatrics updated its evidence-based media use recommendations in 2016 to recommend that parents consider the quality of interactions with digital media rather than just the quantity.

Parenting tip: Consider coordinating with other parents in your community or school to discuss social media use, such as a “Wait until 8th” policy for using the apps. Setting boundaries is easier when your teen doesn’t feel left out.

Signs of problematic social media use among teens

The APA recommends routinely screening teens for signs of “problematic social media use” that can impair their ability to function and may present a risk for more serious psychological harm over time. A pediatrician, therapist or school social worker can help you determine if your teen’s social media use has become a problem.

Parenting tip: Look for the following indicators of problematic social media use from the APA:

• Using social media even when wanting to stop
• Social media use that interferes with necessary tasks
• Disruptions in other activities from missing social media use too much
• repeatedly spending more time on social media than intended
• Lying or deceptive behavior to access to social media
• Disruption to significant relationships or educational opportunities

Helping teens set healthy social media boundaries

Understanding how your teen uses social media can provide a clearer picture of potential risks or benefits. Dr. Gallucci recommends asking specific questions about your teen’s social media habits in an open conversation about their platforms and the content they engage with and enjoy. “Foster that open relationship so that you know, if something unfortunately does happen, they feel comfortable coming to you and talking about it because they trust you,” she says.

Many pediatricians and therapists routinely ask about social media use. “It’s part of our intake process for every new patient at Jackson. I’ll even ask parents if they monitor their children’s social media use,” says Dr. Fitzgerald.

Once you understand your teen’s social media use, you can address any problems that may arise from it. “Even small changes, like reducing phone use from three hours to two hours before bed, can lead to significant improvements,” says Dr. Gallucci.

Monitor the impact of social media use on overall health

Once you open the lines of communication about social media use, you can assess any link between social media and your teen’s overall health. Some teens might not realize that their anxiety or sleep issues stem from their online activities. Feelings of missing out after seeing friends together on social media and even cyberbullying can be so common that your teen might not even realize that social media use is part of the problem.

Parenting tip: If your teen is particularly moody or tired, ask about feelings of belonging, sleep quality and in-person versus online friendships. “I’ve had patients with significant anxiety, and we traced it back to traumatic videos their friends showed them on YouTube or reels,” says Dr. Fitzgerald.

Address sleep disruptions

Your teen might be up late studying, but they’re likely also checking social media platforms at the same time. It’s difficult to set strict boundaries around this behavior because many conversations include academic topics.

But, poor sleep is often a hidden consequence of excessive social media use. Teens may resist acknowledging this connection, but you should ask about their nighttime habits if they’re constantly tired.

Parenting tip: If grades are important to your teen, but they’re struggling to get to school on time or can’t focus in class, discuss ways to improve their sleep. “Try asking what your bedtime routine looks like and how it can be improved so you’re winding down properly,” says Dr. Gallucci.

Involve the whole family

It’s difficult to impose rules or even recommendations on your teen that you’re not following yourself. Consider approaching screen time and social media limits as a collective family experiment rather than singling out your teen. “Teens will often model what they see at home, so if parents are always on their phones, kids will think it’s acceptable,” says Dr. Fitzgerald.

Parenting tip: Dr. Gallucci suggests placing phones in a lockbox after a specific time for everyone in the family. “This reduces the focus on the teen alone and promotes a united effort,” she says.

Be consistent with rules

This applies to any parenting standards you set, but consistency helps teens understand boundaries without constantly trying to push back. Because teens are skilled at testing limits, Dr. Gallucci recommends parents avoid shifting goalposts. For example, rewarding a teen for good behavior with extra access to technology shows that the rules are flexible.

“If you have clear, consistent boundaries, your kids know what to expect and eventually recognize they’re not necessarily going to change the family rules,” says Dr. Gallucci.

Setting healthy boundaries around social media use isn’t easy. Still, with a combination of understanding, monitoring, family involvement and consistency, you can guide your teen toward a healthier relationship with the digital world.

Wendy Margolin is a contributor for UHealth’s news service.

Tags: Dr. Caitlyn Fitzgerald, Dr. Felicia Gallucci, mental health risks, Social media impact, Youth screen time