Content Analysis of Tobacco, Alcohol, and Other Drugs in Popular Music
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ARTICLE Content Analysis of Tobacco, Alcohol, and Other Drugs in Popular Music Brian A. Primack, EdM, MD; Madeline A. Dalton, PhD; Mary V. Carroll, BA; Aaron A. Agarwal, BS; Michael J. Fine, MSc, MD Objective: To perform a comprehensive content analy- depicted other or unspecified substance use. In the 93 sis of substance use in contemporary popular music. songs with substance use, it was most often motivated by peer/social pressure (45 [48%]) or sex (28 [30%]); use Design: We analyzed the 279 most popular songs of 2005 was commonly associated with partying (50 [54%]), sex according to Billboard magazine. Two coders working in- (43 [46%]), violence (27 [29%]), and/or humor (22 dependently used a standardized data collection instru- [24%]). Only 4 songs (4%) contained explicit antiuse mes- ment to code portrayals of substance use. sages, and none portrayed substance refusal. Most songs with substance use (63 [68%]) portrayed more positive Outcome Measures: Presence and explicit use of sub- than negative consequences; these positive conse- stances and motivations for, associations with, and con- quences were most commonly social, sexual, financial, sequences of substance use. or emotional. Results: Of the 279 songs, 93 (33.3%) portrayed sub- Conclusions: The average adolescent is exposed to ap- stance use, with an average of 35.2 substance references proximately 84 references to explicit substance use daily per song-hour. Portrayal of substance use varied signifi- cantly (PϽ.001) by genre, with 1 or more references in in popular songs, and this exposure varies widely by mu- 3 of 35 pop songs (9%), 9 of 66 rock songs (14%), 11 of sical genre. The substance use depicted in popular music 55 R&B/hip-hop songs (20%), 22 of 61 country songs is frequently motivated by peer acceptance and sex, and (36%), and 48 of 62 rap songs (77%). While only 2.9% it has highly positive associations and consequences. of the 279 songs portrayed tobacco use, 23.7% depicted alcohol use, 13.6% depicted marijuana use, and 11.5% Arch Pediatr Adolesc Med. 2008;162(2):169-175 If music be the food of love, play on; players in their bedrooms.1 These figures Give me excess of it, that, surfeiting, have increased substantially even over the The appetite may sicken, and so die. past decade.1,2 That strain again! It had a dying fall: There is convincing evidence that ex- O, it came o’er my ear like the sweet sound Author Affiliations: Division of posure to certain media messages in- That breathes upon a bank of violets, 3-10 General Internal Medicine, Stealing and giving odour! creases substance use in adolescents. For Department of Medicine William Shakespeare, Twelfth Night instance, viewing smoking in movies pro- (Drs Primack and Fine, spectively predicts a substantial propor- Ms Carroll, and Mr Agarwal), tion of adolescent smoking initiation.4,11 Center for Research on Health LTHOUGH THE INFLUENCE Similarly, exposure to smoking-related me- Care (Drs Primack and Fine), of music on human beings dia promotions is associated with smok- and Division of Adolescent 5-8,12 Medicine, Department of was recognized even be- ing initiation. Alcohol use in movies Pediatrics (Dr Primack), fore the time of Shake- and promotions is also linked to actual al- 4,13-15 University of Pittsburgh School speare, current technologi- cohol use. of Medicine, Pittsburgh, Acal and social changes dramatically magnify While the most frequently studied genres Pennsylvania; Department of that influence. While 15- to 18-year-old for this research include movies, televi- Pediatrics and Community adolescents are forming health attitudes sion, and advertising, health behavior theory Health Research Program, Hood and behaviors that will last a lifetime, they strongly supports a link between music ex- Center for Children and are exposed to 2.4 hours of music per day, posure and substance use. According to the Families, Dartmouth Medical according to a large nationally represen- social learning model, human beings learn School, Hanover, New 1 Hampshire (Dr Dalton); and tative study. There are few limits to ac- not only by direct experience but also by ex- Center for Health Equity cess; 98% of children and adolescents live posure to modeled behavior, such as that 16-18 Research and Promotion, VA in homes with radio and CD or MP3 play- represented in popular music. This Pittsburgh Healthcare System, ers, and 86% of 8- to 18-year-old chil- theory further suggests that individuals ex- Pittsburgh (Dr Fine). dren and adolescents have CD or MP3 posed to representations of substance use (REPRINTED) ARCH PEDIATR ADOLESC MED/ VOL 162 (NO. 2), FEB 2008 WWW.ARCHPEDIATRICS.COM 169 Downloaded from www.archpediatrics.com on February 5, 2008 ©2008 American Medical Association. All rights reserved. would be more likely to perform those behaviors them- cluded on more than 1 chart, only 279 unique songs com- selves if they are linked with (1) motivations that are rel- posed this sample. Additional popular charts, such as the “Adult evant, (2) associations that are desirable and familiar, and Top 40,” were also available, but these songs were not in- (3) consequences that are positive.16-18 Music is well- cluded in this analysis because we were primarily interested in known to connect deeply with adolescents and to influ- youth exposure to popular music. ence identity development, perhaps more than any other entertainment medium.19-22 CODING PROCEDURES In addition, prior work suggests that references to sub- stances of abuse in music are common. Several years ago, For each of the 279 songs, we coded multiple elements related to substance use. These measures were selected based on a com- a content analysis published by the Office of National Drug 23,24 prehensive search of prior relevant content analyses of me- Control Policy showed that multiple messages re- dia10,23,24,27 and inclusion of other measures based on the social lated to substance use are present in music lyrics and mu- cognitive theory (such as motivations for, associations with, sic videos. Of the top 1000 popular songs they studied, and consequences of substance use).16-18 Two coders familiar 18% referenced illicit drugs and 17% referenced alco- with popular music then independently analyzed the lyrics of hol.23 Another report24 found that, of 258 popular mu- each song for content related to each of the measures. Before sic videos, 20% verbally referenced illicit drugs and 37% the content analysis, each coder was given lists of frequently displayed alcohol. In every case, marijuana was the il- used substance use slang terms. 28 licit drug most commonly represented.23,24 We computed interrater agreement and statistics for each However, to our knowledge, no comprehensive con- of the data elements coded and found a minimum of 74% agree- ment for all variables. In all interrater disagreements, we used tent analysis of substance use in popular music lyrics has 2 new confirmatory coders (M.V.C. and A.A.A.) to indepen- been published in the peer-reviewed medical literature. Fur- dently code each of the items on which the previous coders did thermore, popular music is rapidly changing, and it has not agree (blinded to the prior responses). When the confir- been more than a decade since the previous data de- matory coders both agreed with 1 of the original coders, the scribed were collected. This is a particularly important coding of that individual was recorded. However, when the con- omission because popular music exposure is increasing firmatory coders disagreed with each other or agreed with each among young people.1 Finally, a more comprehensive and other but not with 1 of the initial coders, the item was dis- theoretically based content analysis may more com- cussed by the coders and the principal investigator of the project pletely capture relevant factors, such as the motivations, (B.A.P.) to achieve a consensus. associations, and consequences associated with sub- stance use in popular music. MEASURES The purpose of this study was to perform a compre- hensive content analysis of contemporary popular mu- General Measures and Determination sic, focusing on the presence and use of substance use of Primary Genre and on the motivations, associations, and consequences of substance use. Based on prior data,23-25 our a priori hy- We coded descriptive information related to each song from Bill- pothesis was that alcohol and marijuana would be more board’s records, including song title, artist, album, song length in minutes and seconds, sex of singer, and primary song genre. commonly represented than tobacco. We also hypoth- Because songs are often associated with more than 1 genre, we esized that representation of substance abuse would dif- used the following standardized approach to identify the pri- fer among genres, and that use would be commonly jux- mary genre. First, we determined its highest position at any time taposed with motivations, associations, and consequences on each of the Billboard charts we analyzed. All songs were as- likely to be deemed positive by adolescents. signed to a primary genre based on their highest ranking on a specialty chart, regardless of the ranking on the “pop” or “hot” charts. For example, Gwen Stefani’s song “Hollaback Girl” peaked METHODS at No. 1 on the pop 100 chart, No. 1 on the hot 100 chart, and No. 8 on the R&B/hip-hop chart and it was, therefore, classi- SAMPLE SELECTION fied as an R&B/hip-hop song. Only songs that never reached any specialty chart but did reach the pop and/or hot charts were de- We used Billboard magazine to identify the most popular songs fined as pop. We combined “modern rock” and “mainstream rock” of 2005.26 Billboard annually uses an algorithm that integrates because the line between these charts has become less distinct data from sales and airplay to determine the top songs accord- over the past 2 decades.