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The long-term health effects of too much television: whose responsibility?
  1. H M McAnally1,
  2. R J Hancox2
  1. 1Department of Psychology, University of Otago, Dunedin, New Zealand
  2. 2Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr R J Hancox, Department of Preventive & Social Medicine, University of Otago, Dunedin 9054, New Zealand; bob.hancox{at}

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Most people realise that too little physical activity is bad for our health. It is less well understood that this does not just mean insufficient physical exercise, but also spending too much time being sedentary. Watching television is among the most sedentary of behaviours, and yet, screen time is now the most common waking activity for many children and may even exceed the amount of time spent asleep for some children.1 ,2 Wennberg et al3 demonstrate, yet again, that too much time spent watching television can have long-term consequences for health. Wennberg and colleagues found that television viewing time in adolescence and early adulthood is associated with a higher risk of metabolic syndrome in mid-life. They confirm previous research that childhood and adolescence may be a particularly sensitive time for developing long-term risk of overweight, poor fitness and the metabolic syndrome.4 ,5

The analysis by Wennberg et al3 is important, because it emphasises that too much sedentary behaviour, such as television viewing, in childhood may have long-term consequences that are difficult to rectify by changes in adult behaviour. The question is what can we do about it? For more than two decades, organisations such as the American Academy of Pediatrics have advocated for a daily limit of 1–2 h of television a day in childhood.6 Even if parents are aware of these recommendations, this advice is routinely ignored.7 Should we be surprised? In 1950, Richard Doll wrote ‘The risk of developing carcinoma of the lung increases steadily as the amount smoked increases.’8 This was followed up by a damning report on smoking and health from the Royal College of Physicians, which was widely publicised.9 Over half a century later, we are still battling to reduce smoking rates. For much of that time, progress was painfully slow and it became clear that simply educating people about the fact the cigarettes are unhealthy was not enough to change health risk behaviours. It was not that people were unaware that smoking was bad for health—the fight against smoking required a much broader range of health promotion approaches, including tax policy and legislation changes, and still the battle is not over. Who is going to undertake this work for reducing children's screen time? Unlike the case for tobacco, there is no easy way to tax media consumption. Media industries have no incentive to encourage children to reduce their use. For parents, television and other digital media offer a convenient (and apparently safe) way to entertain their children, and children resist attempts to limit their screen time. Governments see technology as the key to economic progress and want children to become media-savvy ‘digital citizens’. Meanwhile, children and young people are exposed to more and more forms of electronic media with little regard to the long-term health consequences. Children of course, should not be expected to understand the risks and take long-term responsibility for their viewing habits, but childhood appears to be the time when excessive screen time does the most harm. Regulations do exist to reduce children's exposure to some forms of media content. Some countries, such as Sweden and Norway, have taken the laudable step to ban advertising to children, but today's media environment, where content can be broadcast from other countries or downloaded over the internet, greatly limits the impact that such regulations can have.

We know that too much screen time is bad for our health, we know that childhood and adolescence are particularly sensitive times for developing long-term metabolic risks, and we know that reducing sedentary behaviour has health benefits. What we need to do next is translate this knowledge into action. The governments of many countries have comprehensive strategies to reduce tobacco use. It would be a step in the right direction if researchers and public health practitioners began advocating for governments to adopt similar approaches to reducing excessive media consumption.



  • Contributors Both authors wrote the manuscript and approved the final version.

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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