Breaking down social media use in children: Is it time for a warning label?

“It doesn’t have to be this way.”

This phrase often serves as a plea—begging for help. Begging for change. Begging for something to be done. You might have heard a disappointed parent or friend say it. And in 2023, the United States Surgeon General used it when discussing the problems with children’s social media use.

In his 2023 landmark report, Vivek Murthy, MD, the then-U.S. Surgeon General, sounded the alarm on the many risks of social media use among young people. On the heels of this, in June 2024, he amplified this distress signal when he published a powerful New York Times (NYT) opinion piece.

“It doesn’t have to be this way,” he said, mentioning how social media use is negatively affecting our youth, with large social media corporations not being transparent about sharing data and parents feeling tremendous anxiety about their children being on social media platforms.

Why a warning label is needed

This isn’t the first time a surgeon general has called for a similar label. In 1964—just 61 years ago—Luther Terry, MD, the U.S. Surgeon General at the time, also called for enactment of a warning label for American consumers. At this time, he was gravely concerned about cigarette smoking. His alarm sparked legislation requiring cigarette companies include various labels on their packaging, some of which include “Smoking can kill you,” “Cigarettes cause fatal lung disease” and “Tobacco smoke can harm your children”—all of which have been effective.

Now, the social media warning label is intended not for a small box of packaging, but for every social media platform—and should include information about how social media is associated with significant mental health harms for adolescents and has not yet been proven safe. Unfortunately, we’ve all seen or heard of some of these aforementioned mental health harms ourselves, whether firsthand or by passively reading the scrolling news ticker on our television screen—cyberbullying, anxiety, depression and eating disorders are just some of the issues running rampant.

As Dr. Murthy mentions in his op-ed, these mental health problems are being made even more difficult to address due to the lack of transparency from the large digital media companies. They are reluctant to share the data they continuously collect with independent scientists and the public. It seems like an impossible fight—going up against such powerful corporations—made even worse when it’s so severely affecting the youth of our nation. A warning label prior to creating an account, opening the app on our phones and/or increased parental transparency can help counteract this problem. For our children, it would be worth the effort.

Physical impacts

While bullying and other mental health crises are some of the major concerns about children being on social media, there are other unintended health problems that go along with it as well. For instance, prolonged screen time can lead to health issues in children. To ensure optimal brain development, the American Academy of Pediatrics (AAP) recommends that children under 18 months old have very limited screen time and that children ages 2-5 should have no more than one hour of screen time daily. For tweens and teens, the AAP doesn’t recommend a set time limit, but does encourage parents to have conversations with their children about their media use, who they are communicating with and what they have seen or read online.

In February, JAMA published a study with researchers finding the odds of myopia (nearsightedness) start to increase significantly with daily screen time of more than one hour, followed by “a notable rise in risk between one and four hours of exposure.” Additionally, another JAMA study of adolescents aged 15 and 16 years old found that high-frequency use of modern digital media was associated with increased odds of ADHD symptoms over a 24-month period, after studying the teens at their baselines. These are some of the unintended ripple effects that are taking place in our youth’s developing brains.

Social media and the internet in general have transformed our world as we know it, and there are now new things to be concerned about. Putting something online is like signing a binding, legal contract that your post will stay there forever—eternally accessible and nearly impossible to erase. Developing brains don’t always have the foresight to recognize this type of permanence.

When you inevitably happen to misspeak, spill a glass at a restaurant or otherwise embarrass yourself in public, you hope that your friends or the audience that witnessed it will go home and forget about it by the next morning. When this happens on the internet, the lasting nature and widespread dissemination of the embarrassing content can make the public humiliation feel all the more devastating.

As one of the first generations to grow up with social media, I can remember arguments and disagreements at school stemming from things people saw online the night before. A few choice words or fleeting thoughts said about you on the internet can make middle or high school—already a socially challenging time for many of us—feel like an unbearable experience.

Moving forward

In his NYT piece, Dr. Murthy clarifies that a warning label would not, on its own, make social media exclusively safe for young people. The warning label proposed would function as yet another safeguard against dangerous social media use, but it won’t fully absolve us of some of the underlying issues created from it. The underlying priority to tackle these issues should remain with our policymakers. The ideal legislation from Congress should not only shield children from abuse, exploitation and exposure to violent and sexual content, but also should “prevent platforms from collecting sensitive data from children and should restrict the use of features like push notifications, autoplay and infinite scroll, which prey on developing brains and contribute to excessive use.”

It’s important to recognize that the last time a law was passed to protect children on the Internet was 1998—a time predating the iPhone and social media—with the introduction of the Children’s Online Privacy Protection Rule (COPPA). All of this changed in 2024 when the Kids Online Safety Act (KOSA) passed in the Senate with overwhelming bipartisan support in a vote of 91-3. Even though the bill now awaits further action by the House before any change is enacted, the recognition and introduction of new, protective legislation is a great step forward.

Both Drs. Murthy and Terry raised their bright red warning flags high above the medical landscape, advocating for important public health concerns, sending stones flying through the glass houses of what the American people previously considered normal. Our “normal” must be adjusted when it is hurting our children, and now it’s time we demand safeguards from online media use in order to protect both current and future generations.

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