Lancet Series: harm of digital media to youth tied to app design; authors urge precautionary rules
Authors of a three-paper Lancet Series say design choices and weak rules, not willpower, drive heavy use. They rate the evidence of harm as low in certainty.
A group of public health experts has published a three-paper Series in The Lancet arguing that the harm digital media does to young people comes from business models, design choices and weak regulation, Earth.com reports. earth.com
Earth.comearth.comOpen source ↗ The Series was chaired by Professor Ilona Kickbusch of the Digital Transformations for Health Lab in Switzerland. The first paper was led by Dr. Jay Shaw of the University of Toronto. The authors call for action before cause and effect is proven.
Design and scale of use
Shaw and his co-authors write that infinite scroll, autoplay and personalized recommendation feeds are deliberate design choices that draw attention and collect data. By one estimate they cite, people who were online in 2025 spent on average 141 minutes a day on social media apps. A 2025 survey of more than 10,000 adults in the United States gave an average of more than 6 hours a day on phone apps.
The paper compares the technology industry with the tobacco and ultra-processed food industries, which, the authors say, worked to weaken regulation while their products harmed health. They describe current approaches to governing digital platforms as deeply insufficient to protect public health.
What the evidence shows and what is proposed
Heavy, addiction-like use is linked to poorer mental health, sleep and physical activity, Kickbusch said, but the evidence is not conclusive. The authors rate it low in certainty and describe the links as modest. earth.com
Earth.comearth.comOpen source ↗ Because so many children use digital media, she added, even small adverse effects could have significant public health consequences.
Most studies measure individual behavior such as screen time. Little attention has gone to structures such as algorithm-generated content and targeted advertising. Louise Holly, a Series author, said the most valuable data on how platforms affect users are held inside technology companies, which limits independent scrutiny.
Shaw's paper lists eight recommendations for researchers. They include auditing and publishing the practices of technology companies that harm health, and keeping industry money out of research. The Series calls for action at company, national and global levels at once. Companies would test new products and features for harm before release and share data with vetted public-interest researchers. A global treaty through the World Health Organization would set baseline standards. The authors also worked with a youth advisory group of six adults aged 23 to 30.
