At the heart of the Series lies a new umbrella review, itself a review of published reviews, covering data on nine million people under the age of 25 across 121 individual reviews. The analysis finds consistent associations between what the authors define as problematic digital media use and a range of adverse health outcomes for children, adolescents, and young adults. Crucially, the Series defines problematic use not by the sheer number of hours spent online, but by addiction-like patterns of engagement, in which digital media use becomes compulsive, displaces other activities, and proves difficult to control. Under this definition, problematic use is linked to a higher risk of common mental health problems, sleep problems, and reduced physical activity.

The picture is not uniformly negative. The umbrella review also identifies beneficial associations, including a link between moderate digital media use and higher wellbeing, and between active video game use and both higher wellbeing and healthier lifestyles. These findings underscore the authors’ insistence that the goal is not to demonise technology but to reshape the digital environment so that young people can benefit from online opportunities without substantial risk of harm. Digital media, as the Series frames it, encompasses the content people watch, make, or share online, the platforms through which it is delivered, and the devices used to access it, meaning that interventions can target any of these layers rather than treating screen time as a single undifferentiated exposure.

The authors are candid about the limitations of the evidence base. The certainty of the findings for both harms and benefits is rated low, and the associations between problematic use and health harms are modest in size, resting on observational data that cannot establish cause and effect. Series author Louise Holly of the Digital Transformations for Health Lab in the United Kingdom argues that this uncertainty is itself a product of the current system, noting that the most valuable data on how platforms actually affect users remain hidden within technology companies, limiting independent scrutiny and slowing scientific progress. A key recommendation of the Series is therefore that governments should require technology companies to share data on how their features affect users’ health with vetted public-interest researchers, and should provide the legal and technical infrastructure to make such sharing possible.

To illustrate what even a small individual risk could mean at population scale, the authors modelled the potential burden of high rates of digital media use combined with modestly elevated risks. Their estimates suggest that spending more than two hours a day on screens could be associated with roughly 2.8 million healthy years of life lost to depression and 240,000 healthy years lost to obesity worldwide each year. Dr Falk Müller-Riemenschneider of the National University of Singapore stresses that these projections are intended to be illustrative of the possible scale of harm rather than an accurate measurement, since they are based on low-certainty evidence, and that more research is needed to provide accurate estimates of health impacts at the population level. Even so, the arithmetic illustrates a core principle of public health: small risks applied across billions of users can translate into enormous burdens.

The Series places much of the responsibility not on users but on the architecture of the digital environment itself. Most digital platforms, the authors argue, are designed by companies to capture attention and collect data rather than to protect health. Features such as infinite scroll, autoplay, and personalised recommendation feeds are deliberate design choices engineered to maximise engagement, not accidents of technology that individuals can simply self-regulate away. Dr Jay Shaw of the University of Toronto calls for far more research into how these specific design choices influence the way people use technology, rather than continuing to investigate only the impact of how long people spend online. This reframing shifts the analytical focus from user behaviour to product design, echoing earlier public health battles over products engineered for dependence.

Indeed, the Series draws explicit parallels with tobacco and fossil fuels, arguing that technology companies are drawing on a well-worn corporate defence playbook to delay, weaken, or shape regulation in response to evidence that their products may harm health. Professor Barbara Prainsack of the University of Vienna describes the tactics as manufacturing doubt, discrediting critics, and framing regulation as a threat to freedom. A public health approach counters this, she argues, by assessing what the evidence suggests about harm across whole populations rather than what any single case can prove. Prainsack also contends that good regulation is not the enemy of innovation but a driver of good innovation, channelling it toward safety and trust, and that where regulation is absent, it does not mean a technology is ungoverned, only that companies rather than public policy are setting the rules.

On the policy side, the Series is emphatic that no single measure is sufficient. Age limits alone, a favoured tool of several national governments, cannot address the structural drivers of digital harm. Instead, the authors call for wide-ranging, coordinated action at the company, national, and global levels. Among their specific proposals are requirements that technology companies assess new products or features for harm before releasing them, analogous to pre-market safety testing in other industries, alongside mandatory data sharing with vetted researchers. They further propose a global governance treaty through the World Health Organization to set baseline standards, preventing weak regulation in one country from undermining progress elsewhere, and a dedicated international body to monitor harms to children and young people from artificial intelligence. The Series also highlights how litigation is emerging as a route to hold technology companies accountable, with Professor Ilona Kickbusch, the Series chair, noting that legal action can compel companies to disclose internal documents and shift the public conversation about responsibility for harm, though she cautions that litigation is not a substitute for regulation and should be considered one route to accountability among several.

The Series was informed by a Youth Advisory Group of six young adults aged 23 to 30, who worked with the authors to articulate aspects of lived experience that the research alone could not capture. Group member Dr Salman Fitrat Khan of India argues that the health risks associated with digital systems are preventable, and that with better governance and by empowering citizens, especially young people, to co-shape the digital systems around them, the online world can deliver connection, information, and opportunity without putting health at risk. His message to governments is blunt: they should not wait for perfect evidence before acting for this generation and the ones that follow.

Kickbusch, who leads the Digital Transformations for Health Lab in Switzerland, summarises the Series’ core claim in stark terms: digital media use is now woven into the fabric of childhood and young adult life, yet governments have allowed technology companies to write their own rules, producing business models built to capture attention and collect data with health treated as an afterthought. The evidence linking problematic use to poorer mental health, sleep, and physical activity may not be conclusive, she acknowledges, but in her view it justifies coordinated, global action on precautionary grounds. The Series, published as part of The Lancet’s examination of the digital determinants of health, signals a shift in the scientific and policy conversation, from debates about individual screen time toward a systems-level analysis of how digital environments are designed, regulated, and held to account. Whether governments respond with the coordinated framework the authors demand, or continue to defer to industry self-regulation, will determine whether the next generation inherits a digital world shaped for health or for profit.

Subject of Research: Digital media use and health impacts in children and young people

Article Title: The Lancet: Scale of young people’s digital media use and emerging evidence of harm justify action now, experts argue

Article References: The Lancet: Scale of young people’s digital media use and emerging evidence of harm justify action now, experts argue. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: digital media, young people, public health, The Lancet, mental health, screen time, technology regulation, platform design, sleep problems, physical activity, global governance, umbrella review