Frequent use of social media could be linked to harmful behaviours in children and young people, such as drinking, taking drugs, smoking and gambling, a new study has suggested.
Exposure to alcohol advertising on different platforms had the strongest evidence of harm, researchers said.
A team from the University of Glasgow, the University of Strathclyde and Public Health Scotland examined the impact of social media on young people aged 10 to 19.
They looked at data from 73 studies carried out between 1997 and 2022, comprising 1.4 million teenagers with an average age of 15.
The analysis found daily social media use was associated with the likelihood of drinking alcohol (48%), drug use (28%) and smoking (85%) compared with infrequent users.
In terms of alcohol use, researchers identified stronger associations in people aged 16 and older, with those spending at least two hours a day on social media doubling the odds of drinking compared with people who spend less than two hours a day on the platforms.
Smoking and tobacco use was more frequent in low- to middle-income countries compared to high-income countries.
Researchers acknowledged that the findings, published in the BMJ, could also be influenced by unmeasured factors such as the behaviour of parents.
They added that, while social media use "is associated with adverse health risk behaviours in young people", further research is needed to "establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful".
Frequent social media use was also linked to "risky sexual behaviours", researchers said, such as sexting, transactional sex and inconsistent condom use (77%).
Those who were on the platforms daily were also more likely to engage in anti-social behaviour and were also more likely to gamble.
The team said "experimental and risk-taking behaviours are an inherent part of adolescence" and "safeguards for a digital world are still evolving".
"Precaution across academic, governmental, health and educational sectors may be warranted before the risks of adolescents' use of social media is fully understood," they added.