What’s the evidence for the surgeon general’s proposed social media warning?

United States Surgeon General Vivek Murthy wants to add a warning label on social media. “It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents,” he wrote in an op-ed published on Monday in the New York Times, calling on Congress to take action to add the warning, which would be along the lines of the ones issued against tobacco and alcohol consumption.

Last year, Murthy published an advisory to help parents navigate children’s social media use. At the time, while concluding that “there isn’t enough evidence that it is safe for our kids,” Murthy also acknowledged in an interview with STAT that social media has some benefits, calling to “maximize the benefits and minimize the harms.”

His call to action on Monday was more strident, garnering praise from advocates of stricter social media controls, especially for young people. “Yes, this is a consumer product that is unsafe for children and teens,” wrote NYU social psychologist Jonathan Haidt, a strong proponent of limiting phone time, on X.

But for several experts operating in this field, the type and extent of social media harm exacted on children isn’t quite as clear as Murthy seems to suggest. Indeed, said Michaeline Jensen, a psychologist at the University of North Carolina, Greensboro, there isn’t sufficient evidence to conclude social media is safe — but there isn’t enough to conclude the opposite, either.

“The op-ed by Dr. Murthy really just says that social media is associated with significant mental health harms for adolescents, which feels like a very sweeping statement,” said Jensen, “given that the actual research evidence on this question is far from compelling to support that strong of a statement.”

Candice Odgers, a psychologist at the University of California, Irvine, whose research focuses on the impact of social media on youth, said about 90% of studies in her area have been correlational. They “simply cannot answer the question on everyone’s mind, ‘does social media cause mental health problems in our kids?’” she wrote in a statement shared with STAT. The National Academies of Science agreed, publishing in a 2023 report that “available research that links social media to health shows small effects and weak associations… Contrary to the current cultural narrative that social media is universally harmful to adolescents, the reality is more complicated.”

Justifying the broader climate of skepticism and fear around social media, there are areas in which it has been shown to cause potential harm, said Jensen: cyber bullying, exposure to racism and discrimination, sleep and attention disruptions related to screen time, and social comparison, especially in matters of physical appearance, which can worsen eating disorders.

But there is also fairly strong evidence for some benefits, she said. “To the extent that young people are engaging on social media for online social interactions, social support, or information seeking around health conditions, those can be beneficial experiences — especially for young people who are otherwise isolated or stressed out in their offline lives,” said Jensen.

Asking teens themselves how they feel about social media doesn’t return a picture of doom: A 2023 survey from the Pew Research Center found that 32% of teens said social media platforms had “mostly positive” impact on their life, and only 9% said it had a negative impact.

Would a warning be able to capture the nuance of this research, Jensen wonders, or just capture the downsides? “I don’t know if they can have a three-paragraph surgeon general’s warning that could get at this nuance,” she said. The advisory Murthy published last year, she said, was far more specific, and easier to support, pointing to needs for sexual content warnings, privacy protection, or auditing from outside researchers.

“There’s certainly plenty of research suggesting that the surgeon general’s warnings on things like alcohol and tobacco did work,” said Jensen. “Those were some of the most effective public health interventions that we’ve had.” But the reason they were so effective, she said, is that there was exceedingly strong evidence to support the warnings. A weaker evidence base for a social media warning could even end up compromising the power of warning labels in the future.

Some researchers on X to the op-ed agreed, including Pete Etchells, a professor of psychology and science communications at Bath Spa University and the author of Unlocked: The Real Science of Screen Time. He posted that the warning “sets dangerous precedent, and is a good reminder that the urgency of wanting to ‘do something now’ makes evidence-based approaches all the more important.”

Teens certainly seem to be aware of the risks of social media. In the same Pew poll, when asked what they thought was the impact on their peers, teens reported less positive effects and more harmful ones. “I don’t know that there’s a young person out there who doesn’t know that people are saying that it’s harmful,” said Jensen.