Exploring the influence of user-generated content on alcohol-related attitudes and behaviours among young people: A...

Alcohol-related content on social media, particularly user-generated content (UGC), is an increasingly normal feature of young people's digital lives and has been linked to increased alcohol use; however, a critical gap remains in understanding how different subgroups of young people are exposed to and engage with such content, and how this may be associated with their alcohol-related attitudes and behaviours. This systematic review aimed to synthesise evidence on the association between alcohol-related UGC and young people's alcohol-related attitudes and behaviours, and to describe patterns of exposure and engagement within subgroups of adolescents and young adults.

A systematic search was conducted in September 2023 and again in February 2026 across MEDLINE, PsycINFO, SocINDEX, EMBASE and CINAHL. Eligible peer-reviewed quantitative (cross-sectional and longitudinal), qualitative and mixed-methods studies described alcohol-related UGC (including influencer content); explored social media use; examined associations with alcohol-related attitudes, behaviours or harms; and focused on adolescents or young adults. A narrative synthesis was undertaken. This review was conducted in accordance with PRISMA guidelines, and quality assessment was conducted.

Forty-six studies met the inclusion criteria (24 cross-sectional, 14 longitudinal, seven qualitative, one mixed methods), with quantitative studies including 44 219 participants. Overall study quality was moderate, with limitations in sampling and non-response reporting. Among the quantitative studies examining alcohol-related UGC and behavioural outcomes (including alcohol use and intentions), most (n = 28/29) reported positive associations. These were observed across passive exposure, active engagement and combined measures, as well as across self, peer and influencer generated content. Subgroup findings (n = 22) indicated that associations varied across populations and contexts: adolescents, particularly those under 16, appeared more responsive to peer-generated content via social norms and online identity, while young adults in university settings were influenced by social and institutional contexts, including influencer content. Additional variation was observed among heavy social media users, non-drinkers and sex subgroups.

Exposure to alcohol-related user-generated content on social media (including peer and influencer generated content) and engagement with self-generated content appear to be associated with alcohol use among young people, with largely consistent findings observed across studies. Subgroup findings suggest these associations may vary across contexts and populations, particularly among younger adolescents, young adult university students, heavy social media users, non-drinkers and sex subgroups.