Do surgeon general warnings work? Experts weigh in.

Two stacked boxes of cigarette, Marlboro on top, Newport on bottom, showing surgeon general's warning labels on the side of their packages.
Surgeon general's warning labels appear on only a few harmful products in the U.S., including cigarettes. (James Leynse/Corbis via Getty Images)

Do surgeon general warnings work? That’s a question being asked after U.S. Surgeon General Dr. Vivek Murthy wrote a New York Times op-ed on Monday calling for such warnings — which would have to be approved by Congress — to be applied to social media platforms such as Instagram and TikTok.

“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,” Murthy wrote in his June 17 opinion piece.

These warnings, Murthy noted, would be akin to ones featured on cigarettes, which he cites as a model for stemming use of harmful products. But are those explicit warning labels actually effective? And would taking similar action against social media be successful? Here’s what experts say.

Surgeon general’s warnings are issued relatively rarely, reserved only for things that pose the most serious and well-established risks to human health, including drunk driving or drinking while pregnant. The associated labels are even less common, printed on only a handful of types of products, including alcohol and, most notably, tobacco products. Prescription medications, including opioids and antidepressants, carry similar “black box” warnings describing their dangers.

Most of the research on warning labels pertains to cigarettes. A multipronged attempt to reduce smoking rates and protect people from the diseases smoking causes is widely considered a success. These tactics have included regulations on advertising, restrictions on where smoking is allowed and price hikes, as well as a surgeon general’s warning label cautioning that smoking causes cancer and heart disease, which was required by law beginning in 1965.

Warning labels are pretty effective at informing people of the risks of cigarettes — as long as smokers notice them, according to one 2006 study that compared labeling policies in four different countries. According to a large 2021 study of smokers, warning labels had “a big effect on attention and motivation, but it didn’t actually [have] any behavioral effects,” John Pierce, one of the study’s authors and professor emeritus of public health at University of California, San Diego, tells Yahoo Life. He found that people tried to hide the habit from others when their cigarette packs featured a warning, but they didn’t actually smoke any less, or try any harder to quit.

A 2023 review of research on the effectiveness of similar warning labels on alcohol containers turned up mixed results, concluding that the labels “appear to be a promising approach for supporting more informed alcohol consumption.” But the study said where the labels appear and how they are designed matters and that they are still unlikely to solve the issue of dangerous drinking on their own.

What has worked, says Pierce, is placing strict limitations on how tobacco companies can advertise their products. “Since the Master Settlement Agreement with the tobacco industry” — a 1998 settlement that established these restrictions — “there’s been a massive decline in young people smoking cigarettes,” Pierce says. Smoking rates among teens and young adults declined from nearly 30% to about 5% between 1992 and 2022, according to another of Pierce’s studies (though he adds that e-cigarettes have been tobacco companies’ latest ploy to recapture some of the youth market).

So reducing young people’s use of dangerous products “can be done — there’s no question that you can change behavior,” Pierce says. “But just because there are going to be warnings doesn’t mean they’re going to be effective.”

Murthy himself acknowledged in his op-ed that warning labels alone aren't enough to “make social media safe for young people.” But, experts say, it’s a start — and if nothing else, it signals to the public that these harms are serious.

One challenge is that social media isn’t the same type of product as a pack of cigarettes or a can of beer. “Social media isn’t a concrete physical product; it’s a service and part of the digital world,” David Hammond, a professor of public health at the University of Waterloo in Canada, tells Yahoo Life. Vikram Bhargava, a professor of public policy at George Washington University, notes that even teachers sometimes give students assignments to be completed via social media, making it harder to escape.

“Many people think, intuitively, that the really serious kinds of addictions are the ones that you have to put directly in your body — by inhaling, ingesting or injecting — but the specific way that something brings about the brain changes [involved in addiction] doesn’t so much matter,” Bhargava says about social media's hold. He cites gambling, which is not a product but is nonetheless addictive. Slot machines don’t have warnings, but there are regulations to keep casinos from using them to manipulate players and then become more addictive, he says.

A warning label could at the least make kids and parents aware that social media is designed to keep their attention, the experts say. That message needs to be “sufficiently prominent,” not buried in the terms of service, says Hammond. He adds that his research has shown that these warnings are more effective when paired with supportive information, like toll-free help lines or links to online resources. And, Hammond says, enforceable age restrictions could help too — though, he adds, “all of us could benefit” from spending less time on social media .

The responsibility to keep kids from infinitely scrolling has thus far fallen mostly to parents, who have struggled to enforce rules, the experts say. “I don’t think a warning label will mean that kids will drop using [social media] for any length of time,” says Pierce. “Kids feel forced to use it.” But it could be a step toward changing things for parents. When parents try to limit their kids’ social media use, “kids will typically, from experience, say ‘no other parents are [restricting their kids from using it],'" Pierce says. "This will empower parents; it will give them a response to the kids: ‘It’s our duty to do this.'"