Analysis: The Fallacy of Health Warnings on Social Media, Porn

WASHINGTON—U.S. Surgeon General Vivek Murthy, a renowned medical doctor, announced earlier this week that he wants mental health warnings for social media platforms. In a guest essay published Monday by the New York Times opinion section, Dr. Murthy called on Congress to require public warning labels on the potential harm of social media platforms and their effects on young people.

Dr. Murthy is comparing the labeling for social media platforms to the mandatory labeling on cigarette or e-cigarette packaging.

"A surgeon general’s warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe," Murthy wrote in his Times essay, alluding to existing Surgeon General warnings' success with tobacco products.

"Legislation from Congress should shield young people from online harassment, abuse, and exploitation and from exposure to extreme violence and sexual content that too often appears in algorithm-driven feeds," Murthy continued.

Such a measure is similar to warning labels for porn websites as found in controversial age verification laws like Texas House Bill (HB) 1181. AVN has reported extensively on HB 1181

Adult industry trade group the Free Speech Coalition filed a lawsuit alongside the parent companies of the largest adult platforms in the world in federal court challenging HB 1181 and provisions in it requiring pseudoscientific public health labels about porn. A panel at the U.S. Fifth Circuit Court of Appeals, though upholding age verification measures in HB 1181, found the public health warnings requirement wasn't justified.

The lawsuit brought by the Free Speech Coalition and the parent companies has the Texas case, Free Speech Coalition et al. v. Paxton, pending before the U.S. Supreme Court.

That's beside the point, though. What stands out is concerns over public health labeling for not just adult entertainment platforms but also mainstream social media networks, like Meta Platforms-owned Facebook and Instagram.

To better understand the overlap of these issues, AVN reached out to several experts on the matter.

"Dr. Murthy’s proposed warning label will have absolutely no effect on social media usage," adult industry attorney Corey Silverstein told AVN. "His plan is nothing more than posturing, and the idea that a teenager is going to turn around and not enter a social media platform because of that warning defies logic." 

Silverstein added that he expects Murthy's call will not stand when tested against the First Amendment. Silverstein and other attorneys representing non-governmental organizations, including the Electronic Frontier Foundation and the Woodhull Freedom Foundation, filed an amicus brief in the FSC Supreme Court case indicating that any restrictions and limitations on speech, including labeling, violate the First Amendment.

"Unfortunately, in the current climate of government bodies worldwide attempting to sensor social media and free speech, I am not surprised that Dr. Murthy would make this proposal now when the climate is perfect for him," Silverstein added.

Dr. David J. Ley, a clinical psychologist and author of the book The Myth of Sex Addiction (2012), told AVN that comparing the health impacts of pornography versus social media is slightly different.

But not as different as one would think. In an email, Ley explained, "Different from pornography, there's substantial scientific research to support that social media does have a potential for a negative impact on teens, though there is no scientific consensus on who it affects and how. The use of such warning labels in online and electronic devices and how effective they could be is uncertain and frankly experimental.

"There are decades of research on health warning labels and what makes them effective with cigarettes, medicines, and alcohol," Ley added. "I'm a bit concerned that requiring such warning labels on social media would potentially require these companies to state things that are untrue or at least uncertain. If so, this would likely reflect potential First Amendment violations."

This is exactly what happened in the first round of judicial review pertaining to House Bill 1181 in August and September of last year.

Labeling requirements in HB 1181 were, in part, blocked by Senior U.S. District Judge David Alan Ezra of the Western District of Texas in a preliminary injunction blocking HB 1181. Ezra cited the lack of medical and scientific evidence for public health warnings for porn sites that operate in the Texas digital space. 

HB 1181 in its original form required adult sites to post warnings with the endorsement of the state’s public health and medical regulatory body, the Texas Health and Human Services Commission, in prominent typeface and font size at the top and bottom of adult websites.

“Although these warnings carry the label ‘Texas Health and Human Services,’ it appears that the Texas Health and Human Services Commission has not made these findings or announcements,” Judge Ezra pointed out in an order.

Later in that order, Ezra noted: "As a political, religious, and social matter, consumption of pornography raises difficult and intensely debated questions about what level and type of sexual exposure is dangerous or healthy. ... The government cannot compel a proponent of pornography to display a highly controversial ‘disclosure’ that is profoundly antithetical to their beliefs.” 

Judge Ezra cited Ley's declaration as an expert witness in the case and his work and research throughout much of the case, which was heard at the federal district level in Austin before being appealed by Texas to the Fifth Circuit.

"Included in Ley’s declaration are more than 30 psychological studies and metanalyses contradicting the state’s position on pornography," Ezra wrote, referring to Ley's declaration filed in support of the Free Speech Coalition.

In a similar manner, Dr. Nicole Prause, a neuroscientist and bioinformatics programmer at the University of California, Los Angeles, told AVN that Surgeon General Murthy is suggesting something that doesn't exist.

"There are no smoker's lungs, amputated toes, or similar that should have any impact on behaviors on a computer," Prause said. "Of course, there also is no data supporting the efficacy of text-only warnings for social media or pornography. These recommendations are not based on any science.

"I don't think as a scientist it's good to say something is 'impossible,' like 0 percent, but it appears very unlikely that social media will meet scientific criteria to call its use 'addictive,'" she declared when asked about whether any evidence supports claims that social media, like porn, is potentially addictive in the manner Murthy infers. "Calling something an addiction is a very high bar to meet, scientifically."