Digital Advertising to Children.

Advertising to children and teenagers is a multibillion-dollar industry. This policy statement reviews the forms of advertising that children and teenagers encounter, including newer forms of digital marketing, such as sponsored content, influencers, data collection, persuasive design, and personalized behavioral marketing driven by machine learning. Parents and pediatric health care providers need to be aware of the ways different marketing messages reach children and teenagers, including Internet sites, social media, and mobile apps. Evidence suggests that exposure to advertising is associated with unhealthy behaviors, such as intake of high-calorie, low-nutrient food and beverages; use of tobacco products and electronic cigarettes; use of alcohol and marijuana; and indoor tanning. Children are uniquely vulnerable to the persuasive effects of advertising because of immature critical thinking skills and impulse inhibition. School-aged children and teenagers may be able to recognize advertising but often are not able to resist it when it is embedded within trusted social networks, encouraged by celebrity influencers, or delivered next to personalized content. This policy statement expresses concern about the practice of tracking and using children's digital behavior to inform targeted marketing campaigns, which may contribute to health disparities among vulnerable children or populations. Pediatricians should guide parents and children to develop digital literacy skills to prevent or mitigate negative outcomes, but it is equally important that policy makers and technology companies embrace digital design, data collection, and marketing practices within today's broad digital environment that support healthier decision-making and outcomes.