3 ) exposure to depictions of degrading sexual activity through music and sexual activity in adolescents (Martino et al., 2006; Primack, Douglas, Fine, & , and (4) exposure to violence in the media and aggressive behaviors in adolescents (American Academy of Pediatrics & Council on Communications and Media, 2009b). While limited data are available linking exposure to health-risk behaviors portrayed in music lyrics to certain adolescent health-risk behaviors (i.e., alcohol use and violence), the Social Learning Theory supports the association of exposure to music lyrics portraying health-risk behaviors in an appealing and familiar manner, and health-risk behaviors in adolescents (Glanz K, Rimer BK, & Lewis FM, 2002; Primack, Dalton, Carroll, Agarwal, & Fine, 2008). Hence, it is important to understand the prevalence and nature of health-risk behaviors in the popular media to which adolescents are exposed. The opportunity for adolescent exposure to health-risk behaviors through music media is pronounced. Adolescents aged 15 to 18 years listen to an estimated 3.0 hours of music per day and the increasing use of personal listening devices lessens the ability for parents to monitor the music to which their children are listening (Rideout V, Roberts D, & Foehr U, 2010). Over 75% of children aged 8 to 18 years own a MP3 player and nearly two-thirds of time spent listening to music is spent using a cell phone, MP3 player, or computer (Rideout V et al., 2010). Furthermore, only 26% of children report having rules about types of music choices and 10% about how much time is spent listening to music (Rideout V et al., 2010). The popularity of country music with an estimated audience size of 98 million US residents (Country Music Association, 2012), combined with easier access to music and lyrics through modern technology has resulted in adolescents having more opportunities for exposure to country music than in the past. Compared with other music genres (e.g., rap, hiphop, rock) ( Christenson P, 1999). Thus, it is important to understand better the lyrical content of country music and its potential effects on child and adolescent health. Two previous studies analyzed the written lyrical content of the 279 most popular songs in 2005, including 61 country music songs, and showed that approximately 40% of the country music songs analyzed had references to substance use and nearly one-third to sex Primack, Gold, et al., 2008). However, a content analysis of 212 top-rated country music songs from 1996 and 1997 found that only 14 percent of country music songs had substance use references (Roberts D et al., 1999). An analysis of 111 country music videos in 1994 showed that 10.8% portrayed violence and 6.3% referred to weapon carrying (DuRant et al., 1997). The purpose of this study was to analyze the most popular country music songs from 2001 to 2010 for references to health-risk behaviors, including substance use, sex, violence, and use of weapons. We hypothesized that references to health-risk behaviors were frequent and consistently present in popular country music songs from 2001 to 2010. # II. # Methods # Bob Kingsley's Country Top 40 (http://www.ct40.com/) was used to identify the 30 highest rated country music songs for each year from 2001 to 2010. Country Top 40 is a weekly syndicated radio show that plays the week's top rated music songs based on radio station airplay in 180 US and Canadian radio markets (Wikipedia, 2012a(Wikipedia, , 2012b)). This study did not use human subjects; therefore, the study was not subjected to human subjects review. # a) Coding procedures A six-person team was trained in observation methods that included instructions for detecting references to substance use, sex, violence, and weapons. For each of the 300 songs, four initial investigators (KG, RH, AS, and a non-author) listened independently to MP3 recordings and used a standardized data collection instrument to record multiple elements relating to substance use, sex, violence, and weapons as previously described Primack, Gold, et al., 2008). MP3 recordings were used for this analysis to garner undergraduate student (KG, RH, AS) interest in the epidemiology process and to simulate typical adolescent exposure to music lyrics. Investigators could listen to each song an unlimited number of times to collect the data. Observations were counted if ?3 investigators noted the reference. If just two investigators noted a specific reference, the song was then reviewed independently and in a blinded manner by the two remaining investigators (RT, JL). The reference in question was then counted if both of the second-level reviewers noted the reference; otherwise, the reference was not counted. Only the four initial investigators counted the number of references to health-risk behaviors; the number of references was not confirmed by the two remaining investigators. # b) Measures and analysis Descriptive information for each song was recorded and included the singer, singer's sex (male, female, or both if duo or group), song title, song length, year song appeared on the chart, and chart ranking. We coded any reference to explicit substance use (i.e., alcohol, tobacco, marijuana, and other illicit drugs), figurative substance use (i.e., not explicit substance use or substance use mentioned in form of a simile), places associated with substance use (e.g., "honky tonk", bar, etc.), and "wallpaper" reference to substance use (i.e., substance mentioned in the background but not explicit or figurative substance use) (Table 1) . For each song with explicit substance use, we recorded the number of references for alcohol, tobacco, marijuana, and other illicit drugs . For songs with substance use in the chorus, we recorded each mention of substance use as a separate reference . The number of references we reported for each substance was determined by taking the average number of references noted by those observers who reported references to explicit substance use . Investigators also noted any reference to sex, including any innuendos (Table 1). Songs were coded as having no references to violence, references to threats of or actual bodily harm, or references to threats of or actual loss of life because of violence (DuRant et al., 1997). Songs were coded as having no references to weapons, references to one weapon, or references to either two or more weapons or to at least one weapon used in a violent act (DuRant et al., 1997). A review of written lyrics for only those songs originally detected as having references to substance use, sex, and/or weapons was conducted by two observers (RT and a non-author). When there was disagreement, the song was discussed to achieve consensus. Songs were coded as having the presence of either substance use-related positive, negative, or neutral consequences for the song's character. Songs were coded as having risky sexual activity if the lyrics described a casual or promiscuous sexual encounter, the sexual reference was associated with substance use, or at least one person mentioned was objectified. Additionally, songs were coded as having degrading sexual activity if all of the following criteria were met: a) at least one person mentioned had a large sexual appetite, b) at least one person mentioned was objectified, and c) sexual value was placed on a person solely for physical characteristics (Primack, Gold, et al., 2008). Songs were coded as having references to weapons being used in legal activities (e.g., hunting) or illegal activities (e.g., murder). Kappa values were calculated to assess interobserver reliability (King J, 2004). Fischer's exact or ?2 analysis was used to assess for differences between proportions and a two-sample t test to compare means. Statistics were calculated using OpenEpi (Dean AG, Sullivan KM, & Soe MM). # III. # Results The four initial observers observed 300 songs, totaling 19 hours and 21 minutes. The average song length was 3.9 minutes. The kappa values for interrater agreement between each reference category were 0.80 for explicit substance use, 0.30 for figurative substance use, 0.71 for places associated with substance use, 0.72 for "wallpaper" reference to substance use, 0.39 for sex, 0.35 for violence, and 0.24 for weapons. The second level reviewers reviewed 44 (15%) of the 300 songs. One-hundred (33%) songs had at least one reference to substance use, sex, violence, and/or weapons use. Additionally, song titles also contained references to health-risk behaviors (alcohol = 8, sex = 1, and weapons = 1). The percentage of songs per year with references to health-risk behaviors ranged from 17% to 43% (Figure 1). Songs with references to healthrisk behaviors had a mean chart ranking of 13.9 compared with 16.3 for songs without (p = .02). a) Substance use Seventy (23%) songs had at least one substance use (i.e., explicit, figurative, places, or "wallpaper") reference (Table 2). Of these, 64 had references to explicit substance use, 11 to figurative substance use, 17 to places associated with substance use, and two with "wallpaper" references. Overall, 13.4 alcohol use references occurred per hour of songmusic. Among those songs with explicit substance use references, there were means of 3.7 references per song and 57.5 references per hour of song-music. Additionally, 0.7 tobacco references per hour of songmusic were observed. Two songs were noted to have references to substances other than alcohol, tobacco, or marijuana. No songs were observed to have marijuana references. Songs with substance use references were more likely to have positive consequences (n=47, 67%) associated with substance use compared with negative consequences (n=17, 21%). # b) Sex Twelve percent of the songs analyzed had sexual references (Table 2). The percentage of songs with sexual references by year ranged from 3% to 23%. Songs with sexual references were more likely to contain references to substance use (47%) compared with songs without sexual references (20%) (odds ratio [OR] = 3.6, 95% confidence interval [CI] = 1.7-7.3). Twentythree (64%) of the songs with sexual references (8% of all songs analyzed) had references to risky sexual activity and 4 (11%) to degrading sexual activity. # c) Violence and weapons References to violence and weapons were not common. Eleven (4%) songs had references to violence; of these, 2 had references to threats of or actual loss of life to violence, and 9 had threats of or actual bodily harm. Five songs had references to both violence and substance use. Seven (2%) songs had references to weapons use. Of these, 3 had references to either two or more weapons or to at least one weapon being used in a violent act, and 4 had references to one weapon. Two songs had references to both weapons use and substance use. Six (86%) of the songs with references to weapons referred to legal use of weapons. Only 1 of the 300 songs analyzed referred to illegal use of weapons. # d) Artist characteristics Eighty-nine artists had songs in this analysis. Duets comprised of two solo artists were counted as a unique artist and separate from each solo artist. The median number of songs per artist was 2 (range: 1-21). Two-hundred forty-six (82%) songs were performed by male vocalists, 41 (14%) by female, and 13 (4%) by both male and female. Male artists were more likely to have songs with references to substance use, sex, violence, and/or weapons use compared with female artists (OR = 3.3, 95% CI = 1.3-8.2). There were no significant differences when comparing male and female artists for each health-risk behavior individually. Songs performed by the three artists with the most songs in this analysis (n=52, 17.3%) were more likely to have references to substance use, sex, violence, and/or weapons use compared with songs performed by other artists (OR = 2.6, 95% CI = 1.4-4.8). a The top 30 rated country music songs as ra In the present study, 12% of all songs analyzed had sexual references. The use of subtle and sexually suggestive innuendos (Table 1 al., 2009). Increased viewing of television and music videos was also associated with drinking in adolescents (Robinson et al., 1998). While a single pilot study showed exposure to music lyrics with alcohol references ated with increased alcohol sales among adults in a bar setting (Engels, Slettenhaar, ter Bogt, & Scholte, 2011), the impact on adolescent behavior following exposure to alcohol use portrayed in music lyrics is less understood and in need of further research. In our study, over 13 references to alcohol occurred per music, and the majority of songs with substance use references were associated with positive consequences. Furthermore, 23% of the songs analyzed had references to substance use compared with only rated country music songs in 1996 and 1997 (Roberts D et al., 1999), suggesting references to substance use are not decreasing in frequency over time. This is in contrast with movies where the percentage of tobacco use incidents depicted in topgrossing movies decreased 56% from 2005 to 2010 (Centers for Disease Control and Prevention, 2011). In the present study, 12% of all songs analyzed had sexual references. The use of subtle and sexually suggestive innuendos (Table 1) in country music made it particularly difficult to detect sexual references in this study. The subtleness of many of these references might account for the low interobserver rating ( However, these same studies did not find a statistically significant association between exposure to non-degrading sex in musical lyrics and adolescent sexual activity. Only 11% of songs in this analysis had references to degrading sex; however, country music has previously been associated with lyrics depicting degrading sex. An analysis of 61 country music songs from 2005 found that nearly one-third of songs with references to sex had degrading sexual references . However, 64% of the songs with sexual references in this analysis had references to risky sexual activity. Considering the public health importance of early adolescent sexual activity, further study is required to determine if exposure to nondegrading sexual lyrics, including those with risky sexual activity, is associated with sexual activity in adolescents. In this study nearly one-half of the songs that contained sexual references also had references to substance use, and songs with sexual references were more likely to contain references to substance use compared with songs without sexual references. This is especially troubling as the use of alcohol has been associated with date or acquaintance rape (Rickert, Wiemann, & Vaughan, 2005). Further investigation is warranted to study the impact on behavior resulting from exposure to musical lyrics containing references to both substance use and sex (Primack, Gold, et al., 2008). Only 4% of the songs analyzed had references to violence and 2% to weapons use. The frequency of these references is less than for a previous analysis of 111 country music videos in 1994 (DuRant et al., 1997). Additionally, 6 of the 7 songs with weapons use portrayed legal use of weapons. Artist characteristics appear to be associated with the presence of references to health-risk behaviors in their songs. Male artists were more likely than female artists to have references to health-risk behaviors. In addition, the three artists with the most songs in this analysis, accounting for over 17% of the songs analyzed, had a higher proportion of songs with references to health-risk behaviors compared with all the other artists combined. A song's chart ranking is associated with the frequency of radio airplay (Wikipedia, 2012a(Wikipedia, , 2012b)). A more popular song reaches a larger radio audience a greater number of times, translating to an increase in song-hours. Among all songs studied, the mean chart ranking was significantly higher for those with at least one reference to a health-risk behavior compared with songs without a reference. Based on this analysis, it is unknown whether the use of references to health-risk behaviors contributes to a song's or artist's popularity. Additionally, when adolescents are exposed to songs with references to health-risk behaviors, it is unclear how the artist's sex or popularity influences behavior independent of the reference used. In 1989, the American Academy of Pediatrics (AAP) published recommendations that the music video industry should show self-restraint regarding depictions in the videos they produce (American Academy of Pediatrics & Committee on Communications, 1989). The AAP later published recommendations that music performers should serve as positive role models (American Academy of Pediatrics & Council on Communications and Media, 2009a). Even though the AAP has long recognized the negative influences the media can have on adolescent behavior and has advocated for more responsible musical content, the proportion of top rated country music songs with references to substance use, sex, violence, and/or weapons did not decline during this study and actually increased in years 2007 to 2010 compared with years 2001 to 2002. It is evident that continued and intensive advocacy towards the country music industry is needed to reduce the frequency of references to health-risk behaviors with the intention of lessening the possibility for negative impact on adolescent behavior. This study had several limitations. First, while observers were trained in ways to detect references to substance use, sex, violence, and weapons use, it was not possible to provide a comprehensive list of obscure, slang, or brand-related terms and phrases. This might have led to an underreporting of health-risk behaviors in this analysis. Second, the number of individual references to substance use was not confirmed through an analysis of written lyrics. Had we performed a separate analysis of written lyrics for this purpose, the number of individual references noted through listening could have been confirmed and a higher number of references to substance use might have been detected. Third, the interobserver reliability for sex, violence, and weapons use was low. However, because a secondlevel review by two blinded and independent observers was required for all songs with references noted by only two initial observers, the specificity for the references detected was likely high. Finally, these findings might not be generalizable to all country music songs as this analysis was limited to the 30 top rated country music songs from each year. It is possible that less popular songs had either a lower or a higher proportion of songs with references to health-risk behaviors. V. # Conclusion In summary, references to substance use and sex occurred commonly in popular country music from 2001 to 2010. The average adolescent aged 15 to 18 years listening to top-rated country music is exposed daily to at least 40 alcohol references. Additional research is warranted to determine the impact on adolescent health that is associated with exposure to health-risk behaviors portrayed in the lyrics of country music and other music genres. Parents, healthcare providers, public health practitioners, and school officials should be aware of the music to which children are listening (American Academy of Pediatrics & Council on Communications and Media, 2009a). Local healthcare providers and public health practitioners should work with their local school systems to incorporate media education into their curricula (American Academy of Pediatrics & Committee on Public Education, 1999). When possible, efforts should be undertaken to limit the exposure of adolescents to music with lyrics that portray health-risk behaviors, particularly alcohol use (Institute of Medicine, 2004), in an appealing way. Furthermore, country music artists should serve as role models for adolescents (American Academy of Pediatrics & Council on Communications and Media, 2009a) and the country music industry should consider the consequences of lyrics that could negatively influence adolescent behavior. # VI. Volume XIV Issue II Version I 87 ( H ) "Write a love song that makes you cry/Then turn right around, knock some jerk to the ground/'Cause he copped a feel as you walked by" Threats of, or actual loss of life "Take all the rope in Texas and find a tall oak tree/Round up all of them bad boys, hang them high in the street/For all the people to see" ![xposure to health-risk behaviors portrayed in popular media has been associated with healthrisk behaviors in children and adolescents (American Academy of Pediatrics & Committee on Public Education, 1999; American Academy of Pediatrics & Council on Communications and Media, 2009a, 2009b; Strasburger, American Academy of Pediatrics, & Council on Communications Media, 2010). Examples of these associations include: (1) exposure to tobacco and alcohol use through the media and smoking and drinking initiation in adolescents (Dalton M. A. et al., 2009; Dalton et al., 2003; Robinson, Chen, & Killen, 1998; Sargent et al., 2005; Sargent et al., 2004; Thompson & Gunther, 2007; Wills, Sargent, Gibbons, Gerrard, & Stoolmiller, 2009), (2) exposure to marijuana references in popular music and marijuana use in urban ninth-grade students (Primack, Douglas, & Kraemer, 2010), (](image-2.png "Introduction") ![study, we evaluated the proportion of top-rated country music songs from 2001 to 2010 with references to health-risk behaviors. Notwithstanding abundant evidence showing an association between exposure to health-risk behaviors through popular media and health-risk behaviors in adolescents (American Academy of Pediatrics & Committee on Public Education, 1999; American Academy of Pediatrics & Council on Communications and Media, 2009a, 2009b; Dalton M. A. et al., 2009; Dalton et al., 2003; Martino et al., 2006; Primack et al., 2009; Primack et al., 2010; Robinson et al., 1998; Sargent et al., 2005; Sargent et al., 2004; Strasburger et al., 2010; Thompson & Gunther, 2007; Wills et al., 2009), one-third of the top rated country music songs in this analys references to substance use, sex, violence, and/or weapons use. This has theoretically important implications for adolescents who prefer country music because adolescents typically listen to a small range of music genres (Rideout V, Roberts D, & Foe Alcohol use is among the leading causes of morbidity in adolescents and a serious public health problem (Hingson, Heeren, Winter, & Wechsler, 2005; Mulye et al., 2009). Nearly 40% of all adolescents in grades 9 to 12 are current drinkers and approximately 22% are binge drinkers (Eaton et al., 2012). Consequently, it is important to understand the underlying factors contributing to adolescent drinking. Exposure of adolescents to alcohol use in the movies has been associated with onset of drinking in adolescents (Wills et The top 30 rated country music songs as rated by Bob Kingsley's Country Top 40 (http://www.ct40.com/). In this study, we evaluated the proportion of rated country music songs from 2001 to 2010 with risk behaviors. Notwithstanding abundant evidence showing an association between risk behaviors through popular risk behaviors in adolescents (American Academy of Pediatrics & Committee on Public Education, 1999; American Academy of Pediatrics & Council on Communications and Media, 2009a, 2009b; Dalton M. A. et al., 2009; Dalton et al., al., 2006; Primack et al., 2009; Primack et al., 2010; Robinson et al., 1998; Sargent et al., 2005; Sargent et al., 2004; Strasburger et al., 2010; Thompson third of the toprated country music songs in this analysis had references to substance use, sex, violence, and/or weapons use. This has theoretically important implications for adolescents who prefer country music because adolescents typically listen to a small range of music genres (Rideout V, Roberts D, & Foehr U, 2005). Alcohol use is among the leading causes of morbidity in adolescents and a serious public health problem (Hingson, Heeren, Winter, & Wechsler, 2005; Mulye et al., 2009). Nearly 40% of all adolescents in grades 9 to approximately 22% are binge drinkers (Eaton et al., 2012). Consequently, it is important to understand the underlying factors contributing to adolescent drinking. Exposure of adolescents to alcohol use in the movies has been ng in adolescents (Wills et al., 2009). Increased viewing of television and music videos was also associated with drinking in adolescents (Robinson et al., 1998). While a single pilot study showed exposure to music lyrics with alcohol references was associated with increased alcohol sales among adults in a bar setting (Engels, Slettenhaar, ter Bogt, & Scholte, 2011), the impact on adolescent behavior following exposure to alcohol use portrayed in music lyrics is less understood and in need of further resear In our study, over 13 references to alcohol occurred per hour of song-music, and the majority of songs with substance use references were associated with positive consequences. Furthermore, 23% of the songs analyzed had references to substance use comp 14% of the top-rated country music songs in 1996 and 1997 (Roberts D et al., 1999), suggesting references to substance use are not decreasing in frequency over time. This is in contrast with movies where the percentage of tobacco use inciden grossing movies decreased 56% from 2005 to 2010 (Centers for Disease Control and Prevention, 2011).](image-3.png "") ![) in c particularly difficult to detect sexual references in this study. The subtleness of many of these references might account for the low interobserver rating (Bryington AA, Palmer DJ, & Watkins MW, 2004) for sexual references. Previous studies have demonstrated the association between exposure to degrading sex in musical lyrics and initiation of sexual activity in adolescents (Martino et al., 2006; Primack et al., 2009). ted by Bob Kingsley's Country Top 40 (http://www.ct40.com/).](image-4.png "") ![Bryington AA, Palmer DJ, & Watkins MW, 2004) for sexual tudies have demonstrated the association between exposure to degrading sex in musical lyrics and initiation of sexual activity in adolescents (Martino et al., 2006; Primack et al., 2009).](image-5.png "") 1![Fig.1 : Percentage of songs with references to none, one, or two or more different categories of health (i.e., substance use, sex, violence, or weapons use) in popular country music Percentage of songs with references to none, one, or two or more different categories of health (i.e., substance use, sex, violence, or weapons use) in popular country music Percentage of songs with references to none, one, or two or more different categories of healthrisk behaviors (i.e., substance use, sex, violence, or weapons use) in popular country music a](image-6.png "Fig. 1 :") ![y'all run along and have some fun/I'll see you when you get back/Bet I'll be up all night/Still cleaning this gun" Weapon used in violent act "I dug my key into the side/Of his pretty little souped-up 4 wheel drive/Carved my name into his leather seat/I took a Louisville Slugger to both head lights/Slashed a hole in all 4 tires" Volume XIV Issue II Version I 88 ( H )](image-7.png "") Westerwick S, Musto P, & Shaw K, 2008; Sloane,Wilson, &EAuthorAuthorChristenson, Roberts, & Bjork, 2012; Gruber,Thau, Hill, Fisher, & Grube, 2005; Herd, 2005; Knoblach- 1 2Reference typeExample Lyrics bSubstance useExplicit use"I'ViolenceThreats of, or actualbodily harm © 2014 Global Journals Inc. (US) ## Acknowledgments Reference category * Impact of rock lyrics and music videos on children and youth American Academy of Pediatrics, & Committee on Communications 83 2 1989 Pediatrics * Media education American Academy of Pediatrics, & Committee on Public Education 104 1999 Pediatrics * Policy statement-Impact of music, music lyrics, and music videos on children and youth American Academy of Pediatrics, & Council on Communications and Media 124 5 2009a Pediatrics * Policy statement-Media violence American Academy of Pediatrics, & Council on Communications and Media 124 5 2009b Pediatrics * The estimation of interobserver agreement in behavioral assessment AABryington DJPalmer MWWatkins J Early Intensive Behav Interv 1 1 2004 * Smoking in top-grossing movies-United States Centers for Disease Control and Prevention 60 27 2011. 2010 MMWR * PChristenson DFRoberts NBjork Booze, drugs, and pop music: trends in substance portrayals in the billboard top 2012. 1968-2008 100 * Connect with country 2012 * Accessed January 15. 2013 * Early exposure to movie smoking predicts established smoking by older teens and young adults MADalton MLBeach AMAdachi-Mejia MRLongacre ALMatzkin JDSargent Pediatrics 123 4 2009 * Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study MADalton JDSargent MLBeach LTitus-Ernstoff JJGibson MBAhrens Lancet 362 9380 2003 * AGDean KMSullivan MMSoe Openepi June 23, 2011 * Violence and weapon carrying in music videos. A content analysis RHDurant MRich SJEmans ESRome EAllred ERWoods Arch Pediatr Adolesc Med 151 5 1997 * Youth risk behavior surveillance-United States DKEaton LKann SKinchen SShanklin KHFlint JHawkins MMWR Surveill Summ 61 4 2012. 2011 * Effect of alcohol references in music on alcohol consumption in public drinking places RCEngels GSlettenhaar TTer Bogt RHScholte Am J Addict 20 6 2011 * Health behavior and health education KGlanz BKRimer FMLewis 2002 Jossey-Bass San Francisco 3rd ed. * Alcohol, tobacco and illicit substances in music videos: a content analysis of prevalence and genre ELGruber HMThau DLHill DAFisher JWGrube J Adolesc Health 37 1 2005 * Changes in the prevalence of alcohol use in rap song lyrics DHerd Addiction 100 9 2005 * Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24: changes from RHingson THeeren MWinter HWechsler Annu Rev Public Health 26 2005. 1998 to 2001 * Reducing underage drinking-a collective responsibility 2004 Washington D.C * Software solutions for obtaining a kappa-type statistic. Paper presented at the 27th Annual Conference of the Southeast Educational Research Association JKing 2004 Dallas, TX * Rebellion in the top music charts-defiant messages in rap/hip-hop and rock music 1993 and SKnoblach-Westerwick PMusto KShaw Journal of Media Psychology 20 2008. 2003 * Exposure to degrading versus nondegrading music lyrics and sexual behavior among youth SCMartino RLCollins MNElliott AStrachman DEKanouse SHBerry Pediatrics 118 2 2006 * Trends in adolescent and young adult health in the United States TPMulye MJPark CDNelson SHAdams CEIrwin Jr CDBrindis J Adolesc Health 45 1 2009 * Content analysis of tobacco, alcohol, and other drugs in popular music BAPrimack MADalton MVCarroll AAAgarwal MJFine Arch Pediatr Adolesc Med 162 2 2008 * Exposure to sexual lyrics and sexual experience among urban adolescents BAPrimack ELDouglas MJFine MADalton Am J Prev Med 36 4 2009 * Exposure to cannabis in popular music and cannabis use among adolescents BAPrimack ELDouglas KLKraemer Addiction 105 3 2010 * Degrading and non-degrading sex in popular music: a content analysis BAPrimack MAGold EBSchwarz MADalton Public Health Rep 123 5 2008 * Disclosure of date/acquaintance rape: who reports and when VIRickert CMWiemann RDVaughan J Pediatr Adolesc Gynecol 18 1 2005 * Generation M: media in the lives of 8-to 18-year-olds VRideout DRoberts UFoehr 2005 Kaiser Family Foundation Menlo Park, CA * Generation M2: media in the lives of 8-to 18-year-olds VRideout DRoberts UFoehr 2010 Kaiser Family Foundation Menlo Park, CA * Substance use in popular movies and music DRoberts LHenricksen PChristenson 1999 Office of National Drug Control Policy Rockville, MD * Television and music video exposure and risk of adolescent alcohol use TNRobinson HLChen JDKillen Pediatrics 102 5 E54 1998 * Exposure to movie smoking: its relation to smoking initiation among US adolescents JDSargent MLBeach AMAdachi-Mejia JJGibson LTTitus-Ernstoff CPCarusi Pediatrics 116 5 2005 * Effect of parental R-rated movie restriction on adolescent smoking initiation: a prospective study JDSargent MLBeach MADalton LTErnstoff JJGibson JJTickle TFHeatherton Pediatrics 114 1 2004 * A content analysis of the portrayal of alcohol in televised music videos in New Zealand: Changes over time KSloane NWilson FImlach Gunasekara Drug Alcohol Rev 32 1 2013 * Policy statement-children, adolescents, substance abuse, and the media VCStrasburger American Academy of Pediatrics, & Council on Communications Media 126 2010 Pediatrics * Cigarettes and cinema: does parental restriction of R-rated movie viewing reduce adolescent smoking susceptibility? EMThompson ACGunther J Adolesc Health 40 2 2007 * Bob Kingsley's Country Top 40 Wikipedia 2012a. August 1, 2012 * Wikipedia 2012b. August 1, 2012 * Movie exposure to alcohol cues and adolescent alcohol problems: a longitudinal analysis in a national sample TAWills JDSargent FXGibbons MGerrard MStoolmiller Psychol Addict Behav 23 1 2009