19 Ylikahri RH, Leino T, Huttunen MO, Poso AR, Eriksson CJ, Nikkila.Effects of fructose and glucose on ethanol-induced metabolic changes and on the intensity of alcohol intoxication and hangover. Review methods Three reviewers watched all 10 episodes of the first season and coded incidents of substance use according to the substance used (alcohol, tobacco, or drugs), the way use was portrayed (visually or verbally), the source of the message (the character in the show involved in the incident), and the slant of the incident (endorsement or rejection). Main outcome measuresThe variation in number of messages in an average episode, the slant of messages, and message source.Results The average number of messages per episode was 9.1 (range 2-17). Most drug use messages (15, 54%) implied rejection of drugs, but most alcohol messages (30, 64%) and tobacco messages (12, 75%) implied endorsements for using these substances. Most rejections (34, 94%) were conveyed verbally, but most endorsements (36, 65%) were conveyed visually. Messages varied in frequency and slant by source. Conclusions The reality television show analysed in this study contains numerous messages on substance use that imply both rejection and endorsement of use. The juxtaposition of verbal rejection messages and visual endorsement messages, and the depiction of contradictory messages about substance use from show characters, may send mixed messages to viewers about substance use.

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