Hazardous Alcohol Consumption Depicted in YouTube Videos: A Content Analysis

Aims and objectives Social media platforms such as YouTube allow adolescents and young adults to document substance use and share related beliefs with large audiences. This study primarily aimed to identify and describe hazardous alcohol consumption methods depicted in highly viewed YouTube videos. Secondary exploratory objectives were to characterize the apparent demographic characteristics of on-screen performers, quantify video popularity and engagement, and evaluate the quality, reliability, and scientific accuracy of alcohol-related information presented in these videos. Methods We conducted a retrospective content analysis of YouTube videos identified between January and March 2025 using 48 search terms related to hazardous alcohol use. Key variables included the number of views, the number and apparent characteristics of participants, and the method of alcohol consumption depicted. Video content and quality were assessed using the global quality score (GQS) and a modified DISCERN reliability score, and explicit scientific claims were classified as substantiated or unsubstantiated by two board‑certified toxicologists. Results A total of 278 videos involving 15 distinct methods of alcohol consumption were analyzed, most of which met predefined criteria for hazardous use. Risky practices included alcohol inhalation, alcohol enemas, vodka eyeballing, drunkorexia, funneling, drinking hand sanitizer, marijuana moonshine, and alcohol‑soaked tampons, among others. Only three videos (1.1%) contained trigger warnings. Collectively, the videos were viewed 75 million times (mean 269,784 views) and liked five million times, and they featured 722 participants or observers, predominantly male, Caucasian, and aged 21-25 years. The median GQS and reliability scores were 1 (interquartile range or IQR 2-3) and 1 (IQR 1-2), respectively, and 78.7% (159/202) of scientific claims in informational videos conflicted with published toxicology literature. Interrater agreement was substantial to excellent (Cohen’s kappa 0.66-0.76). Conclusions Hazardous alcohol use is highly visible in popular YouTube videos, which rarely include accurate risk information or explicit harm‑reduction messages. These low‑quality, often misleading depictions suggest that YouTube and similar platforms may contribute to alcohol‑related informational environment for the youth and serve as venues for future efforts to address misinformation and hazardous drinking norms.