Surgeon General Warning Issued: Screen Time Physically and Mentally Harmful to Children

The Surgeon General’s Office has issued a warning about the harms of screen time for children 18 and under, while providing suggestions to families, schools, healthcare providers, researchers, policymakers, and social media companies to help curb screen use. In 2023, President Biden’s Surgeon General, Vivek Murthy, issued an advisory on social media and youth mental health. In 2024, he called for warning labels on social media platforms, similar to surgeon general warnings on cigarettes. This advisory, released by the Trump administration, is for all screen time, including gaming, online gambling, and the “entire digital ecosystem of apps, smartphones, tablets, chatbots, and other screen-associated devices and interfaces.”

There is no serving surgeon general because President Trump has yet to nominate a nominee to be confirmed by the Senate. Janette Nesheiwat was originally chosen to serve in the role, but was revoked in May in favor of Casey Means. Means faced questioning in the Senate as part of the confirmation process, but her nomination was also revoked as she faced an uphill battle to be confirmed. Nicole Saphier is the latest nominee, but hasn’t yet faced questioning from Senators as part of the confirmation process.

The latest advisory suggests that families create a media plan outlining the types of screen time, where, and when each child can use screens. The office recommends that children under 18 months have no screen time; children under 6 have less than 1 hour per day; and children up to 18 have no more than 2 hours per day. The advisory suggests delaying access to portable devices for children and explaining the reasons for the delay or restriction.

The HighWire reported in January about a study showing that increased screen time as infants is associated with slower decision-making for children at the age of 8.5 and higher anxiety at the age of 13. The researchers did not find the same association for children who were exposed to screens at age three and four. The Surgeon General’s advisory warns of developmental and cognitive risks associated with screen use in early life, including poor language outcomes, adverse socio-emotional outcomes, attention and behavioral difficulties, and potential social communication differences.

A 2025 study found that 75-80% of parents are concerned about their children’s screen time, yet 40% of children have their own tablet by age 2. Popular content creator Ms. Rachel has videos specifically for babies that have garnered billions of views. The Google Play Store has baby game apps with more than 50 million downloads.

Studies have also shown an association between increased screen time and anger, while parents may allow screen time as a way to calm the increasing anger their child experiences.

HHS Secretary Robert F. Kennedy Jr. said the report is evidence-based and there are knowledge gaps where more research is needed. He said that while that evidence is collected, the basic precautionary principle of public health is that “action cannot wait until all evidence is available.”

The report includes 68 citations while describing various detrimental physical and mental health effects associated with increased screen time for children.

There are several physical consequences highlighted in the report, with the most evidence to support sleep disruption, which is a condition that often leads to more detrimental physical and mental health outcomes. Higher screen time is also linked with obesity through the increased consumption of ultra-processed foods, increased sedentary behavior, and higher caloric intake. By 2050, nearly 40% of children could be myopic (nearsighted) due to prolonged near-work from screens and limited outdoor time.

Mental health risks are particularly noticeable among teenagers, and excessive use of social media leads to higher rates of anxiety, depression, low self-esteem, and body image concerns. The report notes that addiction-like or compulsive behaviors are observed via loss of control, continued use despite negative consequences, hiding screen time, and withdrawal symptoms that resemble behavioral addictions.

Meta, the company that owns Instagram and Facebook, has internal research that confirms the findings that teenagers recognize the harm of excessive social media activity, but will continue using the platform anyway. This research has been revealed in a series of lawsuits against the company, alleging the platforms are designed to be addictive. Its internal research supports that conclusion.

Increased screen time is also associated with increased substance use, including alcohol, tobacco, and marijuana. There is also a notable association with aggression and higher family conflict.

Nearly half of all teenagers are exposed to cyber-bullying online, which leads to emotional, psychological, and physical symptoms. 3.5-5% of children experience sextortion before adulthood through facilitation by platforms that allow adults to interact with children. Louisiana filed a lawsuit last August against the gaming platform Roblox for allegedly facilitating child sex abuse. The case is currently pending as the court has yet to rule on Roblox’s motion to dismiss.

There is also exposure to harmful content, including self-harm, violence, disordered eating, and risky challenges. Educational outcomes worsen for students who spend more time on screens. There have been noticeable declines in the nation’s report card from 2019 to 2024.

The Surgeon General’s Office recommends facilitating discussions with family about expectations and limits for screen use in the household. Adults should model healthy screen-use habits for children, and healthy alternatives should be provided regularly to ensure that screens are not the default activity for children who are bored. Regularly scheduled times, such as mealtimes or game nights, should be created where everyone in the household disconnects from screens.

Importantly, the report suggests that parents should delay screen time and device access for as long as possible. After that, establish age-appropriate limits on screen use.