Abstract
Growing concerns regarding harmful content on social media platforms underscore the need for systematic examination of these platforms’ advertised safeguards. User reports are a key mechanism through which platforms can be apprised of and address harmful content. This study uses tobacco content as an important public health context to examine how strictly social media platforms moderate content that violates their own community guidelines after it is reported through user-reporting mechanisms. Using a replicable observational study, we tested the responsiveness to user reports across the three platforms most popular with youth: Instagram, TikTok, and YouTube. We identified 294 cases (between 97 and 99 per platform) violating platforms’ community guidelines covering five content areas: insufficient age-gating, disallowed promotions, illegal sales, underage use, and dangerous activities. Cases were reported through the platform’s reporting mechanisms and monitored for at least two weeks for moderation actions. Of a total of 294 cases, 221 (75%) were unmoderated. Instagram moderated 51 of 98 (52%) cases, YouTube 14 of 97 (14%), and TikTok 8 of 99 (8%). Insufficient age-gating was the only category with more than 50% of cases moderated (29 of 56). Less than 10% of dangerous activity (1 of 29) and disallowed promotion (4 of 79) cases were moderated. Results show that obvious violations of community guidelines reported to the platforms through their own mechanisms were rarely addressed, subjecting users to harmful, and sometimes illegal tobacco-, nicotine-, and cannabis-related content. Findings call into question whether the platforms can be relied upon to self-regulate to protect users from harmful tobacco content online.

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Copyright (c) 2026 George D. H. Pearson , Padmini Kucherlapaty, Nathan A. Silver , Barbara A. Schillo, Jennifer M. Kreslake
