{"doi":"10.1016/j.focus.2025.100413","title":"Blasting Off Again: An Observational Study on Substance Use Content Exposure in Pokémon Twitch Streams","abstract":"<h2>ABSTRACT</h2><h3>Introduction</h3> The Pokémon franchise has an array of media (i.e., television series, movies, merchandise and Trading Card Game (TCG)) that attracts global youth and adults since its creation in 1996. Specifically, users have been known to discuss, promote, and purchase Pokémon TCG on the livestreaming platform Twitch. However, Pokémon TCG livestreaming content may also include potential harmful content for youth and adolescents, such depictions of substance use. Hence, the objective of this study was to assess if popular Twitch Pokémon TCG content and influencers promote substance use topics and behavior. <h3>Methods</h3> This study was conducted in three phases: (1) data mining on two Twitch data aggregation websites (Sullygnome.com and TwitchTracker.com) within the Pokémon TCG category; (2) data filtering using keywords through a snowball sampling strategy on the title of a Twitch stream; and (3) content coding using the World Health Organization (WHO) protocol on Internet Monitoring of Marketing of Unhealthy Products to Children and Adolescents for influencer and micro-influencer substance use marketing including depictions of substance use or promotion of products on the streamer's profile. We also conducted assessment of any underage moderation for Twitch livestreams. <h3>Results</h3> A total of 1,025 highly active Pokémon TCG streamers were collected and analyzed. The use and promotion of substance use in the form of alcohol, cannabis, or tobacco was detected in 25.07% (n=257) of these Pokémon TCG Twitch streamers. Frequent substance use detected was alcohol (90.27%, n=232), followed by polysubstance use (6.61%, n=17), cannabis (n=6, 2.33%) and tobacco (n=2, 0.78%) Content coding detected three general themes with behavioral being the most observed. This included behavioral content of substance use for the specific reason of casual use (46.06%, n=228) and for intoxication (26.26%, n=130). Additionally, close to three-quarters (72.76%, n=187) of streamers' accounts did not prohibit underage access to account content or livestreams. <h3>Discussion/Conclusion</h3> In this study we detected Twitch streamers violating Twitch community guidelines that may have exposed millions of youths and young adults on the Pokémon TCG category to different depictions of substance use. Although Twitch prohibits monetary gain in exchange for posting substance use content, apparent lack of enforcement of Twitch community guidelines and absence of age verification means that youth who enjoy Pokémon TCG content may also be exposed to content actively promoting substance use behaviors.","journal":"AJPM Focus","year":2025,"id":572962,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9521,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1479488,"name":"Meng Zhen Larsen","orcid":"0009-0002-8305-0718","position":1,"is_corresponding":false},{"id":315502,"name":"Tim K. Mackey","orcid":"0000-0002-2191-7833","position":2,"is_corresponding":false},{"id":315501,"name":"Matthew Nali","orcid":"0000-0002-0565-8202","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:57:27.876396Z","pmid":"41141954","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}