Risky Business on TikTok: Qualitative Analysis of Hazardous Substance and Alcohol Challenges Among Youth

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

TikTok's rapid growth has been accompanied by an increase in viral challenges, some of which encourage adolescents and young adults to engage in hazardous behaviors such as ingesting toxic substances, misusing over-the-counter medications, and consuming alcohol in dangerous ways. This study systematically characterizes these TikTok challenges, evaluates their medical risks, and explores how such content can inform clinical education and public health prevention efforts.

This qualitative content analysis examined TikTok videos depicting harmful or potentially harmful challenges, identified through TikTok search hashtags and supplemental media, regulatory, and toxicology sources. Eligible videos (with audio, non-duplicate, and visually or verbally representing a challenge) were transcribed verbatim, anonymized, and coded by two independent researchers using standardized abstraction forms capturing challenge characteristics, routes of harm, substances involved, documented complications, demographic targeting, dissemination patterns, and associated warnings or advisories. Safety suggestions or health information within videos were classified as misinformation or disinformation based on consensus ratings from three board-certified emergency physicians.

Forty-five TikTok videos met inclusion criteria; 38 (84%) represented highly prevalent youth challenges (>30,000 views). Most depicted participants were adolescents or young adults; 34% were identifiable as teens or preteens, and 53% were male. All identified challenges were judged medically dangerous by clinical reviewers and were associated with potential outcomes including burns, poisoning, seizures, arrhythmias, coma, and death, consistent with case clusters reported by pediatric burn centers and emergency departments. Platform administrators subsequently banned 19 (42%) challenges-such as the Tide Pod, Dusting/Chroming, Benadryl, and Nutmeg challenges-following multiple deaths and poisonings; however, all banned challenges continued to circulate through user re-uploads. Medical misinformation or disinformation was identified in association with every challenge analyzed.

Hazardous TikTok challenges are widely disseminated, highly engaging, and disproportionately involve adolescents and young adults, driving behaviors with substantial risk of severe toxicity and injury. The persistence of banned challenges through re-uploads, along with pervasive misinformation and disinformation, highlights critical gaps in platform moderation and health communication.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1895

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