Popular video games might make young people more likely to smoke or drink, a new study has asserted.

Many of the bestselling games contain explicit use of alcohol or tobacco, implied use, or paraphernalia, and in a paper in Cyberpsychology, Behavior, and Social Networking, U.K. researchers suggest that young people “who play these video games are more likely to have experimented with tobacco and alcohol.” The authors compared this influence to that of films, noting that exposure to alcohol- and tobacco-related content in movies makes adolescents more inclined to try the drugs themselves. However, “tobacco and alcohol content is highly prevalent in a range of other popular media, and the interactive nature of video games provides multiple opportunities to promote products and behaviors.”

The team from the University of Nottingham looked at a few dozen of the bestselling video games in the U.K. in 2012 and 2013 that had avatars that look and behave like actual people, and took surveys of more than 1,000 kids between 11 and 17 years old that involved self-reported substance abuse. Almost half of the games had some sort of applicable drug content. According to the study, “young people exposed to this content are more than twice as likely to have used tobacco or alcohol.”

But the researchers did not lump all of those kids together: “Exposure to smoking and drinking could be moderated by individual experiences of gameplay and time spent playing, particularly in games ... where the players' choices impact on the story and plot, thus resulting in more or less exposure.”

Smoking and drinking alcohol have long been described as behaviors children and adolescents can pick up from their role models. One study found that when family members smoke, it counteracts anti-smoking education efforts taking place in schools. “The more smokers there are in the family, the more children have the opportunity to handle cigarettes and smoking accessories from an early age: they get, buy, or even light cigarettes,” according to a study in the Central European Journal of Public Health. “Smoking of parents and other relatives led to a substantial increase in the number of children who were determined to smoke in the future or were considering it.”

The study is not the first time video games have been linked to youths’ behaviors — groups disagree on whether violence in video games influences how violently kids behave in real life. The American Academy of Pediatrics and the American Academy of Child & Adolescent Psychiatry say violent media “can contribute to real-life violent behavior and harm children in other ways,” Harvard Medical School notes. But those who question that assertion say that “much of the research on violent video game use relies on measures to assess aggression that don't correlate with real-world violence. Some studies are observational and don't prove cause and effect.” While children learn by observing, the medical school adds, “Federal crime statistics suggest that serious violent crimes among youths have decreased since 1996, even as video game sales have soared.”

Sources: Cranwell J, Whittamore K, Britton J, Leonardi-Bee J. Alcohol and Tobacco Content in UK Video Games and Their Association with Alcohol and Tobacco Use Among Young People. Cyberpsychology, Behavior, and Social Networking. 2016.

Hrubá D and Zaloudíková I. Where do our children learn to smoke? Central European Journal of Public Health. 2008.