"The mental health crisis among young people is an emergency - and social media has emerged as an important contributor," Murthy said in an op-ed in the New York Times Monday.
Murthy cited several studies, including a 2019 American Medical Association study published in JAMA that showed teens who spend three hours a day on social media double their risk of depression. Teens spend nearly five hours a day on social media apps, according to a Gallup poll.
But Murthy cannot act unilaterally to put a warning label on apps - that requirement would have to come from Congress, with whom Murthy pleaded to pass a bill.
"It is time to require a surgeon general's warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents," Murthy said. "A surgeon general's warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe."
Similar labels on tobacco, first instituted in 1965, led to a steady decline in cigarette smoking in America over the past several decades.
Congress has long chastised social media companies, claiming they pose harm to children. CEOs of tech companies have been grilled routinely on Capitol Hill, most notably Meta CEO Mark Zuckerberg - who publicly apologized to families whose children killed themselves because of online bullying and harassment. But Congress has taken little action to curb children's social media usage.
Murthy argued that it's time for Congress to get serious about curbing children's use of social media.
"Not only have companies not demonstrated that their platforms are not safe for kids, but there's growing evidence of harm," Murthy said in an interview on NBC's "Today" show Monday. "That's deeply concerning to me, not only as a surgeon general but also as a parent. A warning label could help parents understand these risks - many parents don't know those risks exist."
An escalating battle
Murthy has warned about social media's harm to children's welfare for years. But Monday's declaration of an emergency and his appeal to Congress represent his most urgent call to action on the issue so far.
In May 2023, Murthy issued an advisory that said there's not enough evidence to determine whether social media is safe enough for children and adolescents' mental health, saying social media use presents "a profound risk of harm" for kids.
He suggested parents restrict their kids' social media use, saying 13 is too young to join social apps. But such advisories are designed to call attention to urgent public health - they don't require action.
"We're in the middle of a youth mental health crisis, and I'm concerned that social media is contributing to the harm that kids are experiencing," Murthy told CNN in May 2023. "For too long, we have placed the entire burden of managing social media on the shoulders of parents and kids, despite the fact that these platforms are designed by some of the most talented engineers and designers in the world to maximize the amount of time that our kids spend on them."
On CNN's "Chasing Life" podcast with Dr. Sanjay Gupta in June 2023, Murthy outlined some steps parents can take to rein in their children's social media usage, including partnering with other parents to make sure kids lack the "I'm the only one without social media" excuse.
More action needed
A warning label, if Congress passes legislation requiring one, would be insufficient to fix the problem, Murthy acknowledged.
He suggested schools become phone-free environments for children, as should dinner time and other family events. And Murthy urged parents to restrict children's use of social media until they graduate from middle school.
Several states have worked to pass legislation to increase the age at which children can begin to use social apps or some of their more time-sucking features, such as algorithms that push people to engage with more content within the app. The bills have been largely bipartisan.
Florida's Republican Gov. Ron DeSantis in March signed a bill that would prohibit children under 14 from obtaining their own social media accounts, and children under 16 would need parental consent to have accounts. New York Democratic Gov. Kathy Hochul said she would sign legislation passed by the state legislature that would ban social media from using algorithms in children's feeds, and the bill would also prevent tech companies from sharing information of children under 18.
"This is much easier said than done, which is why parents should work together with other families to establish shared rules, so no parents have to struggle alone or feel guilty when their teens say they are the only one who has to endure limits," Murthy wrote.
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