Review on Problematic Online Pornography Use in Mainland China

Literature on traditional formats of pornography such as magazines, videos, or adult films has shown that frequent use can lead to negative psychological and social effects on individuals [1]. These effects can include anxiety, depression, and low self-esteem, particularly when individuals feeling shame or guilt about their consumption habit. Furthermore, excessive pornography use can impair attention and memory due to overstimulation of the brain’s reward system. Regular pornography users often withdraw from social interactions and activities, and they may engage in risky or aggressive sexual behaviors influenced by the unrealistic portrayals in pornography. The proliferation of the internet and widespread availability of technological devices have significantly increased global access and consumption of online pornography, which can be easily accessed through various platforms, including social media and dedicated websites. This easy accessibility can lead to early exposure and addictive patterns of consumption. Research indicates that approximately 70 to 80% of adults in Europe, the United States, and Australia report having consumed online pornography [2]. Asian countries generally report similar rates of online pornography use. Particularly, recent statistics show that 80-90 % of young adults in mainland China reporting that they have viewed online pornography at least once [2,3]. While such behaviour does not meet the criteria of a public health crisis, experts agree that pornography use is a public health topic that warrants further investigation [4].

The use of online pornography in mainland China reflects a complex interplay of cultural, social, and technological factors. Chinese culture, heavily influenced by Confucianism, emphasizes modesty, familial piety, and social harmony. Open discussion about sexuality is discouraged which can create a stigma around using pornography. This sexual repression can also lead to curiosity, particularly adolescents and young adults, driving them to explore online pornography in secret as a means of sexual exploration. Traditional gender roles also influence how men and women engage with pornography. Chinese men may be more likely to consume pornography openly, using it to fulfil sexual fantasies or seek sexual satisfaction. Female Chinese users, on the other hand, may experience feelings of shame, guilt, and being pressured to conform to gender stereotypes portrayed in the pornographic content. Despite the cultural stigmas, available literature indicates that pornography consumption rates in mainland China are generally similar to those in Western countries [2,3] and that Chinese women report lower rates of pornography use as compared to Chinese men [5].

The rapid expansion and infiltration of smartphones and social media in mainland China over the past decade have profoundly altered various aspects of daily life, including access to and consumption of pornography. The Chinese government prioritized internet development in the late 1990s and early 2000s, resulting in significant increases in internet accessibility. By 2021, China had over 1 billion internet users, making it the largest online population in the world. The rise of affordable smartphones has further transformed how people access the internet in mainland China, enabling convenient and private access to pornography, thereby reducing the risk of social stigma. Features like incognito modes or private browsing can further enhance anonymity, leading to increased consumption, particularly among younger users who may seek out pornographic content for sexual education or exploration. Despite the extensive internet access, the Chinese government imposes strict regulations on internet content, including pornography. Many pornographic sites are blocked, prompting users to seek alternative methods for access, such as using VPNs or turning to less regulated platforms. This circumvention can affect the type of content consumed, as users adapt to censorship by sharing tips and discussing indirectly on social media.

The rapid expansion of social media platforms in mainland China is a complex phenomenon driven by technological, cultural, economic, and regulatory factors. The Chinese government has promoted the digital economy as a crucial component of national growth, with initiatives like “Internet Plus” encouraging the development of online platforms, including social media. The growth of major Chinese tech companies and their social media platforms, such as Tencent (WeChat), Alibaba (Weibo), and ByteDance (TikTok), and Xiaohongshu (Little Red Book) enables users to share information and opinions about various topics, including sexuality and pornography, facilitating discussions that are often taboo in traditional contexts. This sharing can normalize conversations about sexual topics, helping to demystify pornography and provide balanced perspectives. This is particularly important given the limited formal sex education in many Chinese schools. As discussions about sexuality become more prevalent on social media, cultural attitudes toward pornography may shift. Younger generations, influenced by both domestic and international perspectives, may adopt more liberal views on pornography, viewing it as a normal aspect of sexual expression. Exposure to a wider range of perspectives on social media, including Western viewpoints, can further contribute to these changing attitudes toward sexuality and accepting online pornography as a normal aspect of sexual expression.

Researchers have suggested that online pornography may have more negative effects on individuals than traditional formats of pornography due to its ease of access, 24/7 availability, and the anonymity it provides [6]. Problematic online pornography use (POPU) is conceptualized as a behavioural addiction or impulse control disorder, and both of which are supported by empirical evidence [7]. Common features of POPU include uncontrollability in use, repeated engagement, impairment of functioning, and significant distress. However, research on POPU in mainland China faces significant challenges, including cultural taboos, regulatory constraints, inconsistent definitions, questions about validity of assessment tools, and methodological limitations.

Among the paucity of research on POPU with samples from mainland China, three studies have explicitly estimated prevalence rates of POPU. These studies suggest that the rates of POPU range from 9% to 25% among college students and adults in mainland China, which are consistent with Western samples [3,8,9]. Chen et al. also found that being male, along with poor mental and social health, are significant risk factors for POPU with a sample of 1026 Chinese college students [5]. Li et al. identified predictors of POPU among 771 Chinese high school students, highlighting poor family functioning, low self-esteem, and the need for belongingness in predicting POPU [10]. Yu et al. conducted a study that received only 1483 valid responses from over 31,000 Chinese university students. Their findings indicated that lower levels of self-acceptance and impulse control difficulties predict POPU. Additionally, impulse control difficulties are found to moderate the relationship between self-acceptance and POPU, showing a weaker correlation when impulse control difficulties are more pronounced [11]. Chen et al. recruited both community and help-seeking male Chinese samples online and found that the frequency of online sexual activities predicts POPU, with a stronger association observed among those with more conservative sexual attitudes [12]. Chen and Jiang found that among individuals seeking voluntary POPU service, their presenting problems include preoccupation with online pornography consumption, interpersonal conflict, and physiological/psychological symptoms [8]. However, caution must be taken when interpreting these studies. Most are cross sectional and involve specific samples such as teenagers, men, and servicer users, which may limit the generalizability of the findings. Consequently, the evidence regarding causality remains weak.

The Chinese government expresses deep concern regarding POPU and calls online pornography “online narcotics” [13]. A multifaceted approach has been adopted to address POPU which includes a combination of internet censorship, public awareness campaigns, and educational initiatives. Central to this strategy is the “Great Firewall,” which blocks access to numerous foreign pornography websites and enforces strict regulations on internet content. Internet service providers and social media platforms are required to monitor and filter user-generated content, promptly removing any pornographic material. The Chinese government also actively promotes public awareness campaigns aimed at educating the public about the psychological and social risks associated with pornography consumption.

Access to support services and counselling for individuals struggling with POPU is gradually increasing in mainland China. These services are designed to provide guidance and support, helping individuals develop healthier coping strategies and understand the potential impacts of excessive pornography consumption on their mental and social well-being. Furthermore, helplines and online resources are available for those seeking assistance with addictionrelated issues, ensuring that individuals have access to the support they need. Additionally, youth engagement programmes focus on peer education, training students to educate their classmates about healthy relationships, sexuality, and the risks associated with pornography. Both government and academic institutions are beginning to conduct studies and surveys aimed at understanding the prevalence and effects of POPU. While challenges such as cultural taboos and the effectiveness of educational initiatives persist, these combined efforts represent essential steps toward understanding and addressing the complexities of POPU in mainland China, particularly as societal attitudes toward sexuality continue to evolve.

The future directions for addressing POPU in mainland China should prioritize tailored educational programmes, enhanced mental health support, community engagement, the integration of technology, and robust research efforts. Public and school educational initiatives should focus on developing age- and genderappropriate materials that inform about relationships, consent, and the risks associated with pornography. Additionally, enhancing mental health support systems is also crucial, with expanded access to counselling services specifically targeting individuals affected by POPU. Telehealth options can improve accessibility, especially in underserved areas, while support groups can create safe spaces for sharing experiences. Community-based initiatives can foster local discussions about healthy sexual attitudes through workshops and events, creating a supportive network. Leveraging technology, such as mobile apps and online platforms, can provide valuable resources and self-help tools for those managing their POPU. Developing evidence-based intervention programmes for POPU in mainland China is vital to addressing the psychological, social, and cultural challenges associated with pornography use. By focusing on tailored, data-driven approaches, these programmes can effectively promote mental well-being, reduce stigma, and foster healthier attitudes towards sexuality. Furthermore, enhanced research and data collection are essential to understand the prevalence, individual and social impacts, effectiveness of various prevention and intervention programmes across different demographics. Longitudinal studies can provide deeper understanding of the long-term effects of POPU. Collaborations among researchers, mental health professionals, and policymakers will be crucial in developing culturally relevant assessment tools and methodologies that accurately reflect the experiences of the Chinese population.

With the rapid expansion and pervasive influence of the internet, smartphones, and social media in mainland China, online pornography consumption has increased significantly, despite prevailing cultural taboos and strict government censorship. POPU can lead to serious negative psychological effects and impair social functioning. To effectively tackle POPU, future efforts should prioritize the implementation of tailored public educational programmes and evidence-based interventions. Enhancing mental health support systems through telehealth options and communitybased initiatives is also essential. Additionally, ongoing research is needed to evaluate the effectiveness of these interventions and to gain a deeper understanding of the long-term effects of POPU on individuals and society as a whole.

None.

No conflict of interest.

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