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Background Failure to use seatbelts in motor vehicles is a major source of youth injuries, and previous research has noted the widespread non-use of seatbelts in popular media. Objectives To explore whether increased exposure to entertainment screen media was associated with inflated normative perceptions regarding seatbelt non-use, and to determine any associations between normative perceptions and seatbelt non-use. Methods A nationally representative telephone survey of school-aged American adolescents (14–17 years, n=915) measuring: screen media exposure; normative perceptions with reference to friends' disapproval of non-use, and prevalence of non-use among friends, school peers and peers; and self-reported seatbelt non-use. Results Using structural equation modelling, analyses indicate that, after demographic and individual characteristics relevant to screen media exposure and seatbelt non-use had been controlled for, frequent exposure to entertainment media was associated with positive normative perceptions about seatbelt non-use for boys, but not for girls. Normative perceptions related to friends' and school peers' seatbelt use were associated with seatbelt non-use for both boys and girls. Conclusions Attempts to increase adolescent seatbelt use could include public communication campaigns to alter normative perceptions. Broadcasting these campaigns in conjunction with the media that under-represent seatbelt use may be a successful strategy for reducing the influence of such media on male adolescents. [ABSTRACT FROM PUBLISHER]