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Smoking in Movies Increases Smoking in Teens


Exposure to onscreen smoking in movies increases the probability two to three times of smoking in teens.

According to the Centers for Disease Control and Prevention (CDC), each day in the United States, approximately 4,000 teenagers will try their first cigarette.

Thumbs Up! Thumbs Down! (TUTD), a project of Breathe California of Sacramento-Emigrant Trails, counted the occurrences of tobacco use (termed "incidents") shown in U.S. top-grossing movies during 1991—2009 in an attempt to monitor the extent tobacco use is shown in popular movies.

The report from the CDC summarizing the study is presented in the December 22-29 issue of JAMA. The TUTD study found that the number of tobacco incidents depicted in the movies during this period peaked in 2005 and then progressively declined.

The percentage of high school students who smoke has declined in recent years, but remains high with 19% of high school students reporting current cigarette use (smoked cigarettes on at least 1 day during the 30 days).

For their analysis, TUTD counted the number of incidents of tobacco use in the 50 top-grossing movies each year during 1991--2001 and in all movies that were among the 10 top-grossing movies in any calendar week during 2002--2009.

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For each time frame, teams of trained observers reviewed each movie and counted tobacco incidents. An incident was defined as the use or implied use of a tobacco product by an actor. A new incident occurred each time 1) a tobacco product went off screen and then back on screen, 2) a different actor was shown with a tobacco product, or 3) a scene changed, and the new scene contained the use or implied off-screen use of a tobacco product.

The number of in-theater impressions (one person seeing one tobacco incident one time) delivered in theatrical release was obtained by multiplying the number of incidents in each movie by the total number of tickets sold nationwide to the movie. The number of movies without any depiction of tobacco use also was counted.

The total number of incidents in the entire sample of top-grossing U.S. movies ranged from 2,106 to 3,386 per year from 1991 to 1997, decreased to 1,612 in 1998, and then more than doubled to peak at 3,967 in 2005. From 2005 to 2009, the number of incidents dropped steadily, to 1,935 incidents in 2009. More than 99% of tobacco incidents related to smoking (versus smokeless tobacco use).

The percentage of all top-grossing movies that did not show tobacco use exceeded 50% (51%; 74/145) for the first time in 2009. The percentage of top-grossing, youth-rated movies (G/PG/PG-13) that did not show tobacco use has increased since 2003, reaching an all-time high of 61% (58/95) in 2009.

One major short-coming of the study is the lack of inclusion of all movies. This does not invalidate the need to develop and implement more effective methods to reduce the potential harmful influence of onscreen tobacco use.

The World Health Organization​ has recommended policies to decrease the negative effects on youths of onscreen depictions of smoking in movies which include assigning R ratings to new movies that portray tobacco imagery. Other recommended policies include requiring strong anti-tobacco ads preceding movies that depict smoking, not allowing tobacco brand displays in movies, and requiring producers of movies depicting tobacco use to certify that no person or company associated with the production received any consideration for that depiction.

From the Centers for Disease Control and Prevention Smoking in Top-Grossing Movies—United States, 1991-2009 JAMA. 2010;304(24):2692-2694.