Movie Industry Linked to Increased Tobacco Use by Teens

Tobacco: Fighting teen smoking cessation
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Movies depicting tobacco use leads to increased odds that a teenager or adolescent will become and/or remain a smoker. This is a claim made in a recent study published in the medical journal Thorax where 5,166 fifteen-year-old teenagers were questioned about their movie watching experiences and their use of tobacco products.

These findings support a call by smoking cessation supporters to place a smoking category to film ratings. However, not all anti-smoking supporters believe that a change in movie ratings will be effective.

In the September issue of the journal Thorax, researchers state that their data from a study looking at the influence of top US box office films released between 2001 and 2005— including blockbuster movie titles like Spider-Man and The Matrix—where smoking scenes are depicted, increases the risk of smoking onset by over 100% and increases the risk of current or established smoking behavior by 68%. Social, family and behavioral factors were adjusted for, along with alcohol use and peer smoking as potential influencing factors on tobacco use. The study’s results have led the researchers to conclude that the film industry needs to add a smoking category/ warning to the film ratings of movies with scenes depicting actors smoking.

While the notion of adding smoking warnings to movies ratings is not a new one, in light of the seriousness of this health issue it does have merit.

According to the Centers for Disease Control (CDC), tobacco use which includes cigarette and cigar smoking and smokeless tobacco (chewing tobacco, snuff and dip) accounts for 1 out of every 5 deaths (approximately 443,000 deaths/year) in the U.S. and remains the leading cause of preventable death. Daily, approximately 3,600 youths between the ages of 12 and 17 will have their first cigarette with 1/3 becoming addicted to smoking. In a survey conducted in 2009, researchers reported that 19% of high school students admitted to cigarette use, 14% to cigar use, and 9% to smokeless tobacco use.

Furthermore, the CDC reports that an estimated 88 million non-smoking Americans, of which 54% are children between the ages of 3 and 11, are exposed to secondhand smoke. Secondhand smoke exposure contributes to approximately 3,000 deaths/year from lung cancer, 46,000 deaths from heart disease and approximately 150,000 to 300,000 children 18 months and younger to lower respiratory tract infections.

The good news, however, is that the trend toward smoking is decreasing and is attributed to education programs and peer pressure that are effective toward younger adolescents who are learning at any early age the dangers of smoking. According to the CDC’s Office on Smoking and Health, if the current trend continues at its present rate of decline, the percentage of adult and adolescent smoker will decrease to 12% and 16% respectively in the U.S. population by the year 2020.

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Therefore, numbers such as these make a good argument for imposing regulations such as adding a smoking category to movie ratings. However, while some opponents of the measure can be heard protesting in a collective hacking, not all opponents of the measure are pro-tobacco. Rather, their voices are clear and their meaning not clouded by smoke. In a July 2011 essay in the journal PloS Medicine, written by Simon Chapman and Matthew Farrelly titled “Four Arguments against the Adult-Rating of Movies with Smoking Scenes,” a cogent and compelling argument is made about why we should not pursue a smoking movie rating.

Their reasoning for arguing against the smoking rating is summarized in the essay as follows:

”In the US, a growing number of medical and public health agencies are calling for movies with smoking scenes to be adult rated. We present four arguments against such proposals.”

1. First, studies purporting to demonstrate causal associations between exposure to smoking in movies and smoking uptake do not control for large-scale confounding of the independent variable (smoking in movies).

2. Second, claims for attributable uptake of smoking said to be caused by movie smoking exposure are crudely reductionist, ignoring widespread exposure to smoking scenes elsewhere.

3. Third, adult classification is a highly inefficient way of preventing youth exposure to adult-rated content.

4. Fourth, we have concerns about the assumption that advocates for any cause should feel it reasonable that the state should regulate cultural products like movies, books, art, and theatre in the service of their issue.

While the journal Thorax article appears to meet the conditions for resolving the first argument, it is clear that there is more to this argument than numbers and graphs. There is a human element to it and it possibly may require more of a philosophical debate among sociologists rather than a measure of man by men of measure. Smoking is harmful. There’s no denying that. But at what point do we say “enough”? At what point do we stop trading freedom for regulation in the name of health?

Sources:
“Cross-sectional association between smoking depictions in films and adolescent tobacco use nested in a British cohort study” Thorax 2011; 66:856-861 doi:10.1136/thoraxjnl-2011-200053 http://thorax.bmj.com/content/66/10/856.abstract
Chapman S, Farrelly MC, 2011” Four Arguments against the Adult-Rating of Movies with Smoking Scenes” PLoS Med 8(8): e1001078. doi:10.1371/journal.pmed.1001078
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