Smoking in Movies Promotes Teen Smoking
Despite evidence showing that tobacco use is harmful, smoking remains the leading cause of preventable illness and death in our country. Although substantial progress has been made to curb smoking habits in the last forty years, 28% of teenagers report that they are current smokers and 64% report that they have ever tried smoking—according to recent estimates from the Centers for Disease Control and Prevention (CDC).
In an attempt to understand why teens smoke, researchers have investigated a myriad of possible reasons including industry advertising and marketing, parental smoking habits, and peer pressure. Researchers from Dartmouth College and Dartmouth-Hitchcock Medical Center looked into how exposure to smoking in movies affects adolescent smoking behavior. Their latest findings, published in the June 10, 2003 issue of The Lancet , show that viewing smoking behavior in movies strongly predicts smoking initiation among teens.
About the Study
A team of researchers at Dartmouth conducted an epidemiologic (longitudinal) study to examine whether movie smoking has an impact on teens. In 1999, they identified 3,547 adolescents aged 10 to 14 years in Vermont and New Hampshire who had never tried smoking. They obtained baseline measures of movie watching habits plus information on a variety of other behaviors. One to two years later, the researchers successfully contacted 2,603 (73%) of the eligible adolescents to determine if they had started smoking and to find out which movies they had seen.
Ten percent of adolescents initiated (at least tried) smoking during the follow-up period. Rates of smoking initiation increased significantly with greater movie exposure to smoking behavior in movies. Compared to adolescents with the lowest level of exposure, adolescents with the most movie smoking exposure were three times more likely to initiate smoking. Even after accounting for potential confounding factors such as age, self esteem, having friends or family who smoke, and parent education, the researchers found that 52% of smoking initiation among these children was attributed to the amount of smoking seen in movies.
The study was limited, however, by the fact that the follow-up period was relatively brief. It is not clear if, in the long run, adolescents who try smoking (for whatever reason) will become established smokers. In addition, because nearly all R-rated movies contain smoking, the researchers could not exclude the possibility that something about R-rated movies other than the presence of smoking is associated with smoking initiation among teens. Moreover, the results may not be generalizable since the study sample consisted mainly of a white, rural population.
How Does This Affect You?
The data suggest that eliminating adolescents’ exposure to movie smoking could reduce smoking initiation among young adolescents by as much as a half. But even the researchers acknowledge that this seems overly simplistic. Many factors contribute to teen smoking, and seeing their favorite stars smoke on the screen certainly provides just one of any number of motives. It is not even clear what it is about seeing smoking in movies that provokes kids to start smoking. Considering how often teens go to the movies (only 0.2% of the participants in this study had no exposure to movie smoking), however, it seems plausible that Hollywood is at least part of the problem.
Adolescent smoking continues to be a major challenge for public health officials: more than 5 million children alive today will die prematurely from smoking-related illnesses and nearly every adult who smokes (almost 90%) took his or her first puff at or before the age of 18. The more we learn about ways to resolve this predicament, the more lives—and money—we will save down the line. Has the time come to hold film writers, directors, and producers responsible for their share in the crisis?
Centers for Disease Control and Prevention (CDC): Tobacco Information and Prevention Source (TIPS)
Campaign for Tobacco-Free Kids
Dalton MA, Sargent JD, Beach ML, et al. Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study. Lancet . 2003;361.
Adolescents and School Health. Summary Results, 2001: United States. CDC. Available at:
Accessed June 10, 2003.
Research Center. Campaign for Tobacco-Free Kids. Available at:
Accessed June 10, 2003.
Last reviewed June 12, 2003 by ]]>Richard Glickman-Simon, MD]]>
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