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Exposure to Smoking in Movies Influences Kids Lighting Up

January 10, 2008

New research from Norris Cotton Cancer Center and Dartmouth Medical School (DMS) strengthens the case that children's exposure to smoking in movies influences their decision to start smoking. It further suggests that smoking in movies seen in early childhood has an equally significant impact on that decision as movie smoking exposure closer to adolescence, according to the results of the study published in the January edition of Pediatrics. The study was the first of its kind to focus on elementary school children, and the first to update the children's exposure to movie smoking over time.

The lead author, Linda Titus-Ernstoff, PhD, MA, is a Professor in the Department of Community & Family Medicine and in Pediatrics at Dartmouth Medical School (DMS), and the Associate Director of the Hood Center for Children and Families, and is a member of the Cancer Epidemiology and Chemoprevention Research Program at Norris Cotton Cancer Center. The research team surveyed more than 2,200 children ages 9-12 from 26 schools in New Hampshire and Vermont. Children were asked about movies they had seen and their smoking behavior at an initial baseline survey and at two follow-up surveys. Children who had already tried smoking before the baseline survey were not included in the follow-up surveys.

At the baseline survey, children were given randomly sampled lists containing 50 of the 550 top box office movies over the prior 5.5 years and asked which movies they had seen. Children were interviewed again in two follow-up surveys, one and two years later. During the follow-up surveys, children were again asked about their smoking behavior and the movies they had seen based on updated lists of 50 of the 200 top box office movies and video rentals during the previous year.

By the third survey, 10 percent of the children had initiated smoking. Results from the three surveys showed that each child had seen an average of 37 out of the 150 popular movies they were asked about, exposing them to an average of 150 smoking occurrences. About 80 percent of the children's exposure was due to smoking images portrayed in youth-rated movies (G, PG, PG-13).

"The results indicated that the earliest exposure to movie smoking was as important as exposure measured at the two follow-ups in predicting children's smoking initiation," said Titus-Ernstoff. "This finding suggests that the process which leads children to initiate smoking begins much earlier than adolescence. Viewing smoking in the movies may influence the decision to smoke in more than a third of children."

Titus-Ernstoff says the take-home message from this study is that exposure to movie smoking occurring during early childhood is as influential as exposure that occurs nearer to the time of smoking initiation. Even young children who see smoking in movies may be at risk for smoking later on. Titus-Ernstoff says parents also need to be aware that most of children's exposure to movie smoking comes from youth-rated movies, and that they should try to reduce their children's viewing of movies that contain smoking.

Co-authors of the study included Dr. Madeline Dalton, PhD, who led the research study, Dr. Anna Adachi-Mejia, PhD, Dr. Meghan R. Longacre, PhD, and Dr. Michael Beach, MD, PhD. All of the authors are affiliated with Dartmouth Medical School. Additionally, Dr. Dalton is Director of the Hood Center for Children and Families, and Dr. Adachi-Mejia is Assistant Director of the Community Health Research Program for the Hood Center for Children and Families. Dr. Beach is with the Department of Anesthesiology at Dartmouth-Hitchcock Medical Center and is a member of the Cancer Control Research Program at Norris Cotton Cancer Center.