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Norris Cotton Cancer Center
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The Lowdown on Smoking in Movies

By James Sargent, MD, co-director of the Cancer Control Research Program at Norris Cotton Cancer Center

Can seeing smoking in one movie influence a young person to smoke?

We think that the influence of most movies is small but the influence accumulates over time as kids watch many movies and see literally hours of smoking screen time. Adolescents have reported being influenced by key films; for example, one told me he had to smoke after he saw Brad Pitt smoke in the movie "Fight Club."

How does movie smoking influence compare with smoking at home or in the neighborhood?

Kids are influenced by people important to them--friends, parents, brothers and sisters, and movie stars. They are probably less influenced by strangers they see smoking on the street.

What kinds of smoking are kids seeing in movies…is it teen smoking, good guy/bad guy smoking….and why does it have such an impact?

The most important thing about smoking in movies is that it is done by movie stars. Kids look up to movie stars and emulate them. Surprisingly, each episode of bad guy smoking seems to have more impact than good guy smoking, even though smoking by good guys is far more common (there are more good guys).

How can seeing smoking in a movie actually cause a kid to smoke?

Movies smoking causes smoking by shaping how nonsmoking adolescents perceive smoking. By defining for the adolescent what smoking could do for him or her--relax, look tough, look sexy.

How will giving smoking an R rating reduce teen smoking?

The movie rating is determined by producers before most movies are shot. If a producer wants to target youth with the movie, they will leave out the smoking given an R rating for smoking. If smoking is important to the artistic elements of the movie, then the producer accepts the R rating.

Isn't parenting the best way to prevent a kid from smoking?

Parenting is just as important as movie smoking, but the two work independently of each other. The R rating helps parents because it gives them a quick way to determine whether the movies is appropriate or not.

Who are the kids most likely to take up smoking from seeing images in movies, in terms of household type and socioeconomic perspective?

The kids most vulnerable to movie smoking are medium risk kids: who tend to be middle class, low to medium risk takers, and whose parents do not smoke.

Isn't this R rating business just the nanny state gone wild? How do we decide where to draw the line about other issues like seat belts or bike helmets?

Smoking is worth rating because it is such an important public health problem--it kills more each year than alcohol, obesity, and violence combined, about 3 million worldwide per year. If the ratings system was redesigned with an emphasis on what actually kills people, smoking would be the first behavior rated.

Is an R rating going to make adolescents more likely to see the movie by labeling it as forbidden fruit? How many underage kids get into R rated movies anyway by downloading the movie on the internet?

R rated movie viewership among adolescents is half what PG-13 viewership is. So despite the forbidden fruit notion, adolescents see fewer of these movies. That's why the movie industry prefers the PG-13 rating.

Besides this study, what other evidence is there that smoking in movies make any difference in what a kid will do?

There have been many studies on this topic, not just in the US but also in Germany, Britain and Mexico as well. They all point to a movie smoking--kid smoking association. That's why the US Surgeon General recently declared movie smoking one cause of adolescent smoking.

How can we tell why kids smoke? There are so many influences like TV, music, and the Internet. How can you single out movies from all other media?

Other media may be important as well. But movies have the strongest science supporting policies to reduce smoking in them.

What about all the older movies where smoking was commonplace? Do you eliminate or re-rate that?

No. The ratings changes proposed would only apply to newly-made movies. So the impact would be played out over time, not immediately. And all those old movies, like 101 Dalmatians, would not have to be re-rated.