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Movie Stars: Still Smoking After All These Years
By Gilbert Ross, M.D.
In 2003, I wrote an essay that appeared in USA Today, condemning Hollywood moguls for putting cigarettes in their movies and effectively causing actors to promote smoking. The basis of my attack was a study published in The Lancet that year that documented the effect that smoking in movies had on young teens and pre-teens: a three-fold increase in their likelihood of taking up smoking, as compared to their peers with little or no such exposure to on-screen smoking.
A new study appearing in this month's Archives of Pediatric and Adolescent Medicine evaluates the relationship between smoking initiation and movie-going habits from a different perspective -- but the results are analogous, to an amazing degree. The authors, from the University of North Carolina at Chapel Hill and the Pacific Institute for Research and Evaluation, evaluated 735 youngsters, aged twelve to fourteen, at the beginning of the study, in 2001. One of the key measures they recorded was which of ninety-three popular films they had seen over approximately the past year. Two years later, the researchers re-interviewed the study group to determine how many of them had begun to smoke, and the relationship of smoking to their earlier, self-described moviegoing habits.
White teens who had higher exposures to R-rated movies -- and about two-thirds had such exposures -- had an almost three-fold higher rate of smoking than their peers who had lower or no R-rated movie exposures. (Interestingly, and for no obvious reason, black teens did not have that same increased rate of smoking based upon R-rated movie viewing.) Girls and boys both had higher smoking initiation with increased attendance at R-rated movies.
The authors point out that several other studies -- one of which is the study I discussed in my 2003 op-ed -- have now confirmed that young teen exposure to movies that portray, or are likely to portray, smoking have a significant impact on initiation of smoking by a factor of about three (this degree of elevation was found in all the studies). It should be noted here that approximately 100% of R-rated movies do have smoking scenes.
What can be done about this? I am forced to repeat what I (and many other advocates of reducing the rate of teen smoking) have been saying for some time now. I'll do so by repeating an edited excerpt of my earlier article -- unfortunately, nothing much has changed over the last four years:
When was the last time a star or studio president made a public statement condemning how his or her own movies seduce hero-worshiping kids into smoking, which will prematurely kill at least one-third of those who take it up?
Hollywood bigwigs love to tell us how to live our lives. They are famously active in political and "environmental" crusades, and are often found testifying before Congress and other venues, where their opinions are given great weight despite their almost complete lack of qualifications on health- and science-related issues.
[In this op-ed, I now propose] a simple but probably effective response: Add smoking to the list of factors that draw an automatic "R" rating for a movie.
That would likely cut down dramatically on movie smoking, as producers would want to avoid hurting attendance with an R rating. Additionally, it would help to keep the vulnerable under-seventeen crowd away from smoking scenes.
With all of the evidence of the damage to young lungs and other organs that can be provoked by movie smoking, why are there so few in Hollywood who dare to speak the name of the evil that lurks among them: smoking?
One more thing: parents should be aware of the lethal potential of smoking in movies and discuss the difference between on-screen and "real life" behaviors -- I'm sure many of the actors depicted as smoking in the movies don't partake of this habit when not on camera. Kids need to know the difference -- as a defense against their natural tendency to mimic behavior of people they admire.
Gilbert Ross, M.D., is Executive and Medical Director of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
Check out ACSH's site http://TheScooponSmoking.org and see our book Cigarettes: What the Warning Label Doesn't Tell You -- Information Tobacco Companies Don't Want Teens to Know About the Dangers of Smoking. 
Audrey Silk (March 6, 2007)
I have a hard time understanding why this is only parenthetical when it appears to actually be THE negating factor of the entire hypothesis:
"(Interestingly, and for no obvious reason, black teens did not have that same increased rate of smoking based upon R-rated movie viewing.)"
Or as Dr. Sargent, the researcher of the previous study, is quoted as saying in the news report: "Perhaps black teens, with their higher rates of movie and TV watching, become desensitized to the images of smoking."
The 2003 Lancet study's interpretation read: "Our results provide strong evidence that VIEWING smoking in movies promotes smoking initiation among adolescents." (emphasis mine).
"Viewing." Not viewing WHO was doing the smoking (as explained as a possibility in this study: "One possibility cited in the study was that black teens don't identify with most characters they see on-screen because they are white). Not NUMBER of times viewed. Just the act of seeing smoking depicted as a "normal" behavior.
The fact that there are large differences between black and white youth this time knocks the underlying premise of the "smokefree movies" crowd flat on its back. The nail in that coffin is the "desensitization" explanation. It's stunning in its contradiction to the original premise that "Adolescents who viewed the most smoking in movies were almost three times more likely to initiate smoking than those with the least amount of exposure" (Lancet 2003). Allegedly, the more smoking viewed the more that it was acceptable was reinforced. Now not?
The opinion that this this latest study is analogous with the former (which, upon close inspection, was weak itself) seems like a real stretch. Rather, it sinks the first.
Ben Palmer (March 6, 2007)
What exactly was the purpose of this study? Who is financing such a study and for what purpose? Wasn't the specific outcome preprogrammed from the outset and even a condition for the sponsoring of the study?
Does an apparent association necessarily mean causality? What about confounders, such as education, socioeconomic status, cultural differences between ethnic groups?
And finally, what's to be learned from such a study and how does it help us in our everyday lives? There are differences in behavior in individuals or groups of individuals, we know that without having to finance studies.
Lance Kaczorowski (March 6, 2007)
Let me state first that I have never smoked and I don't understand why it remains legal. I support your good intentions. However, I have trouble following your logic. It seems that you are asserting that nearly all R-rated movies include smoking, that watching R-rated movies inspires teens to smoke, and thus smoking should result in an automatic R-rating. The recommended action assumes that the reason that the teens who have low exposure to R-rated movies are refraining from smoking is *primarily* because of a lack of exposure to seeing movies that include smoking. Being a parent of three teens myself, you need to ask why it is that the low-R-Rating-exposure group of teens has such a low exposure to R-rated movies. If anything, teens *want* to see R-rated movies simply because they legally can't without their parents taking them and/or renting the movie for them. My point is that a teen who voluntarily avoids R-rated movies probably had a stricter upbringing to begin with. I don't think the course of action you are recommending will have a measurable effect. The teens who are most at risk are already watching R-rated movies. Did any of the studies also look for the influence of strict/permissive parenting on the children's smoking?
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