Smoking in Movies Called Greatest Media Threat to Children's Health

According to a press release issued by the American Academy of Pediatrics, two anti-smoking researchers have called smoking in movies the greatest media threat to children's health.

The press release opens: "While headlines have focused on violent video games and Web predators, the single greatest media threat to U.S. kids comes from tobacco-laced movies and videos according to James Sargent, MD, FAAP, and Stanton Glantz, PhD. As discussed today at the American Academy of Pediatrics (AAP) National Conference and Exhibition (NCE), three major population studies between 1999-2004 display a striking dose-response by adolescents to on-screen smoking in movies and videos: the more smoking children see on screen, the more likely they are to become smokers."

The solution to this problem, according to the researchers, is to require films that depict smoking to carry an R-rating. Dr. Glantz was quoted in an ABC News story as stating: "That one simple change in the rules, we think we would prevent about 200,000 kids a year from starting to smoke."

The Rest of the Story

What is not made clear in these news reports is that the claim that requiring a R-rating for movies that depict smoking would result in 200,000 fewer kids starting to smoke each year rests on the assumption that such an intervention would eliminate exposure to smoking in movies for one-half of all kids who are currently exposed to smoking in movies.

But there is no evidence (0.0 studies) that requiring an R-rating for movies that depict smoking would eliminate exposure to smoking in movies.

In fact, research published by one of the very researchers mentioned above documented that only 16% of kids are restricted from watching R-rated movies. So requiring an R-rating for movies depicting smoking would eliminate exposure to smoking in movies for only 16%, not 50% of kids.

And this assumes that parents do not change their behavior if smoking in movies results in an automatic R-rating. Another possibility is that such a move would undermine the current rating system, leading parents not to worry so much about whether their kids view such movies, because they may figure that it might only be smoking to which their kids are being exposed. In other words, the R-rating could become much less meaningful to parents as a way of knowing the movies to which their kids should be restricted if smoking automatically triggers an R-rating.

It is possible, in fact, that such an intervention could actually increase kids' exposure to violence and sex in movies, as parents may be less likely to restrict their childrens' access to R-rated movies.

The important point, though, is that even if there is no change in parental behavior, a whopping 84% of kids are allowed to see R-rated movies anyway. Thus, requiring an R-rating for movies that depict smoking would be expected to have only a marginal impact on eliminating youths' exposure to these depictions.

In fact, the study which found that 84% of kids are allowed to see R-rated movies argued that the appropriate intervention to reduce youth smoking is to try to encourage parents not to allow their kids to see R-rated movies. The article concluded: "Limiting the exposure of adolescents to R-rated movies may prevent early use of alcohol and tobacco."

It is important to note that based on this research, changing the rating of movies that depict smoking would have little impact on youth smoking, in contrast to the claim that such a move would prevent 200,000 kids a year from starting to smoke.

The bottom line is that the claim that requiring an R-rating for movies that depict smoking would prevent 200,000 kids a year from starting to smoke is unsupported by the evidence. It is pure speculation, and not even well-supported speculation at that.

A second assumption underlying this claim, which you won't read about in the news, is that exposure to smoking in movies does not correlate with exposure to other sources of media depictions of smoking, or to cigarette advertising, that may influence smoking initiation. It may be that seeing smoking in movies is simply a measure of a broader construct: overall exposure to smoking depictions from a wide array of media sources.

After all, movies are not the only source of media depictions of smoking. There are smoking depictions in music videos, on television, in magazines, and in cigarette advertising. To the extent that exposure to these depictions correlates with exposure to smoking in movies, the conclusion that it is purely exposure to smoking in movies that is causing nearly half of all kids to start smoking is inaccurate.

A third assumption underlying the claim, which you also won't read about in the news, is that the relationship between seeing smoking in movies and smoking initiation is not at all attributable to factors that correlate with parental styles regarding the restrictiveness of regulation of their childrens' activities. Is is not true that parents who never let their kids see an R-rated movie are probably different in many respects from parents who do let their kids see R-rated movies, and that these differences, rather than the movies itself, could explain some of the observed differences in smoking initiation rates?

These issues are discussed in some detail in an earlier post.

Whether or not smoking in movies is a substantial public health problem in its own right, it seems quite a stretch to claim that giving movies that depict smoking an R-rating will prevent 200,000 kids a year from starting to smoke. It is a stretch that goes beyond the realm of science.

Even if one were to accept that smoking in movies, in and of itself, is a major public health problem, it hardly seems like it would be at the top of the list in terms of the greatest media threats to childrens' health. I can tell you, working in the inner-city of Boston, that the depiction of violence, especially gun violence, on television and in movies is probably at the top of my list. We have already reached our 55th homicide in the city this year, and you would be hard-pressed to convince anyone living in Roxbury or Dorchester that people lighting up in movies is a far more grave threat to our children's health and welfare than the cultivation of a culture of violence.

I don't quite understand why we need to claim that our particular pet issue is the most important one in the world. Why, in the midst of a terrible problem of youths being murdered and families being scared about walking around on the streets, fearing for their lives, do we need to undermine this immediate life-threatening issue by blasting the public with the contention that smoking is the worst possible thing that a movie could show?

Frankly, it seems like a bit of an insult to parents of children who fear for their kids' safety just walking around in their neighborhoods at night.

It seems that every public communication by anti-smoking groups needs to be greatly exaggerated and blown out of all proportion. Tobacco control is just a part of public health. We shouldn't lose our broader perspective by working constantly with blinders on that shield us from seeing anything but the issue on which we are currently working.