Tuesday, June 26, 2007

American Legacy Foundation Testifies that 390,000 Kids Start Smoking Each Year Due to Seeing Smoking in Movies

The American Legacy Foundation, in testimony at a special Congressional hearing on the topic of smoking in movies, claimed that one-third of all youth smoking initiation is due to smoking in movies. The Foundation also reiterated its call for an automatic R-rating for any movie depicting any smoking, with the exception of an accurate historical depiction or if the movie clearly reflects the dangers of tobacco use.

According to a Legacy press release: "Today on Capitol Hill, members of the U.S. Congress representing adults, parents and families across America convened for a hearing to discuss the negative impact that everyday images in media have on our nation's children. The American Legacy Foundation(R) was present to testify about important information on how images of smoking cause youth to start this dangerous and addictive behavior. ... Legacy specifically shared research that establishes a relationship between smoking in movies and on television and youth starting to smoke, finding that one-third of youth smoking initiation can be traced to what youth see on screen after controlling for all other factors, such as peer pressure, parental smoking and more. ... What research tells us, and what Congress heard today from us, is that the film industry -- by showing smoking on the silver screen -- recruits 390,000 new smokers each year. ... If the movie industry seriously intends to solve the problem of movie smoking, they would agree to our call for rating new smoking movies R, with the exception of the accurate representation of a historical figure or if the smoking clearly reflects the dangers of tobacco use."

The Rest of the Story

As I have explained, there are a number of reasons why one cannot validly conclude that on-screen smoking causes one-third of youth smoking initiation, even given the studies which have shown an association between exposure to smoking in movies and smoking behavior.

For one thing, parents who allow their kids to go out and see the types of movies that contain a lot of smoking are quite different from the parents who are more restrictive about what they allow their kids to be exposed to. In addition, the kids who go out to movies often are different from those kids who choose not to go out to these types of movies very often. It is very difficult to control for these major differences between these populations, which could well explain why one group is more likely to smoke. It is quite possible that it is not smoking in movies, but some other factor - related to WHY a parent allows their kids to spend hours and hours out with their friends watching these types of movies rather than forcing them to be home or in more controlled settings - that is the actual cause of increased smoking among this group.

Another serious methodologic problem with these studies is that there is most likely a severe measurement bias. Parents who are controlling enough not to allow their kids to go out to the movies are probably more likely to be listening in to or monitoring the phone call in which their childrens' smoking status is ascertained. It has been demonstrated that kids are significantly less likely to admit that they smoke when they believe a parent may be monitoring the phone call. This effect would create the appearance that kids who see more smoking in movies are more likely to smoke when the real effect has more to do with parental factors.

Even if the smoking in movies were contributing to the initiation of smoking, it is far too premature to make definitive quantitative conclusions about the specific proportion of kids who start smoking because of smoking depictions in movies. These definitive quantitative conclusions are, after all, based on only a handful of studies. If our science were loose enough to be willing to make these kind of quantitative conclusions based on such limited studies, we would have long ago been told that drinking coffee kills thousands of Americans every year from cancer and that if we all only write to Maxwell House, we could save thousands of lives a year.

Moreover, it is extremely unlikely that these studies are measuring an exclusive effect of seeing smoking in movies. Movies are just one source of exposure to depictions of smoking and to the formation of attitudes and social norms regarding smoking. Movies most certainly do contribute to these attitudes and norms, but to suggest that movies are the only such factor or that these studies are measuring an isolated effect of smoking in movies, is ridiculous and certainly not scientifically sound.

And to top it all off, even if we were to accept that smoking in movies does cause one-third of smoking initiation, there is no evidence to suggest that simply requiring an R-rating of movies that depict smoking would reduce kids' exposure. What might happen instead is that parents will stop paying as much attention to the movie ratings and that kids may be more likely to go to R-rated movies. An action like this one could undermine the ratings system to the point that parents don't pay much attention to it anymore. I don't know if that would be the effect or not, but neither do these anti-smoking organizations know that it wouldn't occur. My point is that even if smoking in the movies is as bad as these groups are claiming, it is inappropriate and not scientifically sound to state that the R-rating will save 60,000 lives per year.

What is not made clear in the American Legacy Foundation's press release 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 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.

The rest of the story is that the American Legacy Foundation's testimony amounts to an unsupported and implausible scientific assertion. In my expert opinion, Legacy is grossly overestimating the impact of smoking in movies. More importantly, Legacy is drawing unsound scientific conclusions. This is, in my view, an example of the shoddy science that has begun to surface in the tobacco control movement.

Of course, the ultimate of all hypocrisy is that at the same time that the American Legacy Foundation is blaming the movie companies for killing 60,000 people each year, Legacy is partnering with the chief culprit - Warner Brothers. The American Legacy Foundation and Time Warner are corporate partners. If the problem is really so severe as Legacy testifies, then how can Legacy possibly defend its corporate partnership with Time Warner? That is hypocrisy if I've ever seen it.

It appears that Legacy wants to have it both ways. It wants to look good to the public by condemning smoking in movies. But it also appears not to want to do anything to possibly disturb the financial benefits it obtains from its lucrative partnership with Time Warner. So in an action that is not so apparent to the public and doesn't make the news headlines, Legacy continues to partner with Time Warner and refuses to take the single action that would do the most to put pressure on Time Warner to change its practices -- rescinding the partnership.

A public renouncement of the partnership would bring media attention to the issue and would make a statement that public health organizations cannot partner with media companies until they change their practice of exposing kids to millions of smoking images each year. Instead, Legacy appears to be making the statement: "We want to look like we are doing something about smoking in movies, but we don't want to lose our lucrative financial benefits from our partnership with Time Warner. Money is more important than public health, but since the public doesn't see our partnership in the news headlines, we don't have to worry about the public thinking that we are actually more concerned about money than health."

What I consider to be the insincerity of Legacy's actions is also evidenced by the exceptions to its proposed policy. Apparently, the issue is not youth exposure to smoking in movies after all. Because Legacy states that the historically accurate portrayal of smoking is not a problem. So it is actually the context in which the smoking occurs that is the problem, not the smoking itself.

Legacy also has no problem with showing smoking in movies as long as the movie clearly reflects the dangers of tobacco use. But what does that mean? Does it mean that if a smoker is shown coughing, it is acceptable to depict smoking? Does it mean that if a smoker is shown having few health problems until he reaches older age, that is acceptable (since that may reflect the nature of the health effects of smoking in some situations)?

I can tell you right now - it is going to be hard to beat out the American Legacy Foundation for the 2007 Anti-Smoking Hypocrisy Award.

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