Friday, November 28, 2008

American Academy of Pediatrics Center Director Defends Violence and Abuse in Movies Based on the Non-Addictive Quality of These Behaviors

In a response to Dr. Simon Chapman's criticism of the policy being supported by many anti-smoking groups which would require an R-rating for any movie depicting smoking, Dr. Jonathan Klein - Director of the American Academy of Pediatrics Julius B. Richmond Center of Excellence - argues that smoking, unlike violence and spousal abuse - deserves an automatic R-rating for any depiction because unlike these other behaviors it is addictive.

Dr. Chapman argued, for example, that the R-rating for movies that depict smoking is a narrow-minded approach that ignores the many other unhealthy behaviors that are portrayed in movies (for which the anti-smoking groups are not calling for an automatic R-rating), including: crime, physical inactivity, over-eating, excessive use of alcohol, unsafe sex, speeding and dangerous driving, gambling, risk taking such as extreme sport and adventure, motor cycle use and helmet-less cycling.

Dr. Chapman argues that: "an illustration of how such inconsistency plays out in practice comes from which rates the 2008 'What Happens in Vegas,' starring Cameron Diaz, as a "thumbs up/pink lung" because it contains no smoking. However, it does contain binge drinking, failure to wear seat belts, intoxication leading to possibly unprotected sex, gambling and a parody of spousal abuse."

In his response, Dr. Klein defends the proposed policy - which the American Academy of Pediatrics has endorsed - by arguing that unlike other behaviors, smoking is addictive. Apparently, the addictive nature of smoking is what warrants giving the depiction of smoking an automatic R-rating. Dr. Klein writes: "Other potentially adverse role modeled behavior does not have tobacco's highly addictive drug, nicotine, as a factor in children's exposure. The behavioral expectancy establishes a modeled response which then is reinforced by pharmacology, with well established and substantial health results. This is why the American Academy of Pediatrics and many other medical and public health organizations have endorsed the R rating."

The Rest of the Story

So let's get this straight. While smoking, crime, physical inactivity, over-eating, excessive use of alcohol, unsafe sex, speeding and dangerous driving, failure to wear seat belts, physical and sexual abuse, gambling, risk taking such as extreme sport and adventure, motor cycle use and helmet-less cycling are all unhealthy behaviors depicted in film, smoking is the only one of these which should trigger an automatic R-rating because it, unlike the others, is addictive and in which its effect on children's and adolescent's behavior is pharmacologic.

Coming from the American Academy of Pediatrics, I find this to be an unfortunate and irresponsible statement. How can an organization that is supposed to have a wide view of health problems affecting children and adolescents defend the depiction of crime, binge drinking, unsafe sex, speeding and dangerous driving, and physical and sexual abuse in movies on the grounds that these are not pharmacologically addictive behaviors?

That is, unfortunately, exactly what the statement is doing.

This response seems to me to highlight just how narrow-minded a view of the world anti-smoking groups now have. The only thing that matters is preventing even a single depiction of smoking in movies. You can have all the binge drinking, sex, violence, and abuse that you want, but please - no cigarette smoking.

I don't exactly understand what has caused the anti-smoking movement to reach the point where it has a single-minded view of the world in which smoking is the only problem in the world that needs to be addressed. It perplexes me why we would want to address only the depiction of smoking in movies, while ignoring the extreme violence and physical abuse (and a host of other unhealthy behaviors) that dominate even children's films today.

But that narrow-minded, single-issue approach is exactly what the anti-smoking and health groups that have endorsed the R-rating policy are doing.

And this response to Dr. Chapman's broad-based and well-reasoned argument demonstrates just how unreasonable, irresponsible, and even damaging this single-issue, narrow-minded approach can be.

My published "rapid response" to the commentary and responses appears here.

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