New research reveals how the incidence of smoking in US-made movies is influencing teenagers in countries far beyond American shores. Studies in Germany and Mexico, as well as further evidence from the United States, show a correlation between the amount of smoking imagery in films and the likelihood of young teenagers starting to smoke.

-- A report in the journal Pediatrics [1] confirms that U.S. films deliver billions of tobacco images to U.S. children aged 10-14, the age-group most likely to begin experimenting with cigarettes. The study found that three out of four movies (74%) studied contained smoking. By calculating the number of American adolescents seeing each movie and the amount of smoking contained in each one, the researchers estimated that these films delivered 13.9 billion smoking images. Sixty-one percent of these were delivered by youth-rated movies.

-- The study in Germany [2], published today in the American Journal of Preventive Medicine, tested whether teens in a society where tobacco advertising is still rampant are as influenced by smoking on-screen. After controlling for demographic, media and psychosocial factors, investigators found that teens who had seen the most smoking in films (mostly U.S. blockbusters) were more than twice as likely to have tried smoking than those who saw the least amount - results that mirror findings in the U.S.

-- The study in Mexico [3], as yet unpublished but presented at recent conferences, also found that, after controlling for all other factors known to influence whether teens start to smoke, exposure to on-screen smoking is strongly correlated with teens taking up cigarettes. So far, Germany and Mexico are the largest export markets for U.S. films to replicate U.S. cross-sectional studies of movie smoking and teen smoking.

These new reports come six weeks after the Harvard School of Public Health, invited by the Motion Picture Association of America (MPAA) to make recommendations on the tobacco question, advised the U.S. film industry to "eliminate the depiction of tobacco smoking from films accessible to children and youths." The MPAA, which represents the major studios, has yet to respond publicly.

Tobacco control advocates around the globe are now calling on the film industry to curb smoking in films by:

-- Requiring producers to certify in the credits that no person involved in the production of the film received payment for the use or display of tobacco

-- Prohibiting the identification of tobacco brands in films

-- Requiring strong anti-smoking ads to be shown prior to any film being shown that includes smoking scenes

-- Giving future films containing tobacco images an "adult" rating.

In addition, ASH urges actors to question the need to smoke in any film and to put pressure on producers to not include smoking unless it is editorially justified. The US study found that just 30 actors delivered one quarter of movie character smoking to young adolescents. These were primarily lead males who starred as smoking characters in multiple movies.

Deborah Arnott, Director of the health campaigning charity ASH, said:

"Popular actors can exert a huge influence on young, impressionable minds. Films are a major source of smoking imagery and teenagers are nearly three times as likely to try tobacco if they regularly watch actors smoke. If more actors refused to play smoking characters, fewer children would be exposed to smoking scenes and would be less likely to see smoking as a desirable activity."

[1] Sargent, JD et al. Exposure to movie smoking among US adolescents aged 10 to 14 years: A population estimate. Pediatrics 2007; 119 (5): 1167-1176
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[2] Hanewinkel R and Sargent JD. Exposure to smoking in popular contemporary movies and youth smoking in Germany. Am J Preventive Medicine 2007

[3] Thrasher, JF. Smoking in the movies: Evidence and implications of impact among young adolescents in Mexico. (Unpublished)

www.ash.org.uk