There is now little debate about whether watching smoking in movie scenes increases the risk of smoking in teens. This issue has been examined literally for decades and the results are consistent and strong: the higher the exposure to movie star smoking, the higher the possibility that the teen will start smoking. The question that still remains is whether these effects are permanent/stable. That is, are kids who start smoking in response to repeated exposure to smoking in films likely to continue smoking years later? Or is the effect short lived?

The last issue of the Journal of the American Academy of Pediatrics included a very comprehensive prospective study of the long term effects of exposure to movie smoking among teens. The study was written by Dr. Madeline Dalton and a team of researchers from Dartmouth Medical School. The study included 1,791 children who were initially assessed when they were between 10 and 14 years old. During the initial assessment the kids were presented with a list of 50 popular movies, which had been previously examined for smoking content. Using a formula that accounted for the number of movies seen, the number of smoking occurrences of those movies, and other similar factors, the children were classified into 4 quartiles representing the estimated number of smoking events they saw.

1. 0 to 531 occurrences (low)
2. 532 to 960 occurrences (mild)
3. 961 to 1664 occurrences (moderate)
4. 1665 to 5308 occurrences (high)

(I added the characterization in parenthesis simply to facilitate the discussion of the results below)

A number of other possible confound factors were also measured at this age including gender, age, school, school performance, sensation seeking, rebelliousness, self-esteem, whether their parent, sibling, or friends smoke, parent education, parenting style, and the kids’ perception of parental disapproval.

The kids were then contacted 7 to 8 years later to assess whether they were habitual smokers.

The Results:

While controlling for gender and school, and when compared to the low exposure group:

1. Mild exposure increased the risk of becoming a habitual smoker by 54%
2. Moderate exposure increased the risk of becoming a habitual smoker by 117%
3. High exposure increase the risk of becoming a habitual smoker by 188%

When controlling for all alternative explanatory variables:

1. Mild exposure increased the risk of becoming a habitual smoker by 36%
2. Moderate exposure increased the risk of becoming a habitual smoker by 68%
3. High exposure increased the risk of becoming a habitual smoker by 98%

Therefore, even when controlling for a large number of possible explanations, exposure to high number of movie scenes with smoking during early adolescence can double the chances that the teen will become a habitual smoker. The authors concluded that after controlling for other variables, approximately 35% of habitual smoking during late adolescence and young adulthood can be directly attributed to earlier exposure to movie smoking scenes.

The authors discussed another very interesting finding. Movie smoking exposure was a stronger predictor of habitual smoking than having a parent or a friend who smokes. This is highly significant because it is usually believed that one of the most powerful forces in pushing teens to smoke is peer pressure, or having close friends who smoke. The authors argued that limiting exposure to smoking in the movies through policy changes and parental monitoring would be highly effective in reducing habitual smoking and much easier to do than limiting exposure to friends or family members who smoke.

Is any of my readers familiar with the current status of policies or trends in the presentation of smoking in films? Are the number of scenes with smoking lower than in the past? And if so, is it due to an effort by the movie industry to change this practice?

UPDATE:
After a discussion of this issue on Child-Psych’s facebook page I did some additional reading on teen smoking rates and found an interesting report. Teen smoking peaked during the mid 1990s, and some speculate this was in response to aggressive tactics by the tobacco industry in promoting smoking to teens via the media (remember Joe the Camel). Then teen smoking decreased significantly. It seems that this decrease stabilized by the mid 00′s. From a relevant analysis from the University of Michigan:

It is likely that all of these factors contributed to the dramatic fall in teen smoking that has occurred since the mid-1990s, the investigators said. Thirty-day smoking rates have fallen from their recent peaks in the mid-1990s by 56 percent, 51 percent and 37 percent among 8th, 10th and 12th graders, respectively.

The article points to increases in cigarette prices, changes in advertisement of cigarette products, and a national anti-smoking campaign, as possible causes of this decline. But could a decrease in glamorized smoking in the movies also have contributed to the decline?

Dalton, M., Beach, M., Adachi-Mejia, A., Longacre, M., Matzkin, A., Sargent, J., Heatherton, T., & Titus-Ernstoff, L. (2009). Early Exposure to Movie Smoking Predicts Established Smoking by Older Teens and Young Adults PEDIATRICS, 123 (4) DOI: 10.1542/peds.2008-2102ResearchBlogging.org

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3 Responses to Teen Smoking: Does watching movie stars smoking lead to long-term cigarette use?

  1. Lisa Marini says:

    This is a very interesting review. There are a few groups (state departments of health, professional societies) that have voiced their opinions about the need to remove smoking from movies that children are seeing.

    Thank you for sharing.

  2. me says:

    i think the reason why teens or [teen stars] is because they hav the friends of that smoke and pluss some people may say that they didint hav a choice to do stuff like that but they did. its ashame when teen stars or just teens smoke. but when you read about the magazines with stars like kristen stewart smoke im use to it. we use to look up to these type of pepl ppl now look parctically about 90% percent of actors smok thats ashame

  3. There are possibilities of teens engage into smoking when they see their movie stars do smoke. To be like them they must act or they tend to impersonate their gestures. Teens do explore what the environment and peers are they with. Most of it comes from “curiosity”.

    “The article points to increases in cigarette prices, changes in advertisement of cigarette products, and a national anti-smoking campaign, as possible causes of this decline. But could a decrease in glamorized smoking in the movies also have contributed to the decline?”
    Most of this are already implemented but it never succeed. Even an ads saying “smoking is dangerous for your health” they never consider it either.

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