Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study

Abstract Objective: To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents. Design: Cross sectional survey of 4919 schoolchildren aged 9–15 years, and assessment of occurrence of smoking in 601 films. Setting: Randomly selected middle schools in Vermont and New Hampshire, USA. Main outcome measure: Number of schoolchildren who had ever tried smoking a cigarette. Results: The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49–152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0–50 occurrences of smoking, 13.7% for 51–100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0–50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent. Conclusion: In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents. What is already known on this topic Smoking is often depicted in films, and watching films is a favourite activity of adolescents Adolescents whose favourite actors smoke in films are more likely to have tried smoking What this study adds Adolescents' exposure to smoking in films varies widely Adolescents with higher exposure are significantly more likely to have tried smoking, even when other factors linked with adolescent smoking have been taken into account This study supports the hypothesis that depictions of smoking in films influence adolescents to smoke

[1]  Doris G. Bazzini,et al.  Who smokes in Hollywood? Characteristics of smokers in popular films from 1940 to 1989. , 1998, Addictive behaviors.

[2]  S A Glantz,et al.  Popular films do not reflect current tobacco use. , 1994, American journal of public health.

[3]  Donald F. Roberts,et al.  Substance Use in Popular Movies and Music. , 1999 .

[4]  Scott A. Shamp,et al.  Video Movies at Home: Are They Viewed like Film or like Television? , 1991 .

[5]  L. Cameron,et al.  Adolescent perceptions of smoking imagery in film. , 2001, Social science & medicine.

[6]  T. Heatherton,et al.  Favourite movie stars, their tobacco use in contemporary movies, and its association with adolescent smoking , 2001, Tobacco control.

[7]  E. Donnerstein,et al.  Children, adolescents, and the media in the 21st century. , 2000, Adolescent medicine.

[8]  James D Sargent,et al.  Brand appearances in contemporary cinema films and contribution to global marketing of cigarettes , 2001, The Lancet.

[9]  W. Miller.  Letter from the editor: Tobacco and alcohol , 1995 .

[10]  R. Kronmal,et al.  Assessing the sensitivity of regression results to unmeasured confounders in observational studies. , 1998, Biometrics.

[11]  W. Miller.  Tobacco and alcohol. , 1995, Seminars in roentgenology.

[12]  A. Goldstein,et al.  Tobacco and alcohol use in G-rated children's animated films. , 1999, JAMA.

[13]  D Mangelsdorff,et al.  What is the sensation seeker? Personality trait and experience correlates of the Sensation-Seeking Scales. , 1972, Journal of consulting and clinical psychology.

[14]  E. Gilpin,et al.  Tobacco industry promotion of cigarettes and adolescent smoking. , 1998, JAMA.

[15]  E. Gilpin,et al.  Do movie stars encourage adolescents to start smoking? Evidence from California. , 1999, Preventive medicine.

[16]  S. Chapman,et al.  Smoking in movies: is it a problem? , 1997, Tobacco control.

[17]  Chuan-Fong Shih,et al.  Smoking Scenes in Movies and Antismoking Advertisements before Movies: Effects on Youth , 1999 .

[18]  C. Jackson,et al.  The Authoritative Parenting Index: Predicting Health Risk Behaviors Among Children and Adolescents , 1998, Health education & behavior : the official publication of the Society for Public Health Education.

[19]  Benjamin B. Lahey,et al.  A sensation seeking scale for children: Further refinement and psychometric development , 1993 .

[20]  R. Evans,et al.  Psychosocial determinants of the onset and escalation of smoking: cross-sectional and prospective findings in multiethnic middle school samples. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[21]  J. Carol,et al.  Hollywood on tobacco: how the entertainment industry understands tobacco portrayal , 1999, Tobacco control.

[22]  T. Heatherton,et al.  The incidence and context of tobacco use in popular movies from 1988 to 1997. , 2002, Preventive medicine.

[23]  Children, Adolescents, and the Media , 2002 .

[24]  R. Bonnie,et al.  Growing up Tobacco Free: Preventing Nicotine Addiction in Children and Youths , 1994 .

[25]  L. Cronbach.  Coefficient alpha and the internal structure of tests , 1951 .

[26]  D. F. Roberts,et al.  Media and youth: access, exposure, and privatization. , 2000, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.