Thursday, December 1, 2011

Seeing Through the "Smokescreen": Smoking in the Movies

The Academy Award winning movie “Avatar” is the top earning movie worldwide, with total earnings of $1.84 billion. Perhaps you were among the more than 25 million people who saw it? You might have even seen it with your kids – it is, after all, a 3-D animated film.
While Avatar received rave reviews, not all were positive. A number of critics picked up on something that might have only registered at a subconscious level for the viewer: smoking.

Sigourney Weaver’s character, Dr. Grace Augustine, a hardened but likable scientist, smokes on several occasions in the movie and even has scripted lines about her smoking behavior. While this may seem like a harmless part of her character development - as argued by Director James Cameron1, research suggests that the implications of smoking in the movies are far greater – especially for kids and adolescents.
Smoking is still the number one cause of death and disease in the U.S. today and most adults who smoke started as adolescents2. A study published last month in the Journal of Health Communication3 is the most recent in a series of studies about the effects of smoking in the movies on adolescents. The study used a series of telephone interviews, conducted with 6,522 adolescents (age 10 to 14 at the start of the study) every eight months over the course of two years. Adolescents were asked about their personality traits, smoking behavior, and media exposure, including being asked to report at each call whether or not they had seen any of 50 different randomly selected movies. Researchers were able to estimate how much each adolescent had been exposed to smoking in the movies by analyzing the number of times smoking was depicted in each movie.
Findings from the study suggest that adolescents who see a lot of movies that depict smoking are more likely to start smoking at an earlier age compared to those who have no or little exposure to movies depicting smoking.  However, the study found that smoking in the movies was not related to an increase in overall smoking if the adolescent had already started. Other factors like being around people who smoked and having easy access to cigarettes played a stronger role in continued or increased smoking behavior. In other words, seeing smoking in the movies seems to set in motion smoking behavior in adolescents, which is then maintained or increased by other social factors.
Why Does It Matter if Adolescents start Smoking Earlier?
Children and adolescents make up the majority of new smokers today. The earlier adolescents start smoking, the more likely they are to become heavy smokers and the more challenging it will be for them to quit4. They are also at increased risk for lung cancer, serious respiratory problems, depression and anxiety5. The tobacco industry knows that promoting smoking among youth is one of the best ways to sustain the population of smokers6 and the industry has a long history of promoting tobacco products through movies7.
What Can We Do About It?
These findings suggest that intervening to prevent early adolescent initiation is key, and that lowering exposure to movies that depict smoking may help to do that. So what can you do?
As a parent, you can start by selecting films to see with your children that don’t depict smoking. You can also be more aware of the messaging that is present in films that you do watch with your kids. Finally, you can talk to them early and often about the dangers of smoking.
But you don’t have to stop there - you can also be an activist for the issue and help promote solutions to protect all adolescents, not just your own children or friends, from additional exposure to smoking in the movies. Communities here in the U.S. and internationally have mobilized through a non-profit group called “SceneSmoking” (www.scenesmoking.org) to encourage those concerned about this issue to:
  • Write letters to:
    • Ask local theaters to increase anti-tobacco messages before and after films that depict tobacco products. At least this will provide adolescents with information and imagery on both sides of the issue.
    • Demand that the Motion Picture Association of America assign harsher ratings for films that show smoking. By assigning an “R” rating to films that show smoking, the behavior does not have to censored, but children and adolescents are protected.
    • Ask studios themselves for more transparency in product placement. Often, studios receive large amounts of money to show smoking behavior or even a particular brand of cigarettes. They should be required to disclose this; making the public aware that it is effectively an advertisement within the film.
  • Engage your own kids, neighbors and friends in the issue and empower them to educate their peers. By getting adolescents involved in the issue and raising awareness, they become conscious of what they are seeing. They can advocate for changes in the rating system and even create their own rating system.
What’s the Counter Argument?
While individuals from the film industry and the Motion Picture Association of America (MPAA) acknowledge the dangers of smoking, they argue that film is about depicting the real world and we shouldn’t have to censor or “dumb down” reality. They also point out that violence is arguably more concerning and should be addressed first and foremost.
Ethically, the primary concern among opponents of regulating smoking in the movies is censorship. However, Dr. Stanton Glantz, the Director of the University of California, San Francisco “Center for Tobacco Control Research and Education” is quick to point out that the current movement is not asking for censorship. Dr. Glantz says that, at the very least, integrating smoking into the MPAA rating system is important because “it allows producers to still be free to depict smoking if it is necessary for the art of the film, but to do it in such a way that isn’t going to cause hundreds of thousands of kids a year to start smoking.”
Author Biography: Gillian Schauer is passionate about protecting kids from the harms of tobacco and helping adults to quit. She has worked in cancer prevention and tobacco control for nine years and is now a doctoral student at Emory University.  
1: Cieply, M. James Cameron Responds to Critics of Smoking in “Avatar”, The New York Times, January 3, 2010.
2: U.S. Department of Health and Human Services, 2000. Healthy People 2010: Understanding and Improving Health. Accessed 2011 from: http://www.feddesk.com/freehandbooks/121505-1.pdf.
3:Dal Cin, S., Stoolmiller, M., & Sargent, J.D. (2011). When Movies Matter: Exposure to Smoking in Movies and Changes in Smoking Behavior. Journal of Health Communication, e-pub ahead of print: DOI:10.1080/10810730.2011.585697
4: Chen, J. & Millar, W. (1998). Age of smoking initiation: Implications for quitting. Health Reports, 9, 39-46.
5: CDC. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, 2004. [Accessed 2011 from: www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm].
6: R.J. Reynolds. Report:The Importance of Younger Adults. 1984. Source: http://legacy.library.ucsf.edu/tid/ eyn18c00, Bates:503418151/8156.
7: Glanz SA. Smoking in movies: a major problem and a real solution. Lancet 2003; 362: 258-259.

9 comments:

  1. I wonder how exposure to smoking in real life might influence adolescent smoking as compared to exposure to smoking in reel life. Does having a parent who smokes in the home matter as much as seeing characters in movies? Who's the worse influence: Sigourney Weaver or mom? This question is more about the power of media than whether or not family matters. There's strong evidence that parental smoking in the home leads to increased rates of smoking among adolescents, making it another important target for health intervention, but knowing what factors matter most helps plan where to focus limited resources.
    Kira

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  2. Clearly laid out and easy to read! In Bollywood movies, there is a notice at the top of the film that says smoking is bad for you. in the most recent film "Ra.One", SRKhan the most famous B-wood actor and publicly known chain smoker has a brief scene with a child about how smoking kills 10,000 people every year. It's a charade, but a crude attempt to save a few lives because everyone knows his nasty habit. The subtlety of only the emotionally disturbed/bad guy/slutty woman characters smoking is too subtle for teens and kids. Your article speaks to what adults can do to help the problem. What can schools/pub health do to educate teens that smoking is used to depict these negative traits? Traits they wouldn't want to be associated with, necessarily. Educate the teen through innovative programs. If the parents are already smoking, why would they care if their kids do it too?

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  3. @Kira - thanks for the comments. You are absolutely right in suggesting that a number of other social and environmental factors lead to a higher likelihood of becoming a smoker. Parental variables (smokers or not) as well as social variables (peer norms, access to cigarettes) were measured and controlled in this study. When controlling for those factors, adolescents who saw more media with smoking imagery started smoking at an earlier age than those who did not. This is a fairly new area of research, so much more work would be needed to determine any causal relationship. I think the take away from this study is that all of these factors are important, but at different points in the cycle of becoming a smoker.

    @Doda - Interesting information about Bollywood! I agree that schools and the community can get involved to help keep adolescents from starting to smoke. Unfortunately, there are not many evidence-based programs for adolescent education on this topic, particularly when it comes to school-based programs. The TRUTH mass media campaign, funded by the American Legacy Foundation, has been one of the more effective interventions...

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  4. YAY! I work in tobacco prevention and always enjoy a good read that isn't loaded with technical jargon. Only suggestion - avoid the superscripts for citations - kinda breaks up the post.

    Also, UCSF's Center for Tobacco Control & Research doesn't need to be put in quotes -- threw me off a little. I get to meet Dr Glantz next month - seems like a fiesty one :-).
    ~Kiran, Ariela's former student and perpetual mentee (and a huge advocate for SF movies!)

    PS - more interesting news coming out of the Bollywood scene:
    http://www.hindustantimes.com/Entertainment/Bollywood/Smoking-on-screen-becomes-a-trouble-for-Bollywood/Article1-776088.aspx

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  5. Great post -- friendly to read and engaging!

    I agree with Kiran that it would be more blog-ly to use embedded text links (link the words to the site) instead of the superscript numbers.

    I don't know the literature on this area or on sex/drugs/violence in movies, but I am wondering if the same type of research has been done there. Also, I'm interested in Kira's question regarding impact of certain types of characters in movies. Do bad guys or good guys have more influence? Women or men? (and more influence on whom)?

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  6. The picture is very catchy and very interesting. Next time I watch Avatar, I will try to find this scene. The opening of the blog is very engaging.
    Yunxuan Jiang

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  7. Gillian, Great post – super easy to read and relate to!

    I think it is extremely important that you are discussing the way smoking in movies impacts young viewers and how this may spawn a life-long smoking habit...you've brought to light something we, as adults, likely overlook when watching movies.

    I found it extremely interesting that MPAA defends smoking in movies by saying these activities represent the real-world and that MPAA shouldn't have to "dumb-down" real life experiences because of viewer objections.

    My thoughts: really MPAA, that is your defense? If MPAA wants to represent the real-world and the consequences of real-life smoking, why don't they flash forward to Sigourney Weaver’s character walking around the jungle towing an oxygen tank and respirator to help her combat emphysema. OR, if that is a little too dramatic, how about Sigourney on chemo, or Signourney huffing and puffing as she walks around the jungle, or Sigourney being eaten alive by some jungle animal because she couldn't outrun it. And, let's not forget about blood clots and looking super haggard at a young age...

    We all have a responsibility to our future generation to promote a healthy lifestyle and, Gillian, I really appreciate you your advice on how parents and adults can keep kids informed about smoking.

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  8. Great post Gillian! I liked the introduction and your use of a popular movie to grip readers attention. There was a nice flow of the article from background research to what people can do about the topic, and it was helpful that you had suggestions for both parents and those that want to get more involved as advocates. I also really liked the addition of a counter argument because it allows the readers to see another sides of the topic and draw their own conclusions. Elaborating this side only made your arguments stronger (even if it is presenting a counter argument such as Kira's question about family influences and then answering it with data).
    Nice job with adding links, especially to the scenesmoking for those who want to get more involved (though I found their website a bit confusing when I went to it, maybe they could use someone in health literacy to make it more reader friendly!). I also agree that linking the words is most helpful. It makes it easier to look back and find the links you are interested in viewing. I liked how thorough you were with all the sources though. Overall, great job!

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