Research to be published on THE LANCET'S website (http://www.thelancet.com/) highlights how cigarette smoking in movies could be a trigger for teenagers to take up the habit. An accompanying Commentary is calling for movies that contain smoking to be given an adult rating.

In 1999, Madeline Dalton and colleagues from Dartmouth Medical School, USA, surveyed adolescents (aged 10 to 14 years) about smoking and movie watching. Adolescent exposure to smoking in movies was estimated for individual respondents on the basis of the number of smoking occurrences viewed in unique samples of 50 movies, which were randomly selected from a larger pool of popular contemporary movies. From this survey, they identified 3500 adolescents who had never tried smoking. They did a follow-up survey with three quarters of the sample one to two years later to determine if they had tried smoking.

10% of adolescents had tried smoking during the follow-up period. Smoking initiation increased with greater exposure to smoking in movies. 17% of the teenagers in the highest category (top 25%) for exposure to smoking in movies had tried smoking compared with only 3% among those in the lowest category (bottom 25%) for movie-smoking exposure. After adjustment for other factors that could have influenced smoking initiation (including smoking among peers and parents), the investigators calculated that teenagers who viewed the greatest amount of smoking in movies were almost three times more likely to start smoking compared to those with low movie-smoking exposure.

Madeline Dalton comments: "Our results provide strong evidence that viewing smoking in movies promotes smoking initiation among adolescents. In this population, half of smoking initiation can be attributed to exposure to smoking in movies."

In an accompanying Commentary, Stanton Glantz from the University of California at San Francisco, USA, concludes: "The tobacco-control movement has spent many years and millions of dollars attempting to reduce youth smoking by working to implement policies that restrict youth access to cigarettes--with no effect on youth-smoking prevalence. By contrast, the work by Dalton and colleagues, together with the earlier research in this area, strongly indicates that pushing for policy changes to reduce youth exposure to smoking in movies will have a rapid and substantial effect on youth smoking--and the subsequent disease and death smoking causes. It is time for health advocates worldwide to join with WHO, the American Medical Association, the American Legacy Foundation, and the Los Angeles Department of Health in insisting that the authorities who rate movies give movies that depict smoking an adult content or R rating. Every day of delay means more unnecessary addiction and death because of Hollywood's love affair with the tobacco industry."

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Contact: Sue Knapp, Dartmouth College Office of Public Affairs, 7 Lebanon Street, Suite 201, Hanover, NH 03755-2112, USA;
T) 603-646-3661;
E) Sue.Knapp@Dartmouth.edu

Professor Stanton A Glantz, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA 94143-1390, USA;
T) 415-476-3893;
F) 415-476-2283;
E) glantz@medicine.ucsf.edu