• Advertising and promotion
• health services
• tobacco products

In the 1930s, Edward Bernays, the originator of cigarette marketing strategies still in use today, recognised the marketing power of encouraging the use of cigarettes in film, and cigarettes were made an important prop in movies.1 2 This strategy stuck. Standardised assessments of movies' content over a time period extending from the 1930s to the present day document that cigarettes and cigarette smoking have been commonly portrayed in movies, possibly at a frequency that exceeds actual use patterns.2 Concern about smoking in movies is not new but only recently, however, has research been carried out to assess if seeing smoking in movies increases risk for initiation of smoking.3 The most definitive evidence comes from cohort studies that prospectively assess risk for initiation in association with the profile of movies previously viewed. These studies are not affected by the temporal ambiguity that clouds cross-sectional studies, but even prospectively determined associations might partially reflect a factor—for example, risk-taking behaviour, that affects both movie choices and likelihood of initiating smoking.

Mounting experimental and observational evidence now shows that smoking in movies is associated with initiation of smoking by youths; a 2008 review in the National Cancer Institute Monograph 19, The Role of Media in Promoting and Reducing Tobacco Use, concluded: “The total weight of evidence from cross-sectional, longitudinal, and experimental studies, …