Exposure to smoking in movies among British adolescents 2001–2006
- 1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- 2Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, California, USA
- 3Department of Primary Care and Social Medicine, Imperial College, London, UK
- 4Onbeyond LLC, Fairfax, California, USA
- 5Division of Cardiology, University of California, San Francisco, California, USA
- 6Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
- Correspondence to Professor Stanton A Glantz, Center for Tobacco Control Research and Education, University of California, San Francisco, Box 1390, Room 366, 530 Parnassus, San Francisco, CA 94143-1390, USA
Contributors In addition to all authors' intellectual contributions to the conceptualisation of the study, interpretation of the data and final approval of the submitted manuscript, SJA designed the study, collected and analysed film box office data and BBFC/MPAA classification data, and co-wrote the manuscript; CM analysed audience composition data and commented on earlier drafts of the paper; JRP collected and analysed film studio data, provided general consultation on the structure of the film industry and commented on earlier drafts of the manuscript; and SAG co-wrote the manuscript, provided general consultation on the relevant literature and supervised the project.
- Received 24 November 2009
- Accepted 7 January 2010
- Published Online First 15 March 2010
Objective To estimate youth exposure to smoking in movies in the UK and compare the likely effect with the USA.
Methods We collected tobacco occurrences data for 572 top-grossing films in the UK screened from 2001 to 2006 and estimated the number of on-screen tobacco impressions delivered to British youths in this time period.
Results 91% of films in our sample that contained smoking were youth-rated films (British Board of Film Classification rating ‘15’ and lower), delivering at least 1.10 billion tobacco impressions to British youths during theatrical release. British youths were exposed to 28% more smoking impressions in UK youth-rated movies than American youth-rated movies, because 79% of movies rated for adults in the USA (‘R’) are classified as suitable for youths in the UK (‘15’ or ‘12A’).
Conclusion Because there is a dose-response relation between the amount of on-screen exposure to smoking and the likelihood that adolescents will begin smoking, the fact that there is substantially higher exposure to smoking in youth-rated films in the UK than in the USA suggests that the fraction of all youth smoking because of films in the UK is probably larger than in the USA. Other countries with ratings systems that are less conservative (in terms of language and sexuality) than the USA will also be likely to deliver more on-screen tobacco impressions to youths. Assigning an ‘18’ classification to movies that contain smoking would substantially reduce youth exposure to on-screen smoking and, hence, smoking initiation among British youths.
Funding This research was supported by Health@Work Liverpool, Liverpool Primary Care Trust, Smokefree Northwest, Roy Castle Lung Cancer Foundation and the American Legacy Foundation. CM undertook this study during a Harkness Fellowship in Health Care Policy and Practice and was supported of the Commonwealth Fund in New York. The funding agencies had no role in the conduct of the research or preparation of the manuscript.
Competiting interests None.
Provenance and peer review Not commissioned; externally peer reviewed.
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