Tob Control doi:10.1136/tc.2011.044099
  • Research paper

The reciprocal relationships between changes in adolescent perceived prevalence of smoking in movies and progression of smoking status

  1. Brian G Southwell2
  1. 1Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2RTI International, Research Triangle Park, NC, and University of North Carolina at Chapel Hill, School of Journalism and Mass Communication, Chapel Hill, NC, USA
  1. Correspondence to Dr Kelvin Choi, Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street Suite 300, Minneapolis, MN 55454, USA; choix137{at}
  1. Contributors KC, JF, DE, DL and BGS provided significant contributions to the conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content, and providing final approval of the version published.

  • Received 10 March 2011
  • Accepted 19 July 2011
  • Published Online First 9 August 2011


Background Smoking in movies is associated with adolescent smoking worldwide. To date, studies of the association mostly are restricted to the exposure to smoking images viewed by 9–15-year-olds. The association among older adolescents is rarely examined. In addition, the reciprocal effect of smoking behaviour on subsequent reported exposure to smoking in movies has not been reported.

Methods Data were from the Minnesota Adolescent Community Cohort Study collected every 6 months from 2000 to 2007 when participants were between the ages of 12 and 18 (n=4745). We estimated the prospective effect of the perceived prevalence of smoking in movies (four levels, from never to most of the time) on smoking stage (SS) measured 6 months later (six stages, from never-smoker to established smoker) and the reciprocal prospective association between the two factors. Estimates were adjusted for demographic factors.

Results The perceived prevalence of smoking in movies measured between ages 13½ and 15½ consistently predicted subsequent SS. The association was inconsistent after the age of 15½. SS did not consistently predict subsequent perception of the prevalence of smoking in movies.

Conclusions Perceived exposure to movie smoking primarily influenced teenagers' smoking behaviour at younger ages. If future studies confirm this finding, developing and evaluating interventions to improve young teenagers' resistance to these images may complement policies to reduce smoking in movies to reduce prevalence of adolescent smoking.


  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Minnesota Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Free sample

This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of Tobacco Control.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

This insightful video is produced by Cancer Research UK

Navigate This Article