In 1997 Ron Davis, Tobacco Control’s inaugural editor, and I wrote an editorial titled Smoking in movies: is it a problem?1 Since then, a growing body of research has examined the relation between viewing of movies containing depictions of smoking and subsequent smoking among youth. Reviewing this evidence, a 2008 National Cancer Institute monograph concluded “The depiction of cigarette smoking is pervasive in movies, occurring in three-quarters or more of contemporary box-office hits. Identifiable cigarette brands appear in about one-third of movies. The total weight of evidence from cross-sectional, longitudinal and experimental studies indicates a causal relationship between exposure to depictions of smoking in movies and youth smoking initiation.”2 The report’s conclusion is consistent with commonsense and should give major impetus to what is a growing debate. If the highly choreographed imagery of tobacco advertising influences the uptake of smoking, then so will widespread positive depictions of smoking in movies, now arguably rivalling direct tobacco advertising as the world’s largest vector for sustaining the appeal of smoking. Smoking in movies is a problem.

So what might be done about it? Many nations ban all tobacco advertising because of its influence on smoking. The idea that movies with smoking scenes should similarly be either banned or at least regulated through adult-only classification has gained traction in a small number of nations, particularly India, Thailand and the United States. The debate remains nascent elsewhere, with few signs of government interest.

In this commentary, I critically review three of the most prominent strategies proposed as ways of controlling smoking in movies. I caution that banning smoking from movies constitutes a fundamental threat to freedom of expression, inviting unavoidable ridicule for the inconsistencies and “airbrushing of reality” that its adoption would unleash. This is likely to alienate many ordinary and influential …