Simon Chapman’s recent commentary on smoking in movies misses several
important points with regard to the influence of media portrayal of
tobacco on
children’s health (1). Chapman fails to recognize the ease with which
other
socially questionable behavior is rated R in US films. Using the Motion
Picture
Association of America voluntary ratings system (2), use of the 'F' word
as an
exclamation twice, or once in a sexu...
Simon Chapman’s recent commentary on smoking in movies misses several
important points with regard to the influence of media portrayal of
tobacco on
children’s health (1). Chapman fails to recognize the ease with which
other
socially questionable behavior is rated R in US films. Using the Motion
Picture
Association of America voluntary ratings system (2), use of the 'F' word
as an
exclamation twice, or once in a sexual context, yields an "R".
Other potentially adverse role modeled behavior does not have
tobacco's
highly addictive drug, nicotine, as a factor in children's exposure. The
behavioral expectancy establishes a modeled response which then is
reinforced by pharmacology, with well established and substantial health
results. This is why the American Academy of Pediatrics and many other
medical and public health organizations have endorsed the R rating. The
other Smoke-Free Movie goals: certification of no payoffs, true nonsmoking
counter-messages in trailers, and elimination of brand identification, are
important compliments to the R rating in helping protect youth. Together,
these strategies will moderate the smoking that youth may still be exposed
if
smoking were out of the G, PG, and PG-13 rated movies that are designed
specifically for children. Far from triggering the "backlash" that Chapman
fears, national surveys have shown that 70 percent of US adults agree that
movies that show smoking should be rated R (3).
The evidence base for what strategies are most effective for changing
the
effect of smoking in the movies is less strong. However, proposing
experiments to discover the best way to change the imagery promoting
social
acceptability of smoking would not be appropriate or ethical. Ridiculing
strategies to make it easier for parents to avoid or counter pro-smoking
imagery, as Chapman does, is also not terribly helpful. Definitive action
should be taken now, consistent with each nation's intent to protect their
youth.
Jonathan D. Klein, MD, MPH, Director
American Academy of Pediatrics Julius B. Richmond Center of Excellence
www.aap.org/richmondcenter
(585)275-7760
fax 585-242-9733
jklein@aap.org
1) Chapman, S. What should be done about smoking in movies? Tobacco
Control 2008;17:363-367; doi:10.1136/tc.2008.027557.
http://tobaccocontrol.bmj.com/cgi/content/full/17/6/363.
<http://tobaccocontrolbmj.com/cgi/content/full/17/6/363.> Accessed
11/25/08.
2) Motion Picture Association of America. Rating system. 2005.
http://www.mpaa.org/FilmRatings.asp. Accessed 11/25/08.
3) McMillen R.C., Tanski S., Winickoff J.P., Valentine N. (2007)
Attitudes about
smoking in the movies. Social Climate Survey of Tobacco Control.
Mississippi
State University Social Science esearch Center, American Academy of
Pediatrics. http://socialclimate.org/pdf/smoking-attitudes-movies.pdf
Accessed 11/25/08.
I would have written Simon Chapman's editorial 15 years ago, when I
first joined behind-the-scenes discussions in Hollywood to advocate the
same "solutions" he is now. Serious and sustained efforts by many
organizations (sometimes at substantial cost) to pursue the ideas Chapman
is now proposing repeatedly failed. Indeed, the amount of smoking
onscreen actually increased during this time. We only developed the
Smoke...
I would have written Simon Chapman's editorial 15 years ago, when I
first joined behind-the-scenes discussions in Hollywood to advocate the
same "solutions" he is now. Serious and sustained efforts by many
organizations (sometimes at substantial cost) to pursue the ideas Chapman
is now proposing repeatedly failed. Indeed, the amount of smoking
onscreen actually increased during this time. We only developed the
Smoke Free Movies policies (available at
www.smokefreemovies.ucsf.edu/solution) in consultation with people who
know how the motion picture industry actually works after these repeated
failures. The four Smoke Free Movies policies, particularly the R rating,
are designed to substantially reduce the dose of smoking delivered to
youth onscreen and the corresponding response of tobacco use without the
kind of outright ban that Simon, and we, find unacceptable.
An important new marker of the denormalisation of the tobacco
industry has occurred in Australia in 2008. It is traditional – indeed
usually mandatory -- for industries which may be affected by proposed
changes in government policy or legislation to be fully consulted through
formal processes prior to any changes taking place. In 2008, the
Australian government established a Preventative (sic) Health Task Force,
with s...
An important new marker of the denormalisation of the tobacco
industry has occurred in Australia in 2008. It is traditional – indeed
usually mandatory -- for industries which may be affected by proposed
changes in government policy or legislation to be fully consulted through
formal processes prior to any changes taking place. In 2008, the
Australian government established a Preventative (sic) Health Task Force,
with several key sub-committees, to examine ways that Australia could more
effectively prevent its major causes of chronic disease. The Task
Force’s chief mission was to “provide a blueprint for tackling the burden
of chronic disease currently caused by obesity, tobacco, and excessive
consumption of alcohol. It will be directed at primary prevention and will
address all relevant arms of policy and all available points of leverage,
in both the health and non-health sectors, in formulating its
recommendations.” The group’s report on tobacco control has now been
published (see
http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech
-tobacco).
The terms of reference for the Task Force included a requirement to
obtain “Input from the food, alcohol and medicines industries, from
stakeholders in these industries”. Significantly, no such requirement was
mandated for consultation with the tobacco industry.
This omission would appear to indicate that the Australian government
sees no merit in consulting with the tobacco industry when it comes to
preventing health problems. The local industry has often made overtures to
governments, including statements that it supports all platforms of
tobacco control [1]. The exclusion of the tobacco industry from routine
forms of consultation would seem to be yet another example of its ever-
spiralling pariah status in the community.
References
1. Davies D (Philip Morris) Speech to National Press Club Canberra
2005
http://tobacco.health.usyd.edu.au/site/supersite/resources/pdfs/DDavies_%20HR_%202005.pdf
The authors's Figure 2 identifies the 'smokers' zone' overlaid on a
map of modern Rome as resembling "the
location of the Jewish ghetto during the Third Reich."
In fact, a Jewish community has existed in Rome for over two thousand
years. In 1555 Pope Paul IV created a walled-ghetto for Jews as one of a
series of anti-semitic measures. The walls were torn down in 1870 when
Italy was unified as a single nation, lea...
The authors's Figure 2 identifies the 'smokers' zone' overlaid on a
map of modern Rome as resembling "the
location of the Jewish ghetto during the Third Reich."
In fact, a Jewish community has existed in Rome for over two thousand
years. In 1555 Pope Paul IV created a walled-ghetto for Jews as one of a
series of anti-semitic measures. The walls were torn down in 1870 when
Italy was unified as a single nation, leading to full emancipation of
Jews. Today's Jewish quarter, with its magnificent synagogue adjacent to
the Tiber river, is located on the same area, and is still referred to as
the Jewish Ghetto. It is unrelated to the German Third Reich.
The authors thank Holger Moeller for the previous e-letter. As he
noticed, there is a typographical error in the number related to attributable
deaths in New Zealand. The correct number is 8 per 100,000.
Professor Boddewyn’s reply is interesting for what it admits and
omits.
He admits that the International Advertising Association (IAA)
reports published in 1983 and 1986 were based on his editing of “the draft
paper written by Paul Bingham [of British American Tobacco].” To my
knowledge, there has been no such public admission previously by Professor
Boddewyn, BAT, or IAA in the 20+ years since publication of tho...
Professor Boddewyn’s reply is interesting for what it admits and
omits.
He admits that the International Advertising Association (IAA)
reports published in 1983 and 1986 were based on his editing of “the draft
paper written by Paul Bingham [of British American Tobacco].” To my
knowledge, there has been no such public admission previously by Professor
Boddewyn, BAT, or IAA in the 20+ years since publication of those reports.
However, Boddewyn omits an explanation as to why his name appeared
prominently on the cover of the IAA reports (see the image of the 1983
cover in my paper in Tobacco Control) and as the author of the “Editor’s
Introduction,” but Bingham’s name was nowhere to be seen in the entirety
of both documents.
He explains that “I did reveal from the start that my 1983 and 1986
reports were ‘prepared by and from industry sources, using data from
official and trade organizations.’” I acknowledged that disclosure in my
paper, but I added the following:
“However, the report provides no further information on who conducted
the analyses and wrote the text. Thus, the IAA publication links the
16–country study to the IAA itself, to Boddewyn and to ‘industry sources’,
but it is unclear whether ‘industry’ refers to the advertising or tobacco
industry.”
Boddewyn continues to obscure or ignore Bingham’s role in
ghost–writing the reports when he refers to “MY 1983 and 1986 reports”
(emphasis added).
Boddewyn claims that “MY reports on the impact of advertising bans on
tobacco consumption ... provided much needed information about this issue
at the time” (emphasis added). He omits any response to the comments in my
paper about a key flaw in the analyses by IAA/Bingham—specifically, the
failure to take into account other controls on tobacco demand (besides
advertising) such as tobacco price or income. Because of that flaw, it
would be correct to state that the reports provided misinformation or
disinformation much needed by the tobacco industry.
Ronald M. Davis, MD
Director
Center for Health Promotion and Disease Prevention
What a pleasure to be cited for something I published 25 years ago!
It is, of course, less pleasant to be implicitly incriminated as being
some sort of a “paid hack” for the tobacco industry. Besides,
the intended harm has been done since the Editor did not have the academic
courtesy of asking me to reply to this personal attack in the same issue
where the article by R.M. Davis has appeared.
What a pleasure to be cited for something I published 25 years ago!
It is, of course, less pleasant to be implicitly incriminated as being
some sort of a “paid hack” for the tobacco industry. Besides,
the intended harm has been done since the Editor did not have the academic
courtesy of asking me to reply to this personal attack in the same issue
where the article by R.M. Davis has appeared.
In answering this charge, I must mostly rely on my memory because
moving to a new school building in 2001 and my retirement later on led me
to get rid of some 40 filing drawers of manuscripts and correspondence.
It appears to me that the whole issue of “ghost-writing”
revolves around what an editor does since Ronald Davis correctly states
that I wrote the Introduction and “edited” the 1983 and 1986
editions of Tobacco Advertising Bans and Consumption in 16 Countries, that
were published by the International Advertising Association. I know
editing very well since I served 35 years as Editor of International
Studies of Management & Organization. In such a position of
responsibility, you check the texts that will get your imprimatur in terms
of the facts used, the quality of the arguments, the clarity and flow of
the logic as well as the causal argumentation or, at least, the
plausibility and convincingness of the conclusion.
Was I qualified to do this job at the time? I think so because I
majored in Marketing as well as Business & Its Environment (the
precursor field to Business & Society) at the University of Washington
where I wrote my doctoral dissertation in 1964 on a topic combining
political science and marketing. Since then, I have extensively published
on business-government relations and public affairs, both domestically and
internationally.
That is why the International Advertising Association (IAA) asked me
in the late 1960s and again in the 1970s and 1980s to conduct some 15
studies of the regulation and self-regulation of advertising around the
world on such topics as advertising to children, food advertisings,
decency and sexism in advertisements, and pharmaceutical advertising. The
latter study was good enough to have the World Health Organization –
no less – to ask me to replicate it in 1987 (“Report on the
WHO Survey on Ethical Criteria for Drug Promotion”) shortly after my
1986 second report on tobacco-advertising bans. The WHO must not have
thought badly of me at that time! This is a very good proof of independent
research credibility, is it not?
In any case, when the IAA asked me to edit the draft paper written by
Paul Bingham (who claimed to have “ghost-written” the whole
report), I did what a competent editor should do – namely, meeting
with Paul Bingham in London in order to check on the credibility of his
sources which were almost exclusively government reports based on the
national collections of excise taxes and other records which everybody has
used in tobacco-control studies. I also corresponded with tobacco-industry
market researchers and legal experts in the United States, Sweden and
Switzerland in order to verify or understand various data, statistical
techniques and legal points – hence, for example, my correspondence
with Jean Besques of Philip Morris in Lausanne.
I will add that I found these exchanges with tobacco-industry people
very valuable in understanding their business-government and public-
affairs philosophy, strategies and tactics – one of my predominant
research interests since 1964 (see above).
I did reveal from the start that my 1983 and 1986 reports were
“prepared by and from industry sources, using data from official and
trade organizations.” I was compensated for my time or reimbursed
for my expenses by tobacco firms and associations but most tobacco-control
researchers or their employers are and have to be subsidized one way or
another by somebody. Twenty-five years ago, “Competing
Interests” notes such as the one by Ronald Davis (who received
released time which is as good as money) at the end of his article were
unknown. However, I did acknowledge this industry support in my written
statement to Congress in 1987 and 1989.
Mr. Davis appears to be incensed that my reports on the impact of
advertising bans on tobacco consumption were given and did receive ample
publicity but this happened because they provided much needed information
about this issue at the time. Of course, many factors bear on smoking
initiation, habits and consumption but his criticism of my work fails to
report that tobacco-advertising bans were heavily promoted by antismoking
champions in the early 1980s – otherwise, why would congressional
bodies in the United States, Canada and New Zealand (among other
countries) have held special hearings on tobacco-advertising bans? It was
not just a matter of determining their effects on smoking but also of
testing the constitutionality of restrictions on the freedom of commercial
speech.
If you do not believe me, read the pronouncements of a leading
antismoking advocate at the time, Dr. K. Bjartveit, then Chairman of
Norway’s National Council on Smoking and Health: “A cautious
conclusion would be that the advertising ban [in Norway], with the
concomitant publicity through the legislative process, had an impact on
consumption and young people’s smoking and in combination with
continued and increased educational efforts, was a causal factor in the
new trend (Results and Conclusion. Paper presented at the Seventh World
Conference on Smoking and Health. Perth, Australia: 3 April 1990, p. 8).
Getting my research on tobacco-advertising bans published took some
interesting twists. I first submitted my article that appeared in the
British Journal of Addiction to a leading journal in public-health
management (its exact title escapes me because of my now missing files).
It was promptly returned to me as “unsuitable” but, at the
time, I could have sworn I knew who (Michael Pertschuck?) wrote the
rejection letter because of the similarities of the Editor’s
arguments to what he had written or testified against me and other
researchers not of his persuasion. So much for airing controversial views
in antismoking publications!
This situation led me to write an article for the Journal of
Advertising in 1993 (22,4, pp. 105-107) on “Where Should Articles on
the Link Between Tobacco Advertising and Consumption Be Published?”
For example, why did the famous study of how young kids could remember Joe
Camel ads appear in the Journal of the American Medical Association (JAMA)
– of all places! – rather than in the Journal of Advertising
or the Journal of Advertising Research where reviewers would have been
competent to handle a fairly straightforward proposition about advertising
effects on young people? We could as well have medical articles appear in
the Journal of Marketing!
Altogether, I do not have any regret to have edited these IAA reports
because they forced antismoking researchers to acknowledge (as I did) that
factors other than tobacco-advertising bans – their bˆte noire at
the time – were at play. Ultimately, they had to urge that
everything related to tobacco production, distribution and consumption be
regulated, with tobacco-advertising bans relegated to a complementary
role.
Those were the not-so-strawmen against whom the IAA reports I
introduced and edited had to challenge. In the spirit of free inquiry,
this was a do-able and respectable endeavor for which no apology is
needed.
Jean J. Boddewyn
Emeritus Professor of Marketing & International Business
Baruch College (CUNY)
9 April 2008
In response to our piece cautioning about the use of the
‘precautionary principle’ in debates about setting emissions limits, Nigel
Gray writes that it has been around since the beginning of public health
activity and offers as examples ‘[taking] the precaution of hunting for
clean water on the grounds that doing nothing might allow epidemics of
cholera, typhoid and hookworm to continue’ and the introduction of polio
vac...
In response to our piece cautioning about the use of the
‘precautionary principle’ in debates about setting emissions limits, Nigel
Gray writes that it has been around since the beginning of public health
activity and offers as examples ‘[taking] the precaution of hunting for
clean water on the grounds that doing nothing might allow epidemics of
cholera, typhoid and hookworm to continue’ and the introduction of polio
vaccine ‘as a precautionary manoeuvre because a small percentage of those
infected developed clinical disease’. While these measures (and countless
other public health measures) have been taken for ‘precautionary’ reasons,
this does not mean that they were undertaken as an exercise of what is
today known as the ‘precautionary principle’.
The point we were making in our piece was that the ‘precautionary
principle’ has a commonly understood meaning – one that is being
misapplied in the debate about emissions limits. Framing matters deeply
to the resolution of policy debates. If the debate about setting emissions
limits continues without assertions that the ‘precautionary principle’
favours the setting of limits and without assumptions that the TobReg
proposal is a ‘precautionary’ one, we think the debate will be better for
it.
Regulation and precautions
Nigel Gray
April 11, 2008
Jonathon Lieberman worries about TobReg’s use of the precautionary
principle as justification for recommending reduction of toxicants in
cigarette emissions and suggests that the precautionary principle is a
1970’s development. I thought it had been around since the beginning of
Public Health activity when we took the precaution of hunting for clean
water on...
Regulation and precautions
Nigel Gray
April 11, 2008
Jonathon Lieberman worries about TobReg’s use of the precautionary
principle as justification for recommending reduction of toxicants in
cigarette emissions and suggests that the precautionary principle is a
1970’s development. I thought it had been around since the beginning of
Public Health activity when we took the precaution of hunting for clean
water on the grounds that doing nothing might allow epidemics of cholera,
typhoid and hookworm to continue. Similarly we introduced polio vaccine
as a precautionary manoeuvre because a small percentage of those infected
developed clinical disease. However debating the precautionary principle
takes us away from the intention behind TobReg’s proposals to reduce
toxicants in smoke.
In simple terms we face the choice of doing nothing, or doing
something that has a strong chance of doing good ( eg.,removing
nitrosamines). Doing nothing means accepting the status quo and allowing
the industry to add whatever they like to cigarettes. I think there are
good reasons for objecting to the status quo as we face developments like
the marketing of candy flavoured cigarettes, which will probably appeal to
teenagers but will also probably contain increased sugar content (burning
sugars gives rise to acetaldehyde) so adding them is indirectly increasing
the carcinogen content of the smoke. I am unable to see how anyone can
see this as OK. I can’t imagine anyone adding carcinogens to any normal
consumer product.
In other words I am in favour of regulation of smoke and find it hard
to understand those who favour the status quo. I haven’t heard anyone
objecting to the regulation of beer or strawberry jam but the multi-
toxicant cigarette smoke seems to be different, even though we regulate
everything about its use and marketing.
The argument against this regulation is that we might somehow make
things worse by taking toxicants out of the mixture. We put appropriate
caveats into our reasoning and the article because of this possibility
despite the fact that I personally see it as remote, although I am aware
of the historical observation (1) that some things have gone down and some
have gone up. TobReg’s recommendations should avoid this possibility
It has to be conceded that thinking up rational ways of regulating
smoke was exceptionally difficult simply because of the complexity of the
mixture. I am, however, quite proud of the approach taken which I see as
practical. It will, of course, be supported by monitoring – something we
never had resources to do in the past but which can be easily funded by
hypothecated taxation.
The observation driving my own interest in removing toxicants arises
from the following:
Based on US data (2).
• Tobacco consumption has declined
• Total lung cancer rates have declined (as expected)
• Squamous carcinoma rates have declined ( as expected)
• Adenocarcinoma rates increased ( NOT expected ) during the nineties
(they may be plateauing now)
The only reason I can think of for this observation is that the
recipes for modern US cigarettes became more adenocarcinogenic than they
had been. I think, since cigarettes will continue to be with us, that we
should simplify them a great deal and that to leave their emissions
unregulated would be negligent
Declaration of interest. The writer is a member of TobReg. This
letter, however, is personal and I take responsibility for the views
expressed
Reference List
1. King B, Borland R, Fowles J. Mainstream smoke emissions of
Australian and Canadian cigarettes. Nicotine.Tob.Res. 2007;9(8):835-44.
2. Thun MJ, Lally CA, Flannery JT, Calle EE, Flanders WD, Heath CWJ.
Cigarette smoking and changes in the histopathology of lung cancer.
J.Natl.Cancer Inst. 1997;89(21):1580-6.
Simon Chapman’s recent commentary on smoking in movies misses several important points with regard to the influence of media portrayal of tobacco on children’s health (1). Chapman fails to recognize the ease with which other socially questionable behavior is rated R in US films. Using the Motion Picture Association of America voluntary ratings system (2), use of the 'F' word as an exclamation twice, or once in a sexu...
I would have written Simon Chapman's editorial 15 years ago, when I first joined behind-the-scenes discussions in Hollywood to advocate the same "solutions" he is now. Serious and sustained efforts by many organizations (sometimes at substantial cost) to pursue the ideas Chapman is now proposing repeatedly failed. Indeed, the amount of smoking onscreen actually increased during this time. We only developed the Smoke...
An important new marker of the denormalisation of the tobacco industry has occurred in Australia in 2008. It is traditional – indeed usually mandatory -- for industries which may be affected by proposed changes in government policy or legislation to be fully consulted through formal processes prior to any changes taking place. In 2008, the Australian government established a Preventative (sic) Health Task Force, with s...
The authors's Figure 2 identifies the 'smokers' zone' overlaid on a map of modern Rome as resembling "the location of the Jewish ghetto during the Third Reich."
In fact, a Jewish community has existed in Rome for over two thousand years. In 1555 Pope Paul IV created a walled-ghetto for Jews as one of a series of anti-semitic measures. The walls were torn down in 1870 when Italy was unified as a single nation, lea...
The authors thank Holger Moeller for the previous e-letter. As he noticed, there is a typographical error in the number related to attributable deaths in New Zealand. The correct number is 8 per 100,000.
I think the rate for New Zealand in the discussion was meant to be 8 per 100,000 and not 8 per 10,000 which would be rather high.
Professor Boddewyn’s reply is interesting for what it admits and omits.
He admits that the International Advertising Association (IAA) reports published in 1983 and 1986 were based on his editing of “the draft paper written by Paul Bingham [of British American Tobacco].” To my knowledge, there has been no such public admission previously by Professor Boddewyn, BAT, or IAA in the 20+ years since publication of tho...
What a pleasure to be cited for something I published 25 years ago! It is, of course, less pleasant to be implicitly incriminated as being some sort of a “paid hack” for the tobacco industry. Besides, the intended harm has been done since the Editor did not have the academic courtesy of asking me to reply to this personal attack in the same issue where the article by R.M. Davis has appeared.
In answering this ch...
In response to our piece cautioning about the use of the ‘precautionary principle’ in debates about setting emissions limits, Nigel Gray writes that it has been around since the beginning of public health activity and offers as examples ‘[taking] the precaution of hunting for clean water on the grounds that doing nothing might allow epidemics of cholera, typhoid and hookworm to continue’ and the introduction of polio vac...
Regulation and precautions Nigel Gray April 11, 2008
Jonathon Lieberman worries about TobReg’s use of the precautionary principle as justification for recommending reduction of toxicants in cigarette emissions and suggests that the precautionary principle is a 1970’s development. I thought it had been around since the beginning of Public Health activity when we took the precaution of hunting for clean water on...
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