Research article
Prevalence of Smoking in Movies As Perceived by Teenagers: Longitudinal Trends and Predictors

https://doi.org/10.1016/j.amepre.2011.04.010Get rights and content

Background

Smoking in movies is prevalent. However, use of content analysis to describe trends in smoking in movies has provided mixed results and has not tapped what adolescents actually perceive.

Purpose

To assess the prospective trends in the prevalence of smoking in movies as perceived by teenagers and identify predictors associated with these trends.

Methods

Using data from the Minnesota Adolescent Community Cohort Study collected during 2000–2006 when participants were aged between 12 and 18 years (N=4735), latent variable growth models were employed to describe the longitudinal trends in the perceived prevalence of smoking in movies using a four-level scale (never to most of the time) measured every 6 months, and examined associations between these trends and demographic, smoking-related attitudinal and socio-environmental predictors. Analysis was conducted in 2009.

Results

At baseline, about 50% of participants reported seeing smoking in movies some of the time, and another 36% reported most of the time. The prevalence of smoking in movies as perceived by teenagers declined over time, and the decline was steeper in those who were aged 14–16 years than those who were younger at baseline (p≤0.05). Despite the decline, teenagers still reported seeing smoking in movies some of the time. Teenagers who reported more close friends who smoked also reported a higher prevalence of smoking in movies at baseline (regression coefficients=0.04–0.18, p<0.01).

Conclusions

Teenagers' perception of the prevalence of smoking in movies declined over time, which may be attributable to changes made by the movie industry. Despite the decline, teenagers were still exposed to a moderate amount of smoking imagery. Interventions that further reduce teenage exposure to smoking in movies may be needed to have an effect on adolescent smoking.

Introduction

Smoking in movies is prevalent. About 74%–98% of the top-grossing movies released during 1985–2003 contained at least some depictions of smoking.1, 2, 3, 4, 5 Each year, an estimated 13.9 billion smoking images have been delivered to those aged 10–14 years by the top 100 box-office hits.5 Several studies have demonstrated the association between exposure to these depictions and adolescent smoking,6, 7, 8, 9 leading the National Cancer Institute to conclude a causal relationship exists between exposure to smoking in movies and initiation of smoking among adolescents.10 Although the Master Settlement Agreement prohibits tobacco companies from engaging in product placement activities with the movie industry,11 scholars found that the frequency of tobacco brand appearances in movies did not change after the agreement was implemented.12

Research on changes in prevalence of smoking depictions in movies over time has produced mixed results. A content analysis of the annual 25–30 highest-grossing films in the U.S. found a decline in the prevalence of smoking depictions in movies during 2000–200613, 14; a similar trend was observed when the weekly ten top-grossing movies were analyzed.15 In contrast, a report16 based on content analysis of the five highest-grossing films annually in 2000–2002 observed an increase in the prevalence of smoking images in movies; others also observed an increase in the incidence of smoking in movies after analyzing the top 50–150 box-office films during 2000–2006.17 In addition to the discrepancies in the observed trends, these trends do not necessarily represent changes in exposure to smoking in movies among teenagers because they may watch movies other than those analyzed.

An alternative approach to monitor trends in smoking in movies is to ask teenagers about their perceived prevalence of smoking in movies over time. Their perception can be conceptualized as a function of their exposure to smoking depictions, and is independent of the movie sampling frames and coding schemes determined by investigators. Two previous reports used this approach to examine the trend in exposure to smoking in movies and TV and found a decline in the perceived exposure to smoking depiction in movies and TV during 2000–2004.18, 19 However, because of the serial cross-sectional study design, they were unable to examine changes in perceived exposure to smoking in the media within an individual over time and the interaction between age, cohort, and period effects on the trends. Furthermore, only limited numbers of demographic variables were included in these studies. Smoking-related attitudes and socio-environmental factors, which generally are accepted as predictors of adolescent smoking behavior, were not included in these analyses.

Using data from the Minnesota Adolescent Community Cohort, which collected data on teenagers' perception of prevalence of smoking in movies at 6-month intervals, the association between these trends and smoking-related attitudinal and socio-environmental factors were assessed in addition to demographic characteristics. Because of the longitudinal data used in the analysis, the present study provides additional insights regarding changes in prevalence of smoking in movies, and may further characterize teenagers who are more receptive to smoking images in movies.

Section snippets

Study Population

The Minnesota Adolescent Community Cohort (MACC) is a prospective cohort study designed to examine the effect of state- and local-level tobacco prevention and control programs on youth and young adults in Minnesota, and to deepen the understanding of the transitional process from nonsmoking to smoking in adolescence. The design of the study was detailed elsewhere.20 Briefly, participants were selected through cluster random sampling from geopolitical units (GPUs) in Minnesota, North and South

Results

Among the 4735 participants, 49.1% were male and 85.1% were white. About 35% had a parent who graduated from college, and 47.1% lived in counties in metropolitan areas of 1 million people or more at baseline. About 50% of the participants reported seeing actors and actresses smoking in movies “some of the time,” and another 35.5% reported “most of the time” at baseline.

The frequency of smoking in movies as perceived by MACC participants declined as they aged in all age cohorts (Figure 1), and

Discussion

More than 85% of those aged 12–16 years recalled seeing actors and actresses smoking in movies for at least some of the time at baseline. This finding agrees with other studies that depictions of smoking are ubiquitous in movies1, 2, 3, 4, 5 and a large proportion of teenagers have high perceived exposure to these images in movies.18, 19 It also shows that these images are encoded by teenagers for later recall. Communication scholars have suggested that these depictions can be consequential if

Conclusion

The current findings suggest that the prevalence of smoking in movies as perceived by teenagers declined over time. This provided evidence to support the observed decline in prevalence of smoking depictions in movies in the literature based on the content analysis approach. Even so, teenagers were still exposed to these images some of the time. Interventions may be needed to further reduce teenagers' exposure to these images or the influences of these images on adolescent smoking.

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