We reviewed smoking shown in a random sample of major motion pictures from 1950 through 2002. Smoking incidents declined from 10.7 incidents per hour in 1950 to a minimum of 4.9 in 1980-1982 but increased to 10.9 in 2002. Despite declining tobacco use and increasing public understanding of the dangers of smoking in the real world, smoking in movies has returned to levels observed in 1950, when smoking was nearly twice as prevalent in reality as it was in 2002.