We reviewed the number of incidents of tobacco use (almost exclusively smoking) depicted in movies in the United States in 2011 to compare that with previously reported trends. We counted use or implied use of a tobacco product by an actor in all movies whose box office gross ranked in the top 10 for at least 1 week. Total tobacco incidents per movie rose 7% from 2010 to 2011, ending 5 years of decline; incidents rose 34% per movie rated G, PG, or PG-13 and 7% per R-rated movie. The reversal of progress toward less onscreen smoking in youth-rated movies underscores the need to rate movies with tobacco imagery as R, establishing an industry-wide market incentive to keep youth-marketed movies tobacco-free.