(dailyRx News) Think about the last time you saw an actor smoking in a film. Did the actor look cool or dumb? Were they a "good guy" or a "bad guy?" Was the movie rated PG-13 or R? Does it matter?
A recent study has found that, regardless of the rating of a movie, seeing smoking in films has an impact on whether adolescents decide to try out smoking.
James D. Sargent, MD, of the Norris Cotton Cancer Center at the Geisel School of Medicine at Dartmouth in New Hampshire, and colleagues investigated whether teenagers appeared to respond differently to portrayals of smoking in PG-13 movies as opposed to R-rated movies.
The short answer? They don't. And both types of films that contain smoking will lead some teens to try smoking.
Based on the US Surgeon General's determination that being exposed to smoking in movies leads youths to smoke, this means that PG-13 films can have just as detrimental effect as R films in influencing teens' decisions to use tobacco.
Dr. Sargent and colleagues conducted a long-term study over two years involving 6,522 US teenagers at the start. The researchers checked in with the teens every eight months, though the number of participants dropped at each follow-up.
By the second follow-up, there were 5,019 participants, and by the last one at two years, there were 4,575 participants. The researchers therefore adjusted their calculations incrementally to account for the drop-out rate in the study.
The researchers measured how much "movie smoking exposure" the teens had, based on estimates used with 532 recent box-office hits the teens may have seen.
The films fell into three categories: G/PG, PG-13 and R, and included the top 100 highest-grossing movies of each of the five years leading up to the initial survey, plus the 32 highest-grossing films in the first four months of the study in 2003.
The survey for each teen included 50 randomly selected films from this group that teens were asked whether they had seen. The amount of smoking in the films was counted based on every time a major or minor character handled or used tobacco or when tobacco was shown in the background.
Then the teenagers were asked, "“Have you ever tried smoking a cigarette, even just a puff?” A "yes" answer classified the teen as having tried smoking.
The researchers wrote that they used this measure instead of asking whether teens are "current" smokers (whether they have had a cigarette in the past 30 days) "because current smoking is infrequent in the early stages of cigarette use."
The amount of smoking that occurred in the PG-13 films as a group tended to be about three times higher than the smoking that occurred in the R-rated films, while the amount of smoking in the G and PG-rated movies was low and did not appear to have an impact on teen smoking.
With the PG-13 and R-rated films, however, the teens were about 1.3 to 1.5 times more likely to smoke for every 500 times they saw someone light up on the big screen.
The researchers estimated that reducing the amount of smoking in PG-13 films to the lowest fifth of movie smoking exposure would reduce teen smoking by abut 18 percent. Filmmakers could also assign these movies an R rating instead of PG-13, though teens may still be likely to see these films even with the higher rating.
They compared this potential decrease in smoking to the 16 percent reduction in teen smoking that may occur if all parents employed an "authoritative" approach in their parenting.
This was determined using data from the same teens, who were asked a variety of demographic and lifestyle questions including questions that allowed researchers to classify the parenting style of their parents.
"The equivalent effect of PG-13-rated and R-rated movie smoking exposure suggests it is the movie smoking that prompts adolescents to smoke, not other characteristics of R-rated movies or adolescents drawn to them," the authors concluded. "An R rating for movie smoking could substantially reduce adolescent smoking by eliminating smoking from PG-13 movies."
"With the elimination of image-based tobacco marketing, the epidemic of smoking is maintained, in part, by movie images of smoking," they wrote.
The study was published July 9 in the journal Pediatrics. The research was funded by the National Cancer Institute in the National Institutes of Health and the American Legacy Foundation. The authors declared no conflicts of interest.