Smoking in Movies Linked to Smoking in Children?
Smoking in Movies Linked to Smoking in Children?
Titus-Ernstoff L, Dalton MA, Adachi-Mejia AM, Longacre MR, Beach ML
Pediatrics. 2008;121:15-21
This study evaluated the effect of tobacco use in movies on smoking behavior in a younger age group of children than has been previously evaluated in the literature.
Elementary school students (grades 4-6; aged 9-12 years) from New Hampshire or Vermont were enrolled in this study. The primary outcome measure was lifetime smoking experience; researchers elicited data from each student by asking, "How many cigarettes have you smoked in your life?"
Only children who had never tried smoking were enrolled. Complete follow-up data were obtained for 2255 children. Exposure was measured by assessing the number of smoking occurrences per movie for a list of 550 movies that represented the top 100 box office films for each of 5.5 years before the survey. From this list, each student had a unique list of 50 movies, randomly chosen, but were stratified by movie rating, so each child had an equal percentage of R, PG-13, PG, and G-rated movies.
Data were collected in 3 waves, time zero, and 2 follow up surveys, each a year apart. The list of movies was updated during the course of the study to account for the newest titles each year of the study plus a list of the top 100 video rental titles. During the course of the study period, children saw approximately 37 of 150 movies on their unique lists, including 17 PG-13 and 5 R-rated movies. There was a mean of 149.6 smoking occurrences, with an increase in occurrences per wave of data collection. Most of the smoking occurrences were from PG-13 movies (60%).
Two hundred seventeen children (9.6%) initiated smoking by the third wave of the study. There was an increase in relative risk for initiating smoking following the exposure of approximately 1.1. Given this study's sample size, the findings were all statistically significant. Attributable risk for children who initiated smoking was 0.35. Stated another way, 35% of the instances of initiation of smoking for these children can be linked to exposure to smoking by characters in movies.
The study authors noted that this is a smaller attributable risk than that found in prior studies in adolescents, but the results fall within the 95% confidence intervals of those studies, and are similar to previous cross-sectional studies in adolescents.
This study is the first to demonstrate that what we knew about the onset of risky behaviors in adolescents can also occur in a younger population. Children identify with popular media personalities as role models and may attempt to copy their behavior. Eliminating smoking from movies that carry a PG-13 rating may go a long way to reduce the initiation of smoking in some children. Finally, in the same issue of Pediatrics, the electronic pages contain a second study that looked at smoking exposure in movies and German youth. The authors, Reiner Hanewinkel and James D. Sargent, reported similar findings to those of other studies of American adolescents.
Abstract
Titus-Ernstoff L, Dalton MA, Adachi-Mejia AM, Longacre MR, Beach ML
Pediatrics. 2008;121:15-21
This study evaluated the effect of tobacco use in movies on smoking behavior in a younger age group of children than has been previously evaluated in the literature.
Elementary school students (grades 4-6; aged 9-12 years) from New Hampshire or Vermont were enrolled in this study. The primary outcome measure was lifetime smoking experience; researchers elicited data from each student by asking, "How many cigarettes have you smoked in your life?"
Only children who had never tried smoking were enrolled. Complete follow-up data were obtained for 2255 children. Exposure was measured by assessing the number of smoking occurrences per movie for a list of 550 movies that represented the top 100 box office films for each of 5.5 years before the survey. From this list, each student had a unique list of 50 movies, randomly chosen, but were stratified by movie rating, so each child had an equal percentage of R, PG-13, PG, and G-rated movies.
Data were collected in 3 waves, time zero, and 2 follow up surveys, each a year apart. The list of movies was updated during the course of the study to account for the newest titles each year of the study plus a list of the top 100 video rental titles. During the course of the study period, children saw approximately 37 of 150 movies on their unique lists, including 17 PG-13 and 5 R-rated movies. There was a mean of 149.6 smoking occurrences, with an increase in occurrences per wave of data collection. Most of the smoking occurrences were from PG-13 movies (60%).
Two hundred seventeen children (9.6%) initiated smoking by the third wave of the study. There was an increase in relative risk for initiating smoking following the exposure of approximately 1.1. Given this study's sample size, the findings were all statistically significant. Attributable risk for children who initiated smoking was 0.35. Stated another way, 35% of the instances of initiation of smoking for these children can be linked to exposure to smoking by characters in movies.
The study authors noted that this is a smaller attributable risk than that found in prior studies in adolescents, but the results fall within the 95% confidence intervals of those studies, and are similar to previous cross-sectional studies in adolescents.
This study is the first to demonstrate that what we knew about the onset of risky behaviors in adolescents can also occur in a younger population. Children identify with popular media personalities as role models and may attempt to copy their behavior. Eliminating smoking from movies that carry a PG-13 rating may go a long way to reduce the initiation of smoking in some children. Finally, in the same issue of Pediatrics, the electronic pages contain a second study that looked at smoking exposure in movies and German youth. The authors, Reiner Hanewinkel and James D. Sargent, reported similar findings to those of other studies of American adolescents.
Abstract
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