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A new CDC report could reignite the debate over Hollywood's influence on teen tobacco use

Depictions of tobacco use in youth-oriented films jumped by 43 percent in 2016. 

Martin Freeman as Bilbo Baggins in The Hobbit
Courtesy of Warner Bros. Entertainment Inc.

A new study about a rise in onscreen smoking is helping firm up the link between the media’s influences and our real-life behavior.

A recent report by the Centers for Disease Control and Prevention found that between 2010 and 2016, the number of instances tobacco was used in any calendar week’s top 10-grossing movies had grown by a whopping 80 percent. From 2010 to 2016, the big screen increased overall tobacco impressions — otherwise known as the individual occurrences of tobacco use — by 72 percent, or 1,321 films.

Among R-rated films, the trend grew 90 percent over that six-year period while films that fall under the young-adult-oriented PG-13 rating saw a 43 percent increase. On the other hand, the percentage of youth-oriented films featuring tobacco use dropped to 26 percent in 2016 from 31 percent in 2010. In addition, G and PG films were the only group to see a drop in impressions, which went from 30 to 4 between 2015 and 2016.

The CDC attributes the decline in the percentage of movies featuring tobacco use to “a decline in smoking in movies with larger budgets,” specifically films that spend more than $50 million. For perspective, in 2007 the average cost to produce a major studio movie — without marketing — was $65 million, which seems to be leading to substantially more films losing the presence of tobacco than are retaining it.

The drop in the percentage of youth-oriented films featuring tobacco use, as well as the dramatic decline in tobacco occurrences in G and PG films, is positive. Still, tobacco impressions within films geared toward teens and young adults hasn’t improved since 2010. If it had, the CDC reports that all youth-rated films would have been completely smoke-free by 2015. Instead, “the average number of tobacco incidents increased 55 percent in youth-rated movies with any tobacco depiction,” a result of five of Hollywood’s six major movie companies — all of which have corporate tobacco depiction policies — featuring more tobacco use.

The answer to the issue lies with where, how much, and what type of tobacco is being used in cinema. In short, fewer movies are featuring not just more smoking but more kinds of tobacco use. That concentrated increase is once again raising concerns about the relationship between tobacco’s presence in media and an increased likelihood of picking up the habit.

Shifts in the way we consume tobacco are keeping the habit alive onscreen and raising concerns over public health — especially for teens

The CDC cast a wide net for how it defines tobacco use in its July 7 report, counting any incidents that feature cigarettes, cigars, pipes, hookah, smokeless tobacco products, and electronic cigarettes. That broad classification is pivotal to understanding both the increase in impressions and the larger impact of tobacco use on youth.

A CDC fact sheet reveals that cigarette use among middle and high school students was down by around 50 percent between 2011 and 2016. However, 11.3 percent of high school students reported use of electronic cigarettes in 2016, up from the 1.5 percent in 2011. Middle schoolers also saw a jump, with 4.3 percent claiming they’ve used an electronic cigarette versus the 0.6 percent from 2011. CDC data from 2013 shows that around 46 percent of high school students have tried a tobacco product and more than 31 percent had tried two or more.

If these tobacco use trends continue, “about one of every 13 Americans aged 17 years or younger alive today” will die early of smoking-related illnesses, according to the CDC. But tobacco products don’t just cause smoking-related health issues. The World Health Organization also found that teens who smoke are three times more likely to try alcohol and 22 times more likely to try cocaine, proving nicotine functions as a gateway drug.

But what does that have to do with Hollywood? A lot, according to experts.

Health professionals say smoking onscreen has a direct impact on teen tobacco use

In a 2012 report on preventing smoking and tobacco use among both youth and young adults, the Office of the Surgeon General identified a “causal relationship between depictions of smoking in the movies and the initiation of smoking among young persons.” The report concluded that youth and young adults who are more heavily exposed to onscreen smoking are around two to three times as likely to start smoking as those who receive less exposure.

A comprehensive report from the National Cancer Institute came to a similar conclusion. According to NCI, watching smoking scenes in the 1994 movie Reality Bites “promoted increased personal intentions to smoke among adolescent never smokers.” Conversely, those “viewing a movie that portrayed the tobacco industry in a negative light” experienced “a short-term reduction in intentions to smoke among adult smokers and former smokers.”

All these findings reinforce that a diminishing presence of smoking or tobacco imagery can decrease chances of use. In fact, as the percentage of movies featuring tobacco has decreased, the Substance Abuse and Mental Health Services Administration has reported a drop in the use of cigarettes by teens from nearly 8 percent in 2011 to 4.2 percent in 2015.

This correlation between onscreen smoking and potential personal use reignites a longstanding debate over ways other media content potentially influences behavioral trends.

Recent findings re-raise questions over media influence, censorship, and who can be accountable for influence

New York magazine writer Matt Zoller Seitz argued that there are only certain times Hollywood will take responsibility for its influences on society, and that’s typically when entertainment creates a positive influence. However, “the Surgeon General found a ‘causal relationship.’ If this is the case, my next question has nothing to do with smoking: What other things do movies (and by extension popular culture) ‘encourage’ people to do, or validate them doing?” he tweeted.

He continued:

When I read reports establishing causal relationships between movie/TV behavior and real life behavior, I think of the violence issue. ... Moviemakers are happy to claim a causal relationship with life when the outcome is good or neutral, but not when bad stuff happens. When I hear that art influences life, and then hear that it doesn't, I picture the RAISING ARIZONA guy: "Well, which is it, young fella?”

The MPAA’s system includes warnings for violence beginning at its G rating. And though smoking does occur in G- and PG-rated movies, the system doesn’t address drug use (which includes tobacco) until its PG-13 classification. Individuals and groups, such as those involved in a 2016 class-action lawsuit against the MPAA, have been pushing for years to get smoking banned from any film without an R rating. The suit claims that “... youth-rated movies recruited approximately 4.6 million adolescents in the United States to smoke, of which approximately 1.5 million are expected to die from tobacco-induced diseases in years to come.”

The MPAA defended its current system, stating that restrictions on depictions of smoking are in violation of the First Amendment. A California judge sided with the MPAA last November, dismissing the case.

Still, it seems the CDC’s latest report may have injected new life into the debate over public health, media influence, and censorship.