Smoking in movies: is it a problem?

Relationships of Smoking Media Literacy with Smoking Behavior, Attitudes, and Susceptibility among Adolescents in the Republic of Korea

The literature has indicated that higher smoking media literacy (i.e., SML) can buffer adverse effects of exposure to pro-smoking media content (i.e., PMC) on smoking-related outcomes in adolescence. Thus, we aimed to investigate (a) SML levels among Korean adolescents and (b) relationships of SML with smoking behavior, attitudes, and susceptibility. In 2017, we collected cross-sectional data from nine middle or high schools in Korea, using a convenience sampling method (N = 476). For the first aim, we calculated the average score of SML. For the second aim, we conducted multinomial logistic regression (MLR), multiple linear regression, and binary multiple logistic regression. Additionally, we conducted Firth logistic regression and confirmed the robustness of our findings obtained from the MLR. The average SML score was 6.48 out of 10 points, indicating that our respondents' average SML was slightly above the middle level. In addition, after adjusting for factors potentially affecting associations between SML and the three smoking-related outcomes, we found significant protective relationships of SML with all smoking-related outcomes: smoking behavior, attitudes, and susceptibility. Given our findings, the enhancement of SML through education should be considered an important strategy to weaken the link between exposure to PMC and smoking-related outcomes.

An examination of portrayals of smoking in graphic novels/comic books: A picture is worth a thousand words

INTRODUCTION

Smoking continues to extract an unacceptably high toll in Ireland in terms of both mortality and morbidity. Therefore, attention needs to focus on examining pro-smoking influences on teenagers and young adults, as most smokers start smoking before the age of 21 years. Given that this critical period is one of identity formation and assertion of adulthood, it is useful to look at media representation of smoking. One form of increasingly pervasive media that may require further examination is that of the portrayal of smoking in graphic novels. The broad appeal of graphic novels has been well noted, particularly to those aged under 35 years.

METHODS

This research examined a random selection of ten graphic novels chosen from the main library in a provincial Irish City. The novels were examined on a panel-by-panel basis for images of smokers. Smokers were coded by gender.

RESULTS

Analysis identified a total of 526 panels depicting smoking. Substantial variation was noted in the number of smoking images between novels, varying from 0 to 267. A dramatic difference in the number of male to female smokers was observed, the ratio being approximately 17:1.

CONCLUSIONS

Graphic novels must be considered as a potentially significant source of portrayals of smoking to adolescent and young adult readers of this form of literature.

Media as a "Super Peer": How Adolescents Interpret Media Messages Predicts Their Perception of Alcohol and Tobacco Use Norms

Adolescents' media environment offers information about who uses substances and what happens as a result-how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents' (n = 817, 48 % female, 64 % white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents' media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents' media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents' interest in alcohol and tobacco use.

The role of reported tobacco-specific media exposure on adult attitudes towards proposed policies to limit the portrayal of smoking in movies

OBJECTIVE

To assess the relative, independent contribution of reported tobacco-specific media exposure (pro-tobacco advertising, anti-tobacco advertising, and news coverage of tobacco issues) to US adults' support for policy efforts that aim to regulate the portrayal of smoking in movies.

METHODS

Using the American Legacy Foundation's 2003 American Smoking and Health Survey (ASHES-2), multivariable logistic regression was used to model the predicted probability that US adults support movie-specific tobacco control policies, by reported exposure to tobacco-specific media messages, controlling for smoking status, education, income, race/ethnicity, age, sex, knowledge of the negative effects of tobacco and state.

RESULTS

Across most outcome variables under study, findings reveal that reported exposure to tobacco-specific media messages is associated with adult attitudes towards movie-specific policy measures. Most exposure to tobacco information in the media (with the exception of pro-tobacco advertising on the internet) contributes independently to the prediction of adult support for movie-specific policies. The direction of effect follows an expected pattern, with reported exposure to anti-tobacco advertising and news coverage of tobacco predicting supportive attitudes towards movie policies, and reported exposure to pro-tobacco advertising lessening support for some movie policies, though the medium of delivery makes a difference.

CONCLUSION

Media campaigns to prevent tobacco use and exposure to secondhand smoke have had value beyond the intended impact of single-issue campaigns; exposure to anti-tobacco campaigns and public dialogue about the dangers of tobacco seem also to be associated with shaping perceptions of the social world related to norms about tobacco, and ideas about regulating the portrayal of smoking in movies.

An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study

The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002-04) from a longitudinal cohort originally surveyed at age 11 (1994-95) were conducted. The main outcome measure is smoking at age 19. No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers. There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland.

Role of the media in influencing trajectories of youth smoking

This paper summarizes results of empirical studies on cigarette advertising and promotions, antismoking advertising, product placement in movies, on television and in music media and news coverage about smoking. In addition, we provide an overview of some of the theoretical literature relevant to the study of media uses and effects. Finally, we discuss empirical findings in the context of these theories to draw some conclusions about media influences on smoking and identify issues for further research. We conclude that (a) the media both shape and reflect social values about smoking; (b) the media provide new information about smoking directly to audiences; (c) the media act as a source of observational learning by providing models which teenagers may seek to emulate; (d) exposure to media messages about smoking also provides direct reinforcement for smoking or not smoking; (e) the media promote interpersonal discussion about smoking; (f) the media can influence "intervening" behaviors that may make teenage smoking less likely; and (g) antismoking media messages can also set the agenda for other change at the community, state or national level. We outline priorities for further research which emphasize the need for longitudinal studies, multi-level studies, an awareness of the probably dynamic relationship between tobacco advertising and antismoking advertising, the importance of determining appraisal of tobacco industry youth smoking prevention efforts and the dearth of research on news coverage about smoking.

Interpretations of smoking in film by older teenagers

Research testifies that images of tobacco use in popular films are highly pervasive and typically glamorised. There are concerns that these images may promote motivations to smoke in adolescents, but little is known about how these images are interpreted by members of this age group. A qualitative study was conducted to explore how older teenagers interpret and decode smoking imagery in film. This study builds on earlier work with a younger age group (12 and 13 years) to explore how various interpretations of smoking imagery shape and support common understandings about smoking among older teenagers. Data were collected through focus groups. Eighty-eight 16 and 17 year old students were interviewed at school. Participants discussed their recollections of and responses to recently viewed films. Older teens were receptive to smoking imagery when it was used in a credible manner to portray an emotional state, sub-culture affiliation, and lifestyle. Experience as a smoker appeared to inflate the credibility of realistic smoking images, particularly those presented in gritty realism/drama film. Older teens perceived realistic images, as opposed to stereotypical images, as a salient reference to their own lives. Stereotypical images were also readily recalled and appeared to perform an important role in supporting misconceptions about smoking and contributing to popular ideologies about tobacco use. Stereotypical images presented in comedy and action genre also serve to present paradoxical and contradictory messages about tobacco use. In particular, participants recalled tobacco use in film as associated with stress and anxiety, drug use, and seduction. Film images of tobacco use in specific contexts appear to hold specific and significant meanings for older teens. Realistic images offered salient representations of the perceived reality of smoking for this group. Pervasive and credible smoking scenes in film may offer support and reassurance to older teens who currently smoke or hold ambivalent views about smoking. Consistent with younger adolescents, older teens presented a predominantly nonchalant response to smoking imagery in film, which is a powerful indicator of the pervasiveness and acceptability of smoking in general. In contrast with younger adolescent, older teens tend to draw upon their own experience with tobacco use when interpreting smoking images in film.

'They look like my kind of people'--perceptions of smoking images in youth magazines

Ten years ago research showed that pro-smoking images were prevalent in British youth magazines, whereas there was little coverage of smoking and health. Since then there has been a great expansion in the number of youth magazines, and particularly those aimed at young men. Titles such as FHM and Loaded, which did not exist at the time of the previous research, are now market leaders. New qualitative and quantitative research has therefore been conducted to examine the prevalence and impact of smoking images in this revitalised youth style magazines market. This paper presents the findings of the qualitative element of this research, which examined British first year students' perceptions of the pro-smoking imagery found in the magazines and explored the relationship between this and their own smoking images and identities. The research found that: (a) this imagery was perceived to be, on the whole, attractive, sociable and reassuring; (b) that it supported young people's perceptions of smoking and reinforced their smoker identities; and (c) that it has the potential to be more powerful than advertising imagery.

How the tobacco industry built its relationship with Hollywood

OBJECTIVE

To describe the development of the relationship between the tobacco industry and the entertainment industry.

METHODS

Review of previously secret tobacco industry documents available on the internet.

RESULTS

Both the entertainment and tobacco industries recognised the high value of promotion of tobacco through entertainment media. The 1980s saw undertakings by four tobacco companies, Philip Morris, RJ Reynolds (RJR), American Tobacco Company, and Brown and Williamson to place their products in movies. RJR and Philip Morris also worked to place products on television at the beginning of the decade. Each company hired aggressive product placement firms to represent its interests in Hollywood. These firms placed products and tobacco signage in positive situations that would encourage viewers to use tobacco and kept brands from being used in negative situations. At least one of the companies, RJR, undertook an extensive campaign to hook Hollywood on tobacco by providing free cigarettes to actors on a monthly basis. Efforts were also made to place favourable articles relating to product use by actors in national print media and to encourage professional photographers to take pictures of actors smoking specific brands. The cigar industry started developing connections with the entertainment industry beginning in the 1980s and paid product placements were made in both movies and on television. This effort did not always require money payments from the tobacco industry to the entertainment industry, suggesting that simply looking for cash payoffs may miss other important ties between the tobacco and entertainment industries.

CONCLUSIONS

The tobacco industry understood the value of placing and encouraging tobacco use in films, and how to do it. While the industry claims to have ended this practice, smoking in motion pictures increased throughout the 1990s and remains a public health problem.

Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study

OBJECTIVE

To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents.

DESIGN

Cross sectional survey of 4919 schoolchildren aged 9-15 years, and assessment of occurrence of smoking in 601 films.

SETTING

Randomly selected middle schools in Vermont and New Hampshire, USA.

MAIN OUTCOME MEASURE

Number of schoolchildren who had ever tried smoking a cigarette.

RESULTS

The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49-152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0-50 occurrences of smoking, 13.7% for 51-100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0-50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent.

CONCLUSION

In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents.

Adolescent perceptions of smoking imagery in film

Smoking amongst adolescents in New Zealand continues to be a problem, with more than a one-third increase in smoking prevalence between 1992 and 1997. Favourable portrayals of smoking in the media have been cited as potential motivators of the initiation of smoking among adolescents. To date, however, its role in influencing smoking perceptions and behaviours has not received systematic analysis. A qualitative study was conducted to explore how adolescents interpret and decode smoking imagery in movies. Data was collected through focus groups. Same-gender groups of 12- and 13-year-old students were interviewed at their schools. Participants discussed their recollections of and responses to portrayals of smoking in recently viewed films, as well as their perceptions of smoking in general. Students perceived that smoking in film is both highly prevalent and recognisable, and they regarded on-screen-smoking imagery as an accurate reflection of reality. Adolescents in this study were predominantly nonchalant towards the inclusion of smoking images in film, and they perceived an unrealistically high prevalence of smoking amongst peers and adults. Their noncholant response is linked with the perception that smoking is normal and prevalent and with the broad understanding of the constructed nature of media imagery. Smoking imagery in film may play a critical role in reinforcing cultural interpretations of tobacco use, such as its role as a means of stress relief, development of self-image and as a marker of adult independence.

Brand appearances in contemporary cinema films and contribution to global marketing of cigarettes

BACKGROUND

The appearance of a cigarette brand in a cinema film gives the brand a certain distinction through its association with the characters and general tone of the film. Through the worldwide distribution of films, brands are promoted globally. We assessed the tobacco-brand appearances in a 10-year sample of contemporary films.

METHODS

We viewed the contents of the top 25 US box-office films for each year of release, from 1988 to 1997 (250 films in total). We compared the prevalence of brand appearances for films produced before a voluntary ban on paid product placement by the tobacco industry (1988-90) with films produced after the ban (1991-97). Tobacco-brand appearance was defined as the screen appearance of a brand name, logo, or identifiable trademark on products or product packaging, billboards, store-front advertising, or tobacco promotional items. We defined actor endorsement of a brand as the display of a brand while being handled or used by an actor.

FINDINGS

More than 85% of the films contained tobacco use. Tobacco brands appeared in 70 (28%) films. Brand appearances were as common in films suitable for adolescent audiences as they were in films for adult audiences (32 vs 35%), and were also present in 20% of those rated for children. Prevalence of brand appearance did not change overall in relation to the ban. However, there was a striking increase in the type of brand appearance depicted, with actor endorsement increasing from 1% of films before the ban to 11% after. Four US cigarette brands accounted for 80% of brand appearances. Revenues outside the USA accounted for 49% of total revenues for these films, indicating a large international audience.

INTERPRETATION

Tobacco-brand appearances are common in films and are becoming increasingly endorsed by actors. The most highly advertised US cigarette brands account for most brand appearances, which suggests an advertising motive to this practice.