Incidents of Smoking Increase Dramatically in Youth-Focused, PG-13 Films

Progress in Removing Tobacco Imagery Stalled Six Years Ago, UCSF Study Finds

By Elizabeth Fernandez

a person smokes a cigaretteYouth-rated films, which are designed and marketed as kid-friendly, continue to fill the movie screen with tobacco imagery, according to a new report from UC San Francisco, the U.S. Centers for Disease Control and Prevention, and other entities.

Nearly half (46 percent) of the films with smoking were youth-rated during the analysis period of 2010 to 2016, reported the authors. This amounted to 210 of the 459 top-grossing films. In PG-13 rated movies, which are classified for teens, the number of incidents of smoking surged from 564 in 2010 to 809 in 2016. The amount of smoking in the few G and PG movies during that timeframe dropped from 30 to 4.

This is a public health concern, the authors said, and could lead more young people to become smokers.

The report was released on July 6, 2017, in the CDC’s MMWR (Morbidity and Mortality Weekly Report).

“Modernizing Hollywood’s rating system to protect the audience by awarding movies with smoking an R rating would save a million kids’ lives,” said senior author Stanton A. Glantz, PhD, a UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education. “That is the best way that the six big media companies that control the Motion Picture Association of America could ensure that movies marketed to kids are not also selling cigarettes.”

The U.S. Surgeon General – based on years of published scientific data – concluded in 2012 that depictions of smoking in the movies cause young people to start smoking. The 2012 report also notes that youth who are heavily exposed to images onscreen of smoking are two to three times as likely to begin smoking as youth who receive little exposure.  

UCSF and the CDC collaborated with Thumbs Up! Thumbs Down!, a project of Breathe California of Sacramento-Emigrant Trails, in this study to assess the extent of smoking images in youth-rated movies.

Findings were compared with data from reports dating to 1991, when Thumbs Up! Thumbs Down! began systematically collecting data.

The researchers found that from 2010 to 2016:

  • The number of tobacco incidents in top-grossing movies increased by 72 percent (from 1,824 to 3,145);
  • The number of incidents in G or PG movies decreased by 87 percent (from 30 to 4);
  • The number of incidents in PG-13 movies increased by 43 percent (from 564 to 809);
  • The number of incidents in R-rated movies increased by 90 percent (from 1,230 to 2,332);
  • There’s been a more concentrated exposure to smoking images in top-grossing movies.

The report also showed that PG and PG-13 movies from major media companies, whose Hollywood studios govern the movie ratings, accounted for 71 percent of more than 6,000 youth-rated smoking incidents from 2010 to 2016. Sony (17 percent), Fox (15 percent) and Time Warner (13 percent) featured the largest shares of incidents. Disney (7 percent) had the smallest share, followed by Viacom’s Paramount (9 percent). Comcast’s Universal had 13 times more smoking incidents in its 2016 PG-13 films than in 2010 (266 vs. 19). Lower-budget independent film companies accounted for 29 percent of youth-rated smoking incidents over this time period.

In the study, each incident of tobacco use is defined as the use, or implied use, by an actor of a tobacco product, such as cigarettes, cigars, pipes, hookah, smokeless tobacco products and electronic cigarettes. At least two trained monitors counted all tobacco incidents at in-theater movies that were in the 10 top-grossing movies during a calendar week – such movies in the U.S. accounted for 96 percent of U.S. ticket sales. The monitors counted a new smoking incident each time a tobacco product went off screen then returned on screen; a different actor was shown with a tobacco product; or a scene changed, and the new scene contained the use or implied use of tobacco.

The study did not take into account viewing platforms such as DVD and Blu-ray, television, and online streaming, where youth are also exposed to smoking images in films, the authors noted.

In addition to highlighting the need for an R rating for smoking, the report suggested that state and local health departments work to ensure that public subsidies do not go to studios, distributors and producers that depict tobacco use on screen. From 2010 to 2016, more than two dozen states awarded some $3.5 billion in public subsidies, such as tax credits, to productions of movies with tobacco incidents. 

“Since 2010, there has been no progress in reducing the total number of tobacco incidents in youth-rated movies,” said Glantz, who founded Smokefree Movies, which aims to improve public policy and film industry practice, in 2001. “All the major media companies have had years where all their youth-rated movies are smoke-free. There is an enormous need to implement an industrywide standard by requiring that all movies rated for kids are smoke-free.”

Co-authors of the report are Michael A. Tynan, a public health analyst at the CDC’s Office on Smoking and Health at the National Center for Chronic Disease Prevention and Health Promotion; Jonathan R. Polansky, a consultant with Onbeyond LLC, Fairfax, Calif.; and Kori Titus and Renata Atayeva, who were both with  Breathe California of Sacramento-Emigrant Trails. 

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.