Should Movies with Smoking Be Rated R?

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If cigarette smoking were banned from teen-friendly movies, would kids be less likely to pick up the habit? Researchers at the Geisel School of Medicine at Dartmouth College think so.

In a two-year study, the researchers surveyed more than 6,500 young teens, aged 10 to 14, asking them which of a random selection of box-office hits they’d seen in the previous year. They also asked whether they’d ever tried smoking. The kids were interviewed three more times over two years, and not surprisingly, the researchers say, teens who watched movies with more smoking scenes were more likely to try smoking themselves.

The new study, published in the journal Pediatrics, isn’t the first to link media exposure to tobacco with smoking in teens. Earlier this year, in fact, the Surgeon General’s report on tobacco and youth concluded that there is sufficient evidence that watching movie smoking causes teens to pick up the habit. Still, researchers say it hasn’t been clear from previous research whether it’s on-screen smoking per se or other adult behaviors in films — the sex and violence that accompany smoking — that affect teens’ behavior.

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So the Dartmouth researchers looked more closely at the “dose” of smoking teens got from movies by rating. They found on average that teens saw 275 smoking scenes in PG-13 movies and 93 smoking scenes in R-rated films. (G- and PG-rated movies typically did not show smoking and weren’t linked to teenagers’ smoking, the study found.) If other R-rated behaviors in movies were encouraging teens to smoke, then presumably those who watched more adult-friendly films would be more likely to pick up the habit. But regardless of the ratings of the movies teens saw, the effect of smoking scenes on their behavior remained the same, the study found.

The authors’ conclusion: make all movies with smoking rated R. Given that roughly 60% of teens’ movie smoking exposure comes from movies that are rated for teen viewing, if smoking were eliminated from PG-13 films, the authors estimate that the number of youth who try cigarettes could drop by 18%.

“The film industry has known about the relationship between smoking in movies and kids smoking for years and it still has not meaningfully incorporated smoking into its rating system. What we want them to do is give an unambiguous R rating for smoking,” said Dr. James Sargent, a professor of pediatrics at the Geisel School of Medicine at Dartmouth College, in a statement. “Just as kids shouldn’t be watching extreme violence or extreme sex, they shouldn’t be watching smoking.”

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Most smokers get hooked early, before the age of 18, according to the Surgeon General. It starts as an occasional thing in youth and then escalates into an everyday habit. The long-term damage of smoking is well known, but there are also more immediate health effects in teens and young adults, including reduced lung function, asthma and hardening of the arteries — precursors to other chronic diseases.

“It’s a terrible thing when a kid starts smoking, and the idea that what they see in the movies can cause that and can be responsible for that is something we take very seriously for public health because smoking causes a lot of bad diseases in our population,” said Dr. Sargent.

Whether or not the Motion Picture Association of America includes smoking in its rating system, the researchers note that it’s still up to parents to monitor what and how much their teens watch. Youngsters shouldn’t be watching more two movies a week and they shouldn’t be exposed to R-rated content until late in adolescence, says Sargent. “The next step for us is to motivate and help parents limit access to these movies. Teens still get a lot of exposure to smoking from rated R movies,” he says.

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