Smoking in films: differences between the UK and US

BMC Public Health today published research showing that the amount of smoking shown in US films is less than that in European or Latin American films. We asked the public health charity, Action on Smoking and Health (ASH), for their thoughts on smoking imagery in films. Amanda Sandford explains more here.

Thanks to a raft of tobacco control measures and changing public attitudes, smoking is no longer perceived as a glamorous, desirable habit, at least in much of the western world. In the UK the de-normalization of smoking is reflected in the sharp decline in smoking prevalence among Britain’s youth over the past two decades.

Indeed today’s teenagers are unlikely to recall ever seeing a tobacco advertisement on a billboard or in a newspaper. There is, however, one glaring exception to the generalized ban on tobacco advertising and promotion: images of smoking in films and social media.

Why is this an issue?

Because there is strong evidence that smoking imagery in films contributes to the uptake of smoking among adolescents. The link is causal with a dose-response relationship, so the more films they see featuring smoking scenes, the more likely they are to smoke.

One study of 15-year olds found that those who saw the most films with smoking were 73% more likely to have tried a cigarette than those who saw the least number of films featuring people smoking.

Unfortunately little is being done in the UK to address this problem. There is scant reference to smoking in the British Board of Film Classification’s guidelines and little evidence that the Board takes the portrayal of smoking in films seriously.

A study of 15 of the highest grossing films in the UK box office between 1989 and 2008 found that 56% of the films in which people smoked were classified as suitable for children aged under 15 and 92% were ruled to be suitable for under-18s.

The problem is not unique to the UK as the study published today shows.

The problem is not unique to the UK as the study published today shows. In the US, there has been a long running campaign to require films containing smoking scenes to be R-rated (under 17s requiring an accompanying parent or adult) but so far the film industry and law-makers have resisted the recommendation.

What can be done about this?

One way of tackling the problem would be to require the screening of short anti-smoking films before any movie that contained smoking and could be seen by children. It would apply to cinema, TV and pay-to-view internet.

This approach mirrors the ‘Fairness Doctrine’ adopted in the US which effectively brought an end to tobacco advertising on television. The doctrine required broadcasters to ensure both sides of an argument were given equal air time.

Following lobbying by health campaigners, the Federal Communications Commission ruled that it was not in the public interest for radio and television to advertise cigarettes without some warning of the health hazards involved with smoking.

The Federal Communications Commission decision was upheld by the US Court of Appeals when legally challenged, noting that “The danger cigarettes may pose to health is, among others, a danger to life itself.”

Clearly more needs to be done to raise awareness among film producers and policy-makers of the harm to children and young people of smoking in films.

While changes to film classification would certainly help, reducing smoking imagery in social media, music videos and computer games poses a particular challenge and may only be resolved through changes in attitudes towards smoking. What is certainly needed is a public debate and more pressure applied to the film industry to cut out unnecessary and harmful smoking imagery.

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