What should be done about smoking in movies?

In 1997 Ron Davis, Tobacco Control’s inaugural editor, and I wrote an editorial titled Smoking in movies: is it a problem? Since then, a growing body of research has examined the relation between viewing of movies containing depictions of smoking and subsequent smoking among youth. Reviewing this evidence, a 2008 National Cancer Institute monograph concluded ‘‘The depiction of cigarette smoking is pervasive in movies, occurring in threequarters or more of contemporary boxoffice hits. Identifiable cigarette brands appear in about one-third of movies. The total weight of evidence from crosssectional, longitudinal and experimental studies indicates a causal relationship between exposure to depictions of smoking in movies and youth smoking initiation.’’ The report’s conclusion is consistent with commonsense and should give major impetus to what is a growing debate. If the highly choreographed imagery of tobacco advertising influences the uptake of smoking, then so will widespread positive depictions of smoking in movies, now arguably rivalling direct tobacco advertising as the world’s largest vector for sustaining the appeal of smoking. Smoking in movies is a problem. So what might be done about it? Many nations ban all tobacco advertising because of its influence on smoking. The idea that movies with smoking scenes should similarly be either banned or at least regulated through adult-only classification has gained traction in a small number of nations, particularly India, Thailand and the United States. The debate remains nascent elsewhere, with few signs of government interest. In this commentary, I critically review three of the most prominent strategies proposed as ways of controlling smoking in movies. I caution that banning smoking from movies constitutes a fundamental threat to freedom of expression, inviting unavoidable ridicule for the inconsistencies and ‘‘airbrushing of reality’’ that its adoption would unleash. This is likely to alienate many ordinary and influential people who would otherwise be strongly supportive of comprehensive and tough tobacco control. I conclude that nations should pass or amend laws to require ‘‘no product placement’’ disclosures; global efforts should be increased to expose the extent and consequences of smoking in movies; and whistleblowers should be encouraged to expose instances of tobacco industry inducements to the movie industry so that prosecutions can arise where possible. Efforts should continue to persuade directors to be more judicious in their use of gratuitous smoking where this is unnecessary to the verisimilitude of their productions. And finally, smoking should become one element taken into account in film classification, but as occurs now with film rating classification in relation to other adult elements, it should be considered in overall context on a case-by-case basis rather than triggering automatic upward classification.