Smoking in contemporary American cinema.

OBJECTIVE The true prevalence of smoking among characters portrayed in the movies is unknown. This study examines this prevalence objectively. DESIGN The top 10 movies on the weekly box office charts were reviewed. Whether or not the top five characters in these movies smoked, was documented. It was determined prior to the start of the study that 300 male characters and 300 female characters were needed to detect any significant difference. A total of 447 movies, composed of 193 movies rated restricted (R) [children < 17 years of age must be accompanied by an adult], 131 movies rated PG13 for parental guidance suggested for children < 13 years of age (PG) and 123 movies rated PG for parental guidance suggested, were examined until the sample size was reached. RESULTS Smoking prevalence is the same in contemporary American movies and in the general US population (23.3% vs 24.8%, respectively). However, there was more smoking in these movies among men than among women (25.5% vs 20.5%, respectively; p < 0.006), among antagonists than among protagonists (35.7% vs 20.6%, respectively; p < 0.001), lower vs middle vs upper socioeconomic class (SEC) [48.2%, 22.9%, and 10.5%, respectively; p < 0.001], among independent vs studio movies (46.2% vs 18.2%, respectively; p < 0.001); and among R-rated vs PG13-rated vs PG-rated movies (37.3%, 16.2%, and 8.1%, respectively; p < 0.001). In R-rated movies, and in both subcategories of R-rated studio movies and R-rated independent movies, smoking prevalence is higher than in the US population (37.3%, 30.5%, and 50.6% vs 24.8%, respectively; p < 0.001 for all). Additionally, compared to the US population, men, women and lower SEC members smoke more in R-rated movies, R-rated studio movies, and R-rated independent movies. In R-rated movies, antagonists smoke more than protagonists (43.9% vs 35.8%, respectively; p < 0.001), and whites smoke more than nonwhites (38.3% vs 26.4%, respectively; p < 0.001). In R-rated studio movies, antagonists smoke more than protagonists (42.6% vs 26.6%, respectively; p < 0.001), and men smoke more than women (32.0% vs 27.9%, respectively; p = 0.03). In R-rated independent movies, whites smoke more than nonwhites (51.8% vs 40.5%, respectively; p < 0.001). Smoking prevalence is higher in R-rated independent movies than in R-rated studio movies (50.6% vs 30.5%, respectively; p < 0.001). Smoking prevalence is also higher in R-rated independent movies than in R-rated studio movies in subcategories of men (32.0% vs 49.8%, respectively; p < 0.001), women (21.8 vs 51.8%, respectively; p < 0.001), protagonists (26.6% vs 51.6%, respectively; p < 0.001), whites (31.5% vs 51.8%, respectively; p < 0.001), nonwhites (24.7% vs 40.5%, respectively; p < 0.001), and all three SECs. CONCLUSIONS In contemporary American cinema, the smoking prevalence is higher for men, antagonistic characters, lower SEC, independent movies, and R-rated movies. Smoking prevalence is higher than in the general US population in R-rated movies, and in both its subcategories of R-rated studio movies and R-rated independent movies. There is more smoking in R-rated independent movies than in R-rated studio movies. Smoking in contemporary American cinema is associated with male sex, lower SEC, and antagonistic (ie, bad) characters.