Reach of movie smoking among U.S. adolescents.

B52

OBJECTIVE To determine the reach of movie smoking in a representative sample of young U.S. adolescents. METHODS We conducted a survey of 6522 nationally representative U.S. adolescents aged 10-14 years. We counted occurrences of smoking in 534 popular box office hits. Each movie title was assigned to a random subsample of adolescents (mean = 613) who were each asked to indicate whether or not they had seen it. Using weights, this allowed determination of the total number of U.S. adolescents who had seen each movie. Gross smoking impressions (GSI) seen by adolescents were determined by multiplying the estimated number seeing the movie by the number of smoking depictions within each movie. RESULTS The 534 movies were mainly PG-13 (41%) and R-rated (40%), and 74% contained smoking totaling some 3830 smoking occurrences. On average, each movie was seen by 25% of the 10-14 year olds surveyed. Viewership was inversely associated with age and was lower for R-rated movies (mean = 14%) than PG-13 (27%), PG (47%) or G movies (51%). In aggregate, this sample of movies delivered 13.9 billion GSI of smoking, an average of 665 GSI to each of the U.S. adolescents in this age group. Although R-rated movies from this sample contained 60% of all smoking occurrences, they delivered only 39% of GSI due to lower adolescent viewership. Thirty popular movies each delivered 100 million or more GSI. A group of 30 actors each delivered more than 50 million GSI each, such that just 1.5% of actors delivered, in aggregate, one-quarter of all character smoking to the adolescent sample. Another group of popular stars appeared in as many as 10 of the movies in the sample, but did not smoke in any. CONCLUSION Popular movies deliver billions of smoking images and character smoking depictions to young U.S. adolescents. Removing smoking images from youth-rated films would substantially reduce exposure from new box office hits. In addition, popular actors who often smoke in movies could affect adolescent movie smoking exposure not smoking on screen.