Association between exposure to movie smoking and established adolescent smoking.

B53

OBJECTIVE: To assess the association between exposure to smoking occurrences contained in 532 popular movies and established smoking (ES, lifetime smoking of >=100 cigarettes). METHODS: In September 2003, we enrolled 6522 U.S. adolescents in a random digit dial telephone survey and resurveyed them at 8-month intervals, 8M (n = 5503), 16M (n = 5019), and 24M (n = 4575). Using previously validated methods, we estimated baseline exposure to smoking occurrences in 532 recent box-office hits. A discrete-interval hazard model was used to assess the hazard-odds of ES for each of the three exposure periods as a function MSE, while controlling for sociodemographics, other social influences, personality factors and parenting style. MSE was modeled in increments of 500 movie smoking occurrences (range of exposure 19-2500 smoking occurrences). RESULTS: The incidence of ES was from 7.5, 15, and 15 per 1000 person-years of observation for the 0-8M, 8-16M and 16-24M observation periods respectively. MSE was strongly associated with the incidence of ES at each interval, and the adjusted overall hazard odds of becoming an established smoker during follow-up was 1.24 (95% CI 1.1, 2.5) for each 500-occurrence increase in MSE. Other strong predictors of smoking initiation included age, parent, sibling or friend smoking, and sensation seeking. Teens that were below the median on an index of sensation seeking and rebelliousness were significantly (p = 0.026) more susceptible to the movie smoking exposure effect (hazard odds =1.78 [1.29, 2.46]) compared with teens who were above above median (hazard odds = 1.18 [95% CI 1.004, 1. 39]). CONCLUSIONS: In this nationally representative U.S. adolescent sample, exposure to smoking contained in popular contemporary movies was associated with established smoking. The finding that the association was stronger for low sensation seeking/rebelliousness adolescents undercuts the argument that movie viewing is simply a general marker for the high risk teen.