Two new studies by Dartmouth Medical School pediatrician researchers underscore the significant impact that movies have in influencing teens to smoke. The studies show that movies deliver billions of smoking impressions to American teens; and that even t

Two new studies by Dartmouth Medical School pediatrician researchers underscore the significant impact that movies have in influencing teens to smoke. The studies show that movies deliver billions of smoking impressions to American teens; and that even teens outside the U.S. are affected by smoking images in films distributed internationally by American studios. In a report published in Pediatrics, "Exposure to Movie Smoking Among US Adolescents Aged 10 to 14 Years: A Population Estimate," Dr. James Sargent and his co-authors, researchers at Norris Cotton Cancer Center, used a nationally representative sample of 6,522 U.S. adolescents aged 10-14 years, and assessed their exposure to 534 popular contemporary box-office hits. Three out of four movies (74%) studied contained smoking, for a total of 3,830 smoking images. Based on the number of U.S. adolescents seeing each movie and the smoking contained in each, the researchers estimated that these movies delivered 13.9 billion gross smoking impressions. Sixty one percent of these impressions were delivered by youth-rated movies. Of the group of movies surveyed, some 30 of the movies delivered more than 100 million smoking impressions each. Many of these high-impact movies were rated PG-13. "The apparently free delivery of star smoking to a young teen population is a tobacco marketer's dream," said Dr. Sargent. More than 3,000 actors appeared in these movies, and 500 of them smoked on screen. Yet 30 of the top stars, mostly male, delivered more than 25% of the total smoking images. At the same time, many other top actors starred in five or more of these movies without smoking in any. "If just one of these popular stars decided to quit smoking in movies it would make a major difference on adolescent exposure," said Dr. Susanne Tanski, one of the authors. Just as with their American peers, German adolescents are highly influenced by the on-screen smoking behavior of U.S. movie stars, according to the second study co-authored by Dr. Sargent and published today in the American Journal of Preventive Medicine. The study, "Exposure to Smoking in Popular Contemporary Movies and Youth Smoking in Germany," tested whether teens in a society where tobacco advertising is still prevalent, and where smoking is still socially acceptable, are influenced by smoking in movies. After controlling for demographic, media, and psychosocial factors, investigators found that teens who had seen the most smoking in films (mostly U.S. blockbusters) were nearly twice as likely to have tried smoking than those who saw the least amount - results that mirror previous U.S. findings. "Viewing smoking in globally distributed movies is a risk factor for smoking in European adolescents," says Reiner Hanewinkel, PhD, Institute for Therapy and Health Research, principal investigator in the German study. "Limiting exposure to movie smoking could have important worldwide public health implications." Internationally distributed movies, the majority of which are produced and distributed by Hollywood studios, comprise over 80% of the German film market, and 80 to 90% of these movies contain smoking. The school-based, cross sectional study of 5586 German adolescents assessed exposure to 398 internationally distributed popular movies, 98% of which were produced and distributed by U.S. studios. Exposure to smoking in these movies was associated with trying smoking and current smoking among the adolescents, with high exposure adolescents being 1.8 times more likely to have tried smoking and 1.7 times more likely to be a current smoker. ### The study published in Pediatrics was funded by the National Cancer Institute and the American Legacy Foundation. The study published in the American Journal of Preventive Medicine was funded by the Ministry of Health of the Federal Republic of Germany and the National Cancer Institute. Norris Cotton Cancer Center combines advanced cancer research at Dartmouth Medical School with patient-centered cancer care at Dartmouth-Hitchcock Medical Center. It is one of 39 Comprehensive Cancer Centers designated by the National Cancer Institute (NCI). Learn more about Norris Cotton Cancer Center research, programs, and clinical trials online at

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