Can Movie Ratings Really Stop Teens from Smoking?

By Dorri Olds 01/12/18

Youth who are exposed to images of smoking in movies are more likely to smoke.

boy with a film projector
"If future films that depict smoking are given an R rating, the CDC expects a reduction of 18% in the number of teen smokers."

A long-time sober friend and I were exiting a 12-step meeting a few weeks ago and caught a whiff of cigarette smoke exhaled by a passerby. “Ya know,” I said, “I still crave cigarettes, even though I quit almost three decades ago.”

He agreed. “Yeah, I started smoking when I was 12. When I finally quit 15 years ago, I’d turned 40 and had a ridiculous amount of health problems. It always looked so glamourous in those old Hollywood movies. It still does and I still want to smoke.”

The Centers for Disease Control and Prevention (CDC) issued a report about tobacco use in top-grossing movies during the years 2010 through 2016. “Reducing tobacco use in youth-related movies could help prevent the initiation of tobacco use among young persons,” said the report. And, although it found less smoking in G and PG movies since 2010, tobacco use in PG-13-rated top-grossing films has increased 43% since 2010.

The Surgeon General website states, “Youth who are exposed to images of smoking in movies are more likely to smoke. Those who get the most exposure to onscreen smoking are about twice as likely to begin smoking as those who get the least exposure.” The SG has concluded that there is a causal relationship between smoking in the movies and “the initiation of smoking among young persons.” America’s leading health organizations are now demanding that all movie producers and distributors slap an R rating onto films that show smoking onscreen. Interestingly, they’ve indicated a possible exception for movies based on historical figures.

It would be odd to watch a flick about Franklin D. Roosevelt, Dwight D. Eisenhower, or Lyndon B. Johnson without showing a single cigarette. And can you imagine Winston Churchill without a cigar? On January 8, actor Gary Oldman won a Golden Globe for his portrayal of Churchill in the PG-13-rated film, “Darkest Hour." During his acceptance speech Oldman thanked co-star Kristin Scott Thomas “for putting up with all of those awful cigars."

But who will decide when it’s necessary to include smoking in order to portray history accurately? When will it matter enough for those in the entertainment business to risk receiving an R rating and losing millions at the box office? And doesn’t this idea of sanitizing films reek of censorship? With our nation’s current problem of fake news running rampant in alt-right publications, it seems an especially bad time to paint a rosy picture of U.S. history.

As a kid, it gave me a rush to do anything forbidden. Summer camp was the scene of the crime where I learned to inhale and blow smoke rings as a pre-teen. I pilfered cigarettes from my grandmother’s purse. My whole life, my parents had warned me of the dangers of smoking. In our home hung a large self-portrait of my Uncle Buddy. His hands are about to strike a match while a cigarette dangles on his lower lip. My mother often caught me staring at the painting and lectured me. “Don’t ever forget, my brother Buddy died from cigarettes.” But being willful whenever I was told not to do something, it felt like a dare and I had to do it. It was like yelling, “Don’t think about elephants!” If only they’d insisted, “You must smoke cigarettes.” That might’ve worked.

So, for me, I don’t know if the idea came from movies, although that’s possible. But it could’ve been from television.

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reached out to Stanton A. Glantz, PhD, an American professor, author, and leading tobacco control activist. I asked what he would say to anyone arguing against the R rating.

“Movies are the single most important stimulus for youth smoking,” said Glantz. “When parents and kids buy tickets for movies rated for kids, they should not have to be exposed to toxic images that double the chances that they will become addicted to cigarettes and die prematurely.”

But let’s address that claim. Has research proven that movies are the main culprit? According to the CDC, there are 5.6 million young people alive now who will die from tobacco-related diseases if nothing changes. But, if future films that depict smoking are given an R rating, the CDC expects a reduction of 18% in the number of teen smokers. That stat means that one million future deaths would be prevented. However, studies and statistics are not always spot on and I couldn’t help wondering if it is even possible to separate each one of the factors that can lead youngsters to smoking. So, I turned to another expert—Erika Sward, the Assistant Vice President of National Advocacy at the American Lung Association.

Sward is very much in favor of the R rating. My question for her was, “How can we measure the exact amount that seeing smokers onscreen leads young people to take up smoking cigs?”

“I don’t know if you can ever say one thing is equal to another,” she said. “What we do know is that there are a number of different causal factors that lead to tobacco use. One of them is your socioeconomic status. Another is whether or not your parents, especially your mother, smokes. Then there’s the amount of tobacco industry marketing and advertising that one is exposed to, and then certainly, seeing depictions of tobacco use on screen. But what’s more important to one person and less to another—I don’t think that’s ever been quantified. Those are certainly many factors that come together.”

It seems that even though studies cannot state the exact percentage that movies influence adolescents to begin puffing, the R rating will eliminate at least one of those factors. Lives will be saved. Professor Glantz provided a strong argument for changing the movie ratings for G, PG and PG-13 movies.

“If Hollywood thinks smoking is that important,” he said, “like frontal nudity or using the ‘F’ word repeatedly, they should be willing to accept an R rating, which means this is not a product to be sold to kids.” He added that there’s a huge body of scientific evidence to support the conclusion that exposure to smoking on screen causes kids to smoke. “It’s summarized in the 2012 Surgeon General report,” he said.

Glantz stressed that typically children first pick up between the ages of 12 and 15. “The younger someone starts smoking,” he said, “the harder time they have quitting later. This is because the adolescent brain is still developing and nicotine changes the brain chemistry.”

He referred to a UCLA study that found when teenagers smoke there is reduced activity in their prefrontal cortex, which results in poor decision-making. The greater a teen’s addiction to nicotine, the less active that part of their brain is. Teenagers already have enough brain problems to deal with; adolescents are especially vulnerable to psychiatric disorders—including drug and alcohol addiction and depression.

“Tobacco companies used to pay studios, directors [and] actors for product placement on the screen,” said Sward. “We know that was one of the ways that the tobacco industry directly marketed their products many of which were aimed at young people. That was prior to the Master Settlement Agreement with the tobacco companies in 1998, but we still do see a great deal of tobacco use in the movies and on screen. It was way back in 1964 [that] the Surgeon General concluded that smoking causes lung cancer.”

The R rating is not a governmental action. “This is movie theaters and studios stepping up and saying, ‘We believe that this should happen,’” said Sward. “Then it is executed [by the] Motion Picture Association of America when they assign the ratings.”

The MPAA provides a smoking label along with the regular rating for some movies that contain smoking. However, according to the CDC, almost 9 out of every 10 youth-rated, top-grossing movies with smoking do not yet carry an MPAA smoking label.

Sward added, “Between the tobacco control and the behavioral health worlds, we are not doing enough to work together to make sure that [while people with substance use disorders] are getting help for overcoming behavioral and addiction issues, they’re also getting help with quitting [smoking]. That really has caused a huge disparity and … shorter lifespan for people with behavioral health issues.”

She also pointed out, “It’s common that cigarette use has been a reward for people who have worked to end other addictions, such as crystal meth, cocaine, and heroin. That complicates and compounds the tobacco-caused death and disease within a population.”

When I got sober in rehab, I was told not to quit smoking for a year. My counselor explained that addicts relapse when they try to quit everything at once. It’s like a crash diet. While that may work for a short time, it’s nearly impossible to sustain. For recovery to last, slow and steady changes are the way to go.

I do not disagree with Sward or Glantz that society needs to continue to think of ways to keep kids from picking up the dangerous habit of smoking. If movie studios are willing to accept an R rating for films that depict smoking, it can’t hurt. But with every kid addicted to their cell phone and the internet, it seems naïve to think that they’re not going to see smokers. Even in shows aimed at kids there’s tobacco. One great example is the wildly popular Stranger Things. This Netflix show takes place in the 1980s, so it is historically accurate to show a lot of smoking. And what if they catch an episode of Mad Men? That show would not have been believable without the chain-smoking that was normal in those years. And yes, parents can put controls on what their kids watch at home. But do you remember being a teen? My parents didn’t allow sugary breakfast cereal in our house, which was smart. But I just came up with a workaround: sleepovers. My friends’ houses were full of Lucky Charms and Cap’n Crunch and no helicopter parenting.

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Dorri Olds is an award-winning writer whose work has appeared in many publications including The New York Times, Marie Claire, Woman’s Day and several book anthologies. Find Dorri on Twitter, Facebook, and LinkedIn.