Smoking in movies: impact on adolescent smoking.

This article examines the evidence that supports an association between seeing smoking depictions in movies and adolescent smoking. The portrayal of tobacco use is common in movies and often is modeled by stars, who, from a social influences standpoint, should be powerful behavior change agents. The results of studies that assess audience responses to tobacco portrayal in movies are remarkably consistent in showing a moderate to strong association between seeing movie smoking and more positive attitudes toward smoking and adolescent smoking initiation. The two published longitudinal studies show an independent link between exposure to movie smoking at baseline and initiation in the future, with estimates of the effect size being remarkably consistent with their cross-sectional counterparts. Pediatricians should support public health campaigns to pressure the movie industry to voluntarily reduce smoking in movies and encourage parents to adhere to the Motion Picture Ratings System to reduce adolescent exposure to this powerful social influence to smoke.