Exposure to Movie Smoking: Its Relation to Smoking Initiation Among US Adolescents

• Published in: Pediatrics (Evanston) Vol. 116; no. 5; pp. 1183 - 1191
• Main Authors: Sargent, James D, Beach, Michael L, Adachi-Mejia, Anna M, Gibson, Jennifer J, Titus-Ernstoff, Linda T, Carusi, Charles P, Swain, Susan D, Heatherton, Todd F, Dalton, Madeline A
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL Am Acad Pediatrics 01-11-2005; American Academy of Pediatrics
• Subjects: Adolescent; Adolescent Behavior; Biological and medical sciences; Child; General aspects; Health aspects; Human exposure; Humans; Imitative Behavior; Medical sciences; Motion Pictures; Pediatrics; Portrayals; Psychological aspects; Smoking; Smoking - psychology; Teenagers; Tobacco, tobacco smoking; Toxicology; Youth; United States; United States > US; Human; Pediatrics; Relation; Tobacco; Adolescent; Tobacco smoking; Media; media impact; Exposure; Mass media; Initiation; adolescent smoking
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2005-0714

Regional studies have linked exposure to movie smoking with adolescent smoking. We examined this association in a representative US sample.
We conducted a random-digit-dial survey of 6522 US adolescents aged 10 to 14 years. Using previously validated methods, we estimated exposure to movie smoking, in 532 recent box-office hits, and examined its relation with adolescents having ever tried smoking a cigarette.
The distributions of demographics and census region in the unweighted sample were almost identical to 2000 US Census estimates, confirming representativeness. Overall, 10% of the population had tried smoking. Quartile (Q) of movie smoking exposure was significantly associated with the prevalence of smoking initiation: 0.02 of adolescents in Q1 had tried smoking; 0.06 in Q2; 0.11 in Q3; and 0.22 in Q4. This association did not differ significantly by race/ethnicity or census region. After controlling for sociodemographics, friend/sibling/parent smoking, school performance, personality characteristics, and parenting style, the adjusted odds ratio for having tried smoking were 1.7 (95% confidence interval [CI]: 1.1, 2.7) for Q2, 1.8 (95% CI: 1.2, 2.9) for Q3, and 2.6 (95% CI: 1.7, 4.1) for Q4 compared with adolescents in Q1. The covariate-adjusted attributable fraction was 0.38 (95% CI: 0.20, 0.56), suggesting that exposure to movie smoking is the primary independent risk factor for smoking initiation in US adolescents in this age group.
Smoking in movies is a risk factor for smoking initiation among US adolescents. Limiting exposure of young adolescents to movie smoking could have important public health implications.