Keeping our kids from toking on poison

Pinocchio_Smoking-300x169Tougher ratings for movies targeting teen-agers and higher cigarette taxes may be two good ways to crack down on Big Tobacco’s persistent and harmful peddling of its poisonous wares, health experts say, based on information flowing from the sprawling Golden State.

The federal Centers for Disease Control and Prevention has just assessed Hollywood’s progress in reducing depictions of tobacco in the movies, finding that, under pressure from anti-smoking campaigns,  Tinsel Town had slashed its showing of the use or implied use of cigarettes, cigars, pipes, hookah, smokeless tobacco products and electronic cigarettes from 2005 to 2010. But that progress has reversed since then, and now, based on top 10 grossing movies in any calendar week, cinematic depictions of tobacco use has soared by 80 percent.

Although pictures rated G or PG, those films most accessible to the broadest movie-going audiences, saw reductions in their showing of smoking and other tobacco use, depictions of these negative health practices rose sharply in movies aimed more at teenagers and older youths  in those works with ratings of PG-13 (by 43 percent) and R (by 90 percent).

Data used in the CDC study is displayed on the web site for, an anti-smoking group whose volunteers help gather information on tobacco use in the movies. The group notes that among top 10 movie releases for the week of July 16, four films—Baby Driver, Wonder Woman, Transformers: the Last Knight, and The House—show tobacco use.

The jump in depictions is worrisome, because studies by the U.S. Surgeon General and the National Cancer Institute have shown that seeing tobacco use in movies and in other favorable ways in the media (as reported in research by the RAND Corp.) can push young people toward smoking cigarettes, cigars, pipes, hookahs, and to so-called e-cigarettes and “vaping.” Keeping Americans from starting to smoke at all in their teens can be critical to ensuring they never do so, other research has found.

The growing evidence in the early 2000s had proved sufficiently convincing that state attorneys, state health departments, investors, and the movie industry itself grew wary of giving Big Tobacco too much screen time, with six major studios putting in place policies to restrict shows of smoking in major films.

Hollywood didn’t codify these protective measures for young movie-goers, especially in its ratings system. With the industry appearing to give short shrift to previous anti-tobacco concerns, CDC researchers suggested it may be time for the Motion Picture Association of America to consider if tobacco use ought to be weighted into its ratings, with smoky pictures receiving a tougher R.

Hollywood may also need to be prodded by public pressure to clarify for each film whether its makers received Big Tobacco money, for example, for “product placement,” in which saleable items are shown incidentally but often prominently in use in movie scenes.

Although the movie industry may take major fire from Fox News commentators and others for its supposed liberal bias and progressive politics, money speaks loudly in Los Angeles—and the MPAA, for example, has fought off campaigns to consider the violence levels in big box office films when rating them. Industry leaders also successfully battled a public interest lawsuit, in which a dad tried to get R ratings slapped on successful movies with lots of smoking in them.

California voters, though, may have landed on a powerful way to slash tobacco use, slapping big taxes on cigarettes through a recent, popular statewide ballot measure. Proposition 56, which increased the average per pack cost of smokes to $9 from $6, has been in effect for just two months. But Golden State revenuers say that year over year, cigarette sales plunged 56 percent or by more than 80 million packs.

That’s excellent health news but may have unforeseen budget impacts, because it means lower than anticipated cigarette tax revenue heading to help pay for medical services for California’s poor, experts say.

They note that it may be too early to see fully the results of this anti-tobacco measure, favorable as it may be at its outset.

In my practice, I see not only the harms that patients suffer while seeking medical services but also the huge damage that tobacco causes. Cigarette smoking remains the leading cause of an array of preventable health harms, including deaths from multiple types of cancer, as well as heart and lung diseases. Americans have made huge strides in knocking out the glamour in smoking, and in keeping our young people healthier, now and in the future, by curbing their tobacco use. Let’s hope Hollywood moguls join the rest of us in seeing this as a virtuous cause worthy of their voluntary and full support.

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