"Most investigators have concluded that smoking is portrayed as glamorous and positive, but our study shows that the exact opposite is true," said the study's lead author, Karan Omidvari, MD, FCCP, Heart and Vascular Institute, St. Michael's Medical Center, Newark, NJ. "Additionally, different studies in the past have subjectively concluded that movies are attempting to influence different groups of minorities to smoke. We have contradicted these findings as well."
To quantify the prevalence of smoking in movies, researchers from New York, NY, San Diego, CA, New Orleans, LA, and Stanford, CA recorded the smoking habits of the five leading characters in all top-10 box office movies made after 1990 that portray United States society in the 1990s. Movies in the analysis included Armageddon, There's Something About Mary, As Good As It Gets, Independence Day, and Jerry Maguire. Among the 447 movies included in the study, 193 were R-rated, 131 were PG-13-rated, and 123 were PG-rated (science-fiction and animated movies were excluded, because they are not meant to portray reality). Results show that the prevalence of smoking in the movies is the same as the prevalence of smoking in US society (23.3% vs 21.8%). Male characters were more likely to smoke than female characters (25.5% vs 20.5%) and whites were far more likely to smoke than minorities (38.9% vs 29.4%). Researchers also discovered that 35.7% of antagonists smoked compared to 20.6% of protagonists, and 48.2% of characters who smoked were in the lower socioeconomic class, 22.9% were in the middle class, and 10.5% were in the upper class. These findings indicate that the unsuccessful and unglamorous characters light up in movies more than middle class, successful characters.
"Movies have long been shown to have a significant effect on smoking behavior," said D. Robert McCaffree, MD, Master FCCP, President of The CHEST Foundation.
"This study updates our previous understanding and emphasizes the need for change in this area, including increasing antitobacco messages in coming attractions and films to help educate the public-especially children and young adults-about the harmful consequences of smoking."
"R-rated movies, which are the overwhelming majority of the movies made and watched by most people, have a higher prevalence of smoking than movies rated PG and PG-13," said Dr. Omidvari. "Independent movie-makers, who work outside the Hollywood system, are much more callous and "guilty" when it comes to portraying smoking indiscriminately."
Smoking was especially prevalent in R-rated and independent movies, which both surpassed the smoking rates in US society. Lead characters smoked in 37.3% of R-rated movies, compared to 16.2% of PG-13 movies and 8.1% of PG movies. An even larger gap was found between R-rated, independent, and studio movies, with 46.2% of independent movies containing smoking among the lead characters, compared to 18.2% of studio movies' lead characters. The greatest smoking rates were found in R-rated independent movies, of which half contained smoking (49.8%).
"Children and adults of all ages can be influenced by what they view in movies," said Paul A. Kvale, MD, FCCP, President of the American College of Chest Physicians. "This study emphasizes the need for responsible filmmaking when it comes to portraying smoking, which is an extremely addicting and deadly habit."
CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at www.chestjournal.org. ACCP represents 16,500 members who provide clinical respiratory, sleep, critical care, and cardiothoracic patient care in the United States and throughout the world. The ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication. The CHEST Foundation is the philanthropic arm of the American College of Chest Physicians, whose focus is to assist ACCP members in improving the health and lives of their patients by providing educational resources in the areas of critical care, pro-bono service and clinical research, and tobacco prevention. For more information about the ACCP, please visit the ACCP Web site at www.chestnet.org. For more information about The CHEST Foundation, please visit the Foundation Web site at www.chestfoundation.org/index.php.