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Should films with smoking have adult ratings?


Two articles in this week's PLoS Medicine address the question of whether films with smoking scenes should have "adult" ratings applied to them.

Christopher Millett from Imperial College, London, UK and colleagues report that, despite the WHO Framework Convention on Tobacco Control recommendation that films with smoking scenes have adult content rating, very few governments have complied with this advice. Arguing that exposure to tobacco imagery in movies is a "potent cause of youth experimentation and progression to established smoking," the authors say their primary reason for supporting the film rating recommendation is to create an economic incentive for producers to leave smoking out of movies that are marketed to youths.

Even more problematic, the authors say, is the fact that "many governments provide generous subsidies to the US film industry to produce youth-rated films that contain smoking and as such indirectly promote youth smoking."

"Governments should ensure that film subsidy programmes are harmonized with public health goals by making films with tobacco imagery ineligible for public subsidies," the authors conclude.

In an Essay also published this week in PLoS Medicine and addressing the same issue, Simon Chapman from the University of Sydney, Sydney, Australia and Matthew Farrelly from RTI International, USA strongly argue against adult ratings for film with smoking scenes, laying out four reasons why they believe this to be ill-advised. They argue that 1) the link between exposure to smoking in movies and smoking uptake is vexed by substantial confounding; 2) exposure to smoking scenes is much wider than just films, including internet; 3) adult classification of films is a highly inefficient way of preventing youth exposure to adult-rated content; and 4) censorship is not the best approach for this public health issue.

The authors say: "We believe that many citizens and politicians who would otherwise give unequivocal support to important tobacco control policies would not wish to be associated with efforts to effectively censor movies other than to prevent commercial product placement by the tobacco industry."


Policy Forum article by Christopher Millett and colleagues

Funding: The authors received no direct funding for this article.

Competing Interests: CM has no competing interests to declare. The authors do not consider these competing interests, but in the interest of full transparency declare the following: SAG holds two research grants related to tobacco from the National Cancer Institute, an endowed chair as American Legacy Distinguished Professor in Tobacco Control, and a grant from the University of California Tobacco Related Diseases Research Program. SAG also administers an endowment from the American Legacy Foundation, which supports the UCSF Center for Tobacco Control Research and Education that SAG directs, and the Legacy Tobacco Documents Library. He also has the William Cahan Endowment provided by the Flight Attendant Medical Research Institute. SAG and JP run the Smoke Free Movies project (, which advocates policies, including an adult content rating for films with smoking. None of the funding organizations played any role in the preparation of this paper or the decision to submit it for publication.

Citation: Millett C, Polansky JR, Glantz SA (2011) Government Inaction on Ratings and Government Subsidies to the US Film Industry Help Promote Youth Smoking. PLoS Med 8(8): e1001077. doi:10.1371/journal.pmed.1001077



Christopher Millett
Imperial College London
Primary Care and Social Medicine
St Dunstan's Road
London, London W6 8RP
Tel: +44 20 7594 0817

Essay by Simon Chapman and Matthew Farrelly

Funding: No specific funding was received for writing this article

Competing Interests: SC has over 30 years experience in tobacco control research and advocacy and has won several international and national awards, including the American Cancer Society's Luther Terry medal for outstanding international leadership. He was deputy editor then editor of Tobacco Control for 17 years and is now Editor Emeritus. He is committed to exposing tobacco industry marketing practices and supporting the WHO's Framework Convention on Tobacco Control's provisions on banning tobacco advertising. MCF has dedicated his 17-year research career to conducting objective research and evaluation of major tobacco control programs such as the American Legacy Foundation's truthH campaign and key policy interventions such as cigarette excise taxes and smoke-free air laws.

Citation: Chapman S, Farrelly MC (2011) Four Arguments against the Adult-Rating of Movies with Smoking Scenes. PLoS Med 8(8): e1001078. doi:10.1371/journal.pmed.1001078



Simon Chapman
University of Sydney
Sydney Medical School
A27 - Edward Ford Building Sydney NSW 2006 Australia
Tel: +61 2 9351 5203
Fax: +61 2 9351 7420

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