92,000 current smokers in Ontario aged 12-17 were recruited to smoking because of watching smoking in movies

The Ontario Tobacco Research Unit in Canada recently published "Exposure to Onscreen Tobacco in Movies among Ontario Youth, 2004-2013".  Here is the executive summary:
 
Movies are a powerful vehicle for promoting tobacco and health; authorities all over the world have concluded that smoking in movies is a cause for smoking initiation and progression to regular smoking among youth. Higher exposure to onscreen tobacco increases the uptake of smoking among youth and undermines tobacco prevention efforts.

The Ontario Tobacco Research Unit collaborated with the Ontario Coalition for Smoke-Free Movies to conduct a study to examine the extent of onscreen tobacco exposure in movies among Ontario youth. The study aimed to examine data on the number of incidents of onscreen tobacco in movies released from 2004 to 2013 and estimate the impact of exposure to onscreen tobacco in movies on youth smoking.
 
Data on the level of onscreen tobacco in movies was obtained from a sample of 1434 top-grossing movies (i.e. movies whose box office ranked in the top 10 for at least one week) released to theatres in the “domestic” (Canada and US) market between January 2004 and December 2013. For these movies, tobacco incidents (i.e. the occurrences of tobacco use or implied use in a movie) and tobacco impressions (number of tobacco incidents multiplied by paid admissions per movie) were analyzed.
 
Key findings of the study include:
 
• Of 1434 top-grossing movies released in theatres from 2004 to 2013, 1289 (90%) were youth-rated in Ontario, with 633 rated PG (44%), 500 rated 14A (35%), 156 rated G (11%). Adult-rated movies accounted for 10% of the sample, with 144 movies rated 18A and a single movie rated R.
• A total of 818 movies (57%) featured onscreen tobacco. Eighty-six percent (701/818) of movies with tobacco were youth-rated in Ontario, much higher than in the US (54%, 440/818). As a result, Ontario youth had greater exposure to onscreen tobacco imagery than their US counterparts.
 
• The top grossing movies contained a total of 26,850 tobacco incidents. Eighty-five percent of tobacco incidents were depicted in movies that were youth-rated in Ontario, twice the percentage (42%) found in US youth-rated movies. Although the average number of tobacco incidents per movie decreased by 16% in the past 10 years (22.1 in 2004 to 18.5 in 2013), Ontario youth still had higher chances of exposure to onscreen tobacco than their US counterparts because a greater share of tobacco incidents were depicted in Ontario youth-rated movies.
 
• The trend in tobacco impressions largely resembled that of the tobacco incidents, a decline between 2005 and 2010 followed by a rebound in 2011 and 2012 and a slight decrease in 2013. There was a 13% decrease (1024 million to 892 million) in annual tobacco impressions between 2004 and 2013. The top-grossing movies delivered an estimated 8.1 billion in-theatre tobacco impressions to moviegoers in Ontario from 2004 to 2013. Youth-rated movies delivered the vast majority of tobacco impressions (86%, overall) to Ontario audiences.
 
• Discrepancies exist between the number of movies that have tobacco related labels issued by the Ontario Film Review Board (OFRB) and the number of movies with tobacco incidents reported by independent monitors. In 2008 the OFRB included a “tobacco use” detailed observation for movies listed at http://www.ofrb.gov.on.ca/. Of 749 movies released between 2008 -2013, 51% (379/749) depicted tobacco, as reported by independent monitors, while just 34% (255/749) received a “tobacco use” detailed observation by the OFRB. In addition, the OFRB also assigned an “illustrated or verbal reference to drugs, alcohol or tobacco” detailed observation to 28% of these movies (206/749). The OFRB issued tobacco-related observations to 78% (296/379) of the movies that independent monitors had identified as depicting tobacco imagery.
 
• On March 2012, the OFRB included a ‘tobacco use’ content advisory when classifying movies. Between Mar 2012- 2013, 237 movies were released; 54% (127/237) depicted tobacco incidents as reported by independent monitors, while 6% (14/237) were given a ‘tobacco use’ content advisory by the OFRB.
 
• The Smoke-Free Ontario Scientific Advisory Committee notes that an effective way to reduce youth exposure to onscreen tobacco in Ontario is to require adult ratings (18A in Ontario) for movies with any tobacco imagery. This policy measure has been recommended by public health stakeholders and institutions provincially, nationally and internationally.
 
• Over the seven years (2005, 2007-2012) where data were available, it is estimated that 92,000 current smokers in Ontario aged 12-17 were recruited to smoking because of watching smoking in movies. Twenty-nine thousand of these smokers are projected to die prematurely as a result of tobacco imagery in movies.
 
The full report is available here.