The December 15 issue of the British Medical Journal contains a paper by team from Dartmouth College and the Dartmouth Medical School that links adolescent smoking to depictions of smoking in movies. James Sargent, a pediatrician at the Norris Cotton Cancer Center at Dartmouth-Hitchock, headed the team. The paper reports that adolescents who have seen extensive smoking in movies are two and a half times more likely to try a cigarette than their peers who had seen movies with less smoking.

The team surveyed 5,000 Vermont and New Hampshire adolescents ages nine to fifteen. The adolescents identified movies that they had seen from a list of fifty movies randomly selected from a master list of 601 released between 1988 and 1999. The research team found an average of five occurrences of tobacco use in each of these films.

The adolescents were split into four groups based on their exposure to smoking in movies. The researchers then analyzed how this exposure to smoking in movies compared to their subjects' personal smoking habits. The adolescents in the group with the most exposure to smoking in the movies experienced a 32% rate of tobacco experimentation, compared to 5% for the lowest exposure group. Dr. Sargent and his team controlled factors such as peer pressure and age.

This is the first comprehensive study linking teen smoking to movies. While the researchers said that they have taken into account factors that might also influence the surveyed adolescents, one must wonder if the study does not present its own flaws. For instance, 458 of the 601 movies used by the group are rated PG-13 and R. The team found a direct correlation between the rating of a film and the amount of smoking in that film. The study found an average of 8.5 occurrences of tobacco usage in R-rated movies, compared with just one occurrence per G-rated movie. Clearly, some parents are more likely to allow their children to view R-rated movies. The same research group that put out this study released another study in December concluding that children who were discouraged to smoke by their parents were less likely to start. One could conclude that parents who don't actively discourage their children from smoking might also allow their children view more PG-13 and R-rated movies. It is also important to realize that the adolescents who view R-rated movies, which contain more smoking, could be previously more inclined to try a cigarette, considering factors like "rebelliousness."

The study did not take temporal effects into account. It does not determine if some, all, or any of the surveyed films were viewed before the subject started smoking. Because of geographic constraints, the study also fails to measure the effect of the movies on urban teens, who are likely exposed to tobacco more regularly.

The group hopes to continue its research into tobacco and the movies. The National Cancer Institute, which funded this study, has pledged an additional $3.6 million dollars to clarify the tie between movies and teen smoking. In addition to the report put out in December that links parental attitudes to teen smoking, the group has published two other reports last year related to smoking and the cinema. In January 2001, they released a report concluding that actor endorsement of cigarette brands was increasing, even though a voluntary ban on the practice had been implemented by the tobacco industry in the late Eighties. In March 2001, the team reported that children whose favorite movie stars smoke were more likely to smoke as well.