Exposure to onscreen smoking in movies in New Zealand accounts for greater fraction of smoking than in USA

Philip Gendall, Janet Hoek, Richard Edwards, and I just published "Effect of Exposure to Smoking in Movies on Young Adult Smoking in New Zealand" in PLOS One.  This paper showed that 18-25 year olds in New Zealand were affected by exposure to on-screen smoking just as youth around the world are, with people who saw more smoking being more likely to smoke.

Interestingly, the population attributable risk for smoking among the New Aealand young adults was 54%, higher than the 37% observed in the USA.  This is not surprising because traditional cigarette advertising is banned in New Zealand, so the movie smoking is competiting with fewer other pro-tobacco influences as the reason people start smoking. 

Here is the abstract:

Onscreen Smoking Is a Form of Tobacco Marketing

Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents’ exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012.  Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies.

Effect of Smoking in Movies on New Zealand Youth

Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents’ likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents,  (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it it legal to view smoking in movies would support New Zealand’s smokefree 2025 goal.

The full paper is available for free here.