Key reports | US Surgeon General
The R-rating would substantially reduce youth smoking | The Surgeon General's 2014 report The health consequences of smoking — 50 years of progress includes an extensive discussion of on-screen smoking’s effects on young people. It also discusses how to eliminate tobacco imagery in the movies that young people see most.
The Surgeon General reports that updating the R-rating to reduce adolescents’ in-theater exposure from an annual mean of 275 tobacco images to ten images or less would reduce young people's smoking rates by 18 percent (Chapter 14, pages 775-777).
The Surgeon General also projects that, given current conditions, 5.6 million US children alive today can be expected to die from tobacco-induced diseases (Exec. Summary, page 1).
Combining these two facts leads to the conclusion that an R-rating for movies with smoking would avert one million tobacco deaths among today’s children and adolescents. Indeed, the US Centers for Disease Control stated this conclusion in its fact sheet on smoking in the movies (August 2014).
Movies with smoking cause young people to smoke | The Surgeon General's 2012 report Preventing tobacco use among youth and young adults contains an extensive discussion of the effects of smoking in movies on young people. The conclusion:
The evidence is sufficient to conclude that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among young people. (Chapter 1, page 10)
The report includes its 36-page section on movie smoking in Chapter 5: The Tobacco Industry's Influences on the Use of Tobacco Among Youth. In effect, the Surgeon General considers on-screen smoking in the same context as conventional cigarette marketing activities.
The report reviews the "Historical Links Between the Tobacco Companies and the Movie Industry" (Chapter 5, pages 565-566); concludes that lowering young people's level of exposure to on-screen smoking leads to lower risk of smoking (page 593), and endorses an R-rating for smoking as a way to reduce exposure (page 598).
The fact sheet accompanying the report states:
Youth who are exposed to images of smoking in movies are more likely to smoke. Those who get the most exposure to onscreen smoking are about twice as likely to begin smoking as those who get the least exposure. Images of smoking in movies have declined over the past decade; however, in 2010 nearly a third of top-grossing movies produced for children — those with ratings of G, PG, or PG-13 — contained images of smoking.