Movie Smoking and Youth Initiation: Parsing Smoking Imagery and Other Adult Content

Abstract

Objectives: To isolate the independent influence of exposure to smoking and other adult content in the movies on youth smoking uptake. Methods: We used discrete time survival analysis to quantify the influence of exposure to smoking and other adult content in the movies on transitioning from (1) closed to open to smoking; (2) never to ever trying smoking; and (3) never to ever hitting, slapping, or shoving someone on two or more occasions in the past 30 days. The latter is a comparative outcome, hypothesized to have no correlation with exposure to smoking in the movies. Results: Exposure to smoking in the movies significantly increased the likelihood of youth having tried smoking (OR = 1.06; 95% CI: 1.00-1.12) and being open to smoking (OR = 1.09; 95% CI: 1.04-1.15). Smoking initiation would have been 21% lower had this cohort never been exposed to smoking in the movies. However, exposure to adult content is also associated with trying smoking (OR = 1.06; 95% CI: 1.00-1.13) and becoming open to smoking (OR = 1.10; 95% CI: 1.04-1.17). The correlation coefficient between the two exposure measures is 0.995 (pConclusion: Although exposure to smoking in the movies is correlated with smoking initiation and susceptibility, the high correlation between exposure to smoking in the movies and other adult content suggests that more research is needed to disentangle their independent influence on smoking.