Abstract
Exposure to tobacco, alcohol and fast-food use in films is associated with initiation of these behaviours. India is the world's largest film producer, but the extent of such imagery in Bollywood (Hindi cinema) films is unclear. We therefore aimed to describe the extent of and trends in tobacco, alcohol and fast-food imagery in Bollywood films, between 1994-2013. For the 15 top-grossing films each year between 1994-2013, the number of five-minute intervals containing product images were determined separately for tobacco, alcohol and fast-food. Both the proportion of films containing at least one image occurrence, and occurrences per film, were described overall and by year. Negative binomial regression described associations between film rating and occurrences/film, and estimated time-trends in occurrences/film, adjusted for rating. We analysed 93 U-rated (unrestricted), 150 U/A-rated (parental guidance for children aged <12 years) and 55 A-rated (restricted to adult audience) films, containing 9,226 five-minute intervals (mean intervals/film 30.8, SD 4.0). 70% (n = 210), 93% (n = 278) and 21% (n = 62) of films contained at least one tobacco, alcohol and fast-food occurrence, respectively. Corresponding total mean occurrences/film were 4.0 (SD 4.9), 7.0 (4.7) and 0.4 (0.9). Tobacco occurrences were more common in U/A films (incidence rate ratio 1.49, 95% confidence interval 1.06-2.09) and A films (2.95; 1.95-4.48) than U-rated films. Alcohol occurrences were also more common in A-rated films than U-rated films (1.48; 1.15-1.85). Tobacco occurrences/film became less common over the observed period (adjusted trend -4% per annum; -2 to -7%; p <0.001), while alcohol (+2%; 0-3%; p = 0.02), and fast food (+8%; 2-14%; p = 0.01) occurrences/film became more common. Although the extent of tobacco imagery in Bollywood films fell over 1994-2013, it is still frequently observed. Alcohol imagery is widespread, even in U-rated films, and trends in both alcohol and fast-food imagery are upwards.
Highlights
Tobacco, alcohol and fast-food have been collectively described as health harmful commodities (HHCs) [1]
Tobacco occurrences were more common in U/A films and A films (2.95; 1.95–4.48) than U-rated films
To-date, HHC advertising restrictions have again focused on tobacco more than other HHCs, and the relevance of indirect advertising has increased as constraints on direct advertising have tightened
Summary
Alcohol and fast-food have been collectively described as health harmful commodities (HHCs) [1]. Key reports have highlighted the link between tobacco film imagery and youth tobacco use initiation [11, 12]. Whilst this association is relatively well-evidenced [3,4,5,6, 13] the high plausibility of a more generalisable principle and consistent evidence suggests such relationships hold for HHCs more generally [9, 10, 14, 15]. Concern that direct advertising restrictions were stimulating indirect advertising led to a 2008 World Health Organization (WHO) clarification that product placement falls within the definition of advertising and promotion that the widely-adopted WHO Framework Convention on Tobacco Control (FCTC) recommends for constraint [16]. We aimed to describe the extent of and trends in tobacco, alcohol and fast-food imagery in Bollywood films, between 1994–2013
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