title: Effect of seeing tobacco use in films on trying smoking among adolescents: cross sectional study.
abstract: OBJECTIVE
  To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents.
  
  
  METHODS
  Cross sectional survey of 4919 schoolchildren aged 9-15 years, and assessment of occurrence of smoking in 601 films.
  
  
  METHODS
  Randomly selected middle schools in Vermont and New Hampshire, USA.
  
  
  METHODS
  Number of schoolchildren who had ever tried smoking a cigarette.
  
  
  RESULTS
  The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49-152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0-50 occurrences of smoking, 13.7% for 51-100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0-50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent.
  
  
  CONCLUSIONS
  In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents.
authors.affiliation: Department of Pediatrics, Dartmouth Medical School, One Medical Center Drive, Lebanon, NJ 03756, USA. James.D.Sargent@Hitchock.org
authors.forename: J D
authors.initials: JD
authors.lastname: Sargent
authors.forename: M L
authors.initials: ML
authors.lastname: Beach
authors.forename: M A
authors.initials: MA
authors.lastname: Dalton
authors.forename: L A
authors.initials: LA
authors.lastname: Mott
authors.forename: J J
authors.initials: JJ
authors.lastname: Tickle
authors.forename: M B
authors.initials: MB
authors.lastname: Ahrens
authors.forename: T F
authors.initials: TF
authors.lastname: Heatherton
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007100:Imitative Behavior; D008297:Male; D009040:Motion Pictures; D009513:New Hampshire / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011594:Psychometrics; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D012931:Social Environment; D013690:Television; D014707:Vermont / Q000453:epidemiology