title: The incidence and context of tobacco use in popular movies from 1988 to 1997.
abstract: OBJECTIVE
  The aim of this study was to describe tobacco use in a large representative sample of movies.
  
  
  METHODS
  We analyzed the content of the top 25 box office hits per year from 1988 to 1997. Outcomes included the number of occurrences of tobacco use, the time tobacco use appeared on screen, the context in which tobacco use was portrayed, and characteristics of smokers compared with nonsmokers.
  
  
  RESULTS
  Eighty-seven percent of the movies portrayed tobacco use, with a median of 5 occurrences per film. Tobacco use was not related to year of release or box office success of the movie. R-rated movies had the greatest number of occurrences (median = 8.5; P < 0.05) and were most likely to feature major characters using tobacco (81%, P < 0.001). Among major characters, males were more likely to use tobacco than females (28% vs 17%, P < 0.001), but there was no difference in the prevalence of tobacco use by age, race, or socioeconomic status. Tobacco users were typically adults (96.3%) who were more likely to engage in a variety of other risk behaviors. Most tobacco use involved cigarettes or cigars (89.5%). Motivations for on-screen smoking included agitation (20.1%), sadness (5.1%), happiness (15.3%), and relaxation (17.1%). Characters were often shown smoking while confiding in others (30.7%) or in social/celebratory situations (18.0%). Negative reactions to tobacco use were rarely shown (5.9%) and negative consequences resulting from tobacco use were depicted for only 3.4% of the major characters who used tobacco.
  
  
  CONCLUSIONS
  Despite increasing anti-smoking sentiments in our society, negative reactions to smoking are rare and there is no evidence that tobacco use in movies has declined over the past decade. Movies continue to model smoking as a socially acceptable behavior and portray it as both a way to relieve tension and something to do while socializing. By depicting positive images of tobacco use, movies have the potential to influence adolescent smoking behavior as much as any other environmental exposure, such as family or friend smoking.
authors.affiliation: Department of Pediatrics and the Norris Cotton Cancer Center, Dartmouth Medical School, Lebanon, New Hampshire 03756, USA. Madeline.Dalton@Dartmouth.edu
authors.forename: Madeline A
authors.initials: MA
authors.lastname: Dalton
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Tickle
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.forename: Michael L
authors.initials: ML
authors.lastname: Beach
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Ahrens
authors.forename: Todd F
authors.initials: TF
authors.lastname: Heatherton
mesh_terms: D000704:Analysis of Variance; D006801:Humans; D015994:Incidence; D009040:Motion Pictures / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D012959:Socioeconomic Factors