Exposure to movie smoking: its relation to smoking initiation among US adolescents.
OBJECTIVE
Regional studies have linked exposure to movie smoking with adolescent smoking. We examined this association in a representative US sample.


METHODS
We conducted a random-digit-dial survey of 6522 US adolescents aged 10 to 14 years. Using previously validated methods, we estimated exposure to movie smoking, in 532 recent box-office hits, and examined its relation with adolescents having ever tried smoking a cigarette.


RESULTS
The distributions of demographics and census region in the unweighted sample were almost identical to 2000 US Census estimates, confirming representativeness. Overall, 10% of the population had tried smoking. Quartile (Q) of movie smoking exposure was significantly associated with the prevalence of smoking initiation: 0.02 of adolescents in Q1 had tried smoking; 0.06 in Q2; 0.11 in Q3; and 0.22 in Q4. This association did not differ significantly by race/ethnicity or census region. After controlling for sociodemographics, friend/sibling/parent smoking, school performance, personality characteristics, and parenting style, the adjusted odds ratio for having tried smoking were 1.7 (95% confidence interval [CI]: 1.1, 2.7) for Q2, 1.8 (95% CI: 1.2, 2.9) for Q3, and 2.6 (95% CI: 1.7, 4.1) for Q4 compared with adolescents in Q1. The covariate-adjusted attributable fraction was 0.38 (95% CI: 0.20, 0.56), suggesting that exposure to movie smoking is the primary independent risk factor for smoking initiation in US adolescents in this age group.


CONCLUSIONS
Smoking in movies is a risk factor for smoking initiation among US adolescents. Limiting exposure of young adolescents to movie smoking could have important public health implications.
Sargent
James D
JD
Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA. james.d.sargent@dartmouth.edu
Beach
Michael L
ML
Adachi-Mejia
Anna M
AM
Gibson
Jennifer J
JJ
Titus-Ernstoff
Linda T
LT
Carusi
Charles P
CP
Swain
Susan D
SD
Heatherton
Todd F
TF
Dalton
Madeline A
MA
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D006801:Humans; D007100:Imitative Behavior; D009040:Motion Pictures; D012907:Smoking / Q000523:psychology*