title: High youth access to movies that contain smoking in Europe compared with the USA.
abstract: BACKGROUND
  Based on evidence that exposure to smoking in movies is associated with adolescent smoking, the WHO has called on countries to assign a rating that restricts youth access to such movies.
  
  
  OBJECTIVE
  To evaluate youth access to movies that portray smoking in European countries and compare with that in the USA.
  
  
  METHODS
  The authors identified the most commercially successful movies screened in six European countries (Germany, Iceland, Italy, the Netherlands, Poland and UK) and the USA between 2004 and 2009. The authors coded the 464 movies that were screened in both Europe and the USA according to whether or not they portrayed smoking.
  
  
  RESULTS
  87% of the movies were 'youth' rated in Europe (ratings board classification as suitable for those younger than 16 years) compared to only 67% in the USA (suitable for those younger than 17 years). Smoking was portrayed in 319 (69%) movies. 85% of the movies that portrayed smoking were 'youth' rated in Europe compared with only 59% in the USA (p<0.001).
  
  
  CONCLUSIONS
  Tobacco imagery is still common in popular films shown in European countries and the USA. None of the seven countries examined followed the WHO recommendations on restricting youth access to movies that portray smoking. Compared to the USA, European youths have access to substantially more movies in general, and this gives them access to more movies that portray smoking in particular.
authors.affiliation: Institute for Therapy and Health Research (IFT-Nord), Harmsstrasse 2, Kiel, Germany. hanewinkel@ift-nord.de
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
authors.forename: James D
authors.initials: JD
authors.lastname: Sargent
authors.forename: Sólveig
authors.initials: S
authors.lastname: Karlsdóttir
authors.forename: Stefán Hrafn
authors.initials: SH
authors.lastname: Jónsson
authors.forename: Federica
authors.initials: F
authors.lastname: Mathis
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Faggiano
authors.forename: Evelien A P
authors.initials: EA
authors.lastname: Poelen
authors.forename: Ron
authors.initials: R
authors.lastname: Scholte
authors.forename: Ewa
authors.initials: E
authors.lastname: Florek
authors.forename: Helen
authors.initials: H
authors.lastname: Sweeting
authors.forename: Kate
authors.initials: K
authors.lastname: Hunt
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D005060:Europe; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D007100:Imitative Behavior; D009040:Motion Pictures; D012907:Smoking; D014481:United States; D014944:World Health Organization