title: Are movies with tobacco, alcohol, drugs, sex, and violence rated for youth? A comparison of rating systems in Argentina, Brazil, Mexico, and the United States.
abstract: BACKGROUND
  This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States.
  
  
  METHODS
  Content and ratings were analyzed for 362 films that were popular across all four countries from 2002 to 2009. Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films. Within-country differences in this content over time were also assessed, comparing films released from 2002 to 2005 with those released from 2006 to 2009.
  
  
  RESULTS
  In the US, films rated for youth were less likely to contain all five risk behaviors than in youth-rated films in Argentina, Brazil, and, when the "15 and older" rating was considered a youth rating, in Mexico. All three Latin American countries "downrated" films that received an adult rating in the US. Nevertheless, tobacco and drug use in youth-rated films declined over time in all countries, whereas moderate to extreme alcohol use and violence involving children or youth increased in all countries.
  
  
  CONCLUSIONS
  Tobacco and drug use have declined in popular US films, but these behaviors are still prevalent in films rated for youth across the Americas. The apparent success of advocacy efforts to reduce tobacco and other drugs in films suggests that similar efforts be directed to reduce alcohol portrayals.
authors: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, SC, USA; Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico. Electronic address: thrasher@sc.edu.
authors: James F
authors: JF
authors: Thrasher
authors: Norris Cotton Cancer Center, Geiser School of Medicine at Dartmouth, NH, USA.
authors: James D
authors: JD
authors: Sargent
authors: Instituto Nacional de Cancer, Rio de Janeiro, Brazil.
authors: Rosa
authors: R
authors: Vargas
authors: Programa de Medicina Interna General, Hospital de Clinicas, University of Buenos Aires, Buenos Aires, Argentina.
authors: Sandra
authors: S
authors: Braun
authors: Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico; Department of Epidemiology, University of Michigan, MI, USA.
authors: Tonatiuh
authors: T
authors: Barrientos-Gutierrez
authors: Department of Criminology and Criminal Justice, University of South Carolina, SC, USA.
authors: Eric L
authors: EL
authors: Sevigny
authors: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, SC, USA.
authors: Deborah L
authors: DL
authors: Billings
authors: Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
authors: Edna
authors: E
authors: Arillo-Santillán
authors: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, SC, USA.
authors: Ashley
authors: A
authors: Navarro
authors: Department of Epidemiology & Biostatistics, University of South Carolina, SC, USA.
authors: James
authors: J
authors: Hardin
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D001118:Argentina; D001938:Brazil; D002648:Child; D006801:Humans; D013287:Illicit Drugs; D008800:Mexico; D009040:Motion Pictures / Q000592:standards* / Q000639:trends; D012309:Risk-Taking; D012725:Sexual Behavior; D014026:Nicotiana; D014481:United States; D014754:Violence
chemical_list: D013287:Illicit Drugs
keywords: Cinema; Movie rating systems; Policy; Risk behaviors; Youth