Equally important, researchers have observed a dose-response relationship between teens’ exposure to on-screen smoking and smoking initiation: the greater teens’ exposure to smoking in movies, the more likely they are to start smoking. Conversely, if their exposure to smoking in movies were reduced, proportionately fewer teens would likely start smoking.

To track smoking trends at the movies, previous analyses have studied the U.S. motion picture industry’s top-grossing films with the heaviest advertising support, deepest audience penetration, and highest box office earnings.4,5 This report is the first to examine the U.S. movie industry’s total output. It is also the first to identify smoking movies, tobacco incidents and tobacco impressions with the companies that produced and/or distributed the films — and with their parent corporations, which claim responsibility for tobacco content choices.† Examining Hollywood’s product line-up, before and after the public voted at the box office, sheds light on individual studios’ content decisions and industry-wide production patterns amenable to policy reform.

We surveyed all U.S.-produced live action films released to theaters in the five years between December 25, 1998, and December 24, 2003, and offer three different measures of smoking in movies:

1. INTENTION: Number of films that include smoking (and those smokefree) by year, Motion Picture Association of America (MPAA) age-classification, and corporation responsible;

2. PERFORMANCE: Number of smoking incidents in these films (an index of smoking intensity) by year, MPAA age-classification, and corporation responsible;

3. IMPACT: Number of smoking impressions (each film’s smoking incidents x tickets sold) delivered to theatrical audiences overall, to children aged 6-11 and to teens aged 12-17, by year, MPAA age-classification, and corporation responsible.

Because exposure to smoking in movies accounts for more than half of smoking initiation by U.S. adolescents, we pay particular attention to smoking in movies rated G/PG and PG-13 and to the effect of the proposed R-rating for tobacco use on screen.

KEY FINDINGS

Analysis of 776 U.S. movies released in the five years 1999-2003 established that:

• 80% of all films across the board included smoking — almost 90% of R-rated films, 80% of PG-13 movies and 50% of G/PG movies.

• Three media conglomerates — Time Warner, Disney and Sony — accounted for more than half of all movies with smoking and 55% of all tobacco impressions delivered to children and teens.

• The number of a studio’s releases ultimately determined its ranking in most tobacco dimensions. Companies with fewer releases tended to concentrate more of their tobacco incidents in films rated PG-13 but tobacco content patterns were otherwise remarkably uniform across major motion picture companies.

• Confirming past analyses, individual R-rated movies with smoking averaged twice as many tobacco incidents as youth-rated movies with smoking.

• The number of PG-13 releases with smoking has remained stable over five years. A five-year decline in R-rated releases and sharply lower ticket sales in 2003 has shifted the majority of tobacco incidents and impressions into movies rated G, PG and PG-13.

• The U.S. movie industry delivered an estimated 32.6 billion first-run theatrical tobacco impressions to audiences of all ages over the past five years. A quarter of these impressions — 8.3 billion evenly divided between youth-rated and R-rated movies — were delivered to children and teens. Time Warner alone delivered a quarter of child and teen tobacco impressions.

• More first-run tobacco impressions are delivered to teen moviegoers 12-17 than to children 6-11 or young adults 18-34 — 1,350 larger-than-life impressions per capita between 1999 and 2003. This estimate does not include the tobacco impressions delivered by a movie with smoking’s theatrical and on-air advertising trailers or from multiple viewings of the movie on pre-recorded video media and on cable, on-demand and broadcast television.

• By all measures, over the past five years rating on-screen smoking “R” would reduce children’s and teens’ first-run theatrical exposure to tobacco impressions, strongly associated with teens’ smoking initiation, by at least 50%.