6 lessons learned: How to tell the smoking movie story

1) Media coverage continues to be impressive. But over the years, it has been ten times easier to get coverage from major newspapers and magazines than from the major media companies' broadcast networks or affiliate stations. (See SFM News archive)

Local ABC (Disney) and NBC (Comcast) affiliates have occasionally covered smoking in movies. The CBS network (a Viacom spin-off) has been attentive. Fox and its affiliates have not. PBS, NPR and their affiliates have provided consistent coverage.

It's important to note that no SFM partner or state program has ever gotten pushback when pitching this story; it hasn't affected TV coverage of other health or tobacco topics. Some media outlets may be a bit cautious when it comes to an issue touching their corporate parent. 

2) Polls show  more support for “making kid-rated movies smokefree” than “R-rating movies with smoking.” 

These adults want kid-rated movies to be smokefree but consider the R-rating too porous a barrier to keep kids from seeing movies with smoking. In reality, the R-rating for smoking is aimed at producers and studios, not kids. 

If the R-rating's impact is explained ("The R-rating will convince producers and studios to keep smoking out of the movies that kids see most”), then support for the R-rating rises to match support for "making kid-rated movies smokefree." This is a technical nuance, but useful to keep in mind.

3) Kids and adults are most quickly convinced if you mention the “long, documented history of Hollywood and Big Tobacco working together to sell smoking and tobacco brands.” 

The historical evidence of decades of tobacco industry payoffs and product placement (as recently as 2013, in France) provides essential context. “Money talks” is intuitive. The strong scientific evidence of harm to kids then locks in that understanding.

We're careful to cite the historical evidence every time we talk about smoking in movies. The Surgeon General surveyed the history of tobacco deals in Hollywood in 2012 [Chapter 5, pages 565-566].

Absent the “money talks” context, reporters may lead a story with a “smoking used to be glamorous” angle, which normalizes smoking on screen and mistakenly frames it as an artistic choice. In reality, tobacco has bought its way on screen for most of Hollywood's history. UCSF has prepared a graphic timeline of tobacco-film collusion with supporting citations.

4) Online, a few chronic commenters ridicule efforts to reduce smoking on screen, each using an identical talking point: “Smoking is trivial compared to movie violence.”  

Fact: Among all movie content, only on-screen smoking has been conclusively proven to cause widespread physical harm to young audiences. While parents may be legitimately concerned about kids’ exposure to violence or strong language, so far only on-screen smoking is an urgent, evidence-based, dose-related public health problem.

Without directly comparing smoking to other public health challenges, it’s always useful to remind people that smoking is the leading cause of preventable death, taking nearly half a million U.S. lives each year.

Tragically, the rating system that’s supposed to give parents adequate notice fails in the case of tobacco imagery. “Tobacco” and “smoking” are never mentioned in the Motion Picture Association of America's official film rating guidelines. The small-print “smoking" descriptors that the MPAA announced in 2007 are left off of 85 percent of all kid-rated movies with smoking.

What value to parents is a rating system that actually plays down movies' biggest, real-world risk to kids? We urge partners to briefly comment on any online story about smoking in movies, to balance the conversation. 

5) PG-13 movies are the battleground. G/PG movies are an insubstantial factor (2%) in domestic audience exposure. When looking at movie-smoking statistics, focus on PG-13 movies. That’s where the R-rating will make the big difference.

• One in four (26%) of all kid-rated (G/PG/PG-13) movies featured smoking in 2016. But more than one in three (35%) of PG-13 movies did. 

• From 2010 through 2016, PG-13 films delivered nearly half (46%) of total audience exposure to tobacco imagery. 

• PG-13 films with any smoking average 42 percent fewer tobacco incidents than do R-rated films with smoking (44 vs. 31 incidents, 2010-2016). Yet the average PG-13 film attracts a 44 percent larger theater audience (10.7 million per film vs. 6.0 million).

• As a result, the typical PG-13 film with smoking delivers 14 percent more audience tobacco exposure than the typical R-rated film (308 million vs. 264 million tobacco impressions).

6) Simple arithmetic employed by the CDC shows that the R-rating will prevent one million tobacco deaths in this generation of American kids. We’ve summed this up in a simple tagline: “One little letter 'R' will save one million lives."

To make the number more concrete, we can adapt CDC statistics about what diseases account for the most primary tobacco deaths. The R-rating will prevent: 385,000 cancer deaths, 375,000 heart and stroke deaths and 265,000 deaths from respiratory diseases.

These specific numbers may be useful to voluntary organizations focusing on one or more health risks. And the disease fractions (0.374 cancer, 0.366 cardiovascular, 0.259 respiratory) can also be applied to your state’s death projections from on-screen smoking to estimate how many cancer deaths will be averted in New York, Nebraska or New Mexico.

Finally, never forget to name the major media companies accountable for exposing kids to toxic tobaco imagery, just as the CDC did in its July 2017 report. Smokefree Movies keeps a current tally of smoking in movies, by company and MPAA rating:

Now Showing displays the week’s top films and DVDs

Who’s Accountable tracks data by company, in charts

Screen Captures includes images from select films.

Download this blog article here. And tell us: What experiences have you had telling this public health story? How else can we help?