TUESDAY, July 6, 2004 (HealthDayNews) -- Teens whose parents let them see R-rated films are more likely to start smoking, new research suggests.
While other factors could conceivably account for the link between the movies and tobacco use, researchers said they were fairly certain that depictions of on-screen smoking spell bad news for the health of teens.
The only cure? Alert parents, the study authors noted.
"Parents aren't taking the ratings system seriously," said study co-author Dr. James Sargent, a pediatrics professor at Dartmouth Medical School.
To make matters worse, "with the VCR and DVD revolution, these movies that were once shown only in theaters are available in everybody's living room. It's much harder to keep a lid on that exposure," he said.
Despite an ongoing decline in smoking in the United States, many movie stars continue to light up on screen. The American Lung Association reviewed 498 movies from 1994 to 2003 and found that nearly three-quarters featured tobacco use, even The Lord of the Rings: The Return of the King, which boasts a pipe-smoking wizard, Gandalf.
Previous research by Sargent and colleagues found that R-rated movies feature twice as many instances of smoking as other movies.
In the new study, the Dartmouth researchers surveyed 2,596 middle-school students in 1999 from 15 schools in New Hampshire and Vermont. One to two years later, the researchers contacted those who initially said they had never smoked.
Nineteen percent of the teens said their parents never let them watch R-rated movies; 2.9 percent of them started smoking during the follow-up period.
But nearly five times that number -- 14.3 percent -- of the kids who got to see R-rated movies had begun smoking. And of those who were allowed to see R-rated movies only occasionally, 7 percent had taken up the habit.
Using a statistical analysis, the researchers said those teens whose parents were lenient about letting them see R-rated movies were nearly three times as likely to start smoking as those with the strictest parents.
"They're seeing people that they hold in high regard depicting the [smoking] behavior," Sargent said. "Those movie actors serve as role models for the adolescents. When the stars do things, kids are going to emulate them."
Other factors -- including older age, poor grades, and lower parental education levels -- increased the likelihood that the teens would try smoking, the researchers said.
But they also found adolescents who weren't exposed to family smoking in the first place were 10 times more likely to start if they got to see R-rated movies frequently.
The study findings appear in the July issue of the journal Pediatrics.
Previous studies also have linked smoking in movies to smoking among teens. The difference is that this new study followed students over a long period to see how they changed, said Stanton A. Glantz, director of the Center for Tobacco Control Research at the University of California, San Francisco.
"This is about as strong as it gets in this kind of research," Glantz said. "It's much stronger than just taking a snapshot in time. What it shows is that smoking in movies actually affects behavior in kids."
Glantz and others are pushing the Motion Picture Association of America to automatically give R-ratings to movies that feature scenes of tobacco use.
In a related study, researchers reported Monday that teens and young adults were exposed to more alcohol advertising in magazines than adults. Surprisingly, girls saw more alcohol ads than boys, according to the study in the July issue of the Archives of Pediatrics & Adolescent Medicine.
The study, by researchers at Georgetown University and elsewhere, examined people aged 12 to 20 in 2001 and 2002, and compared them to groups of men and women who could legally drink.
The younger people saw 45 percent more advertising for beer and 65 percent more advertising for so-called "low-alcohol refreshers," like sweet-flavored liquor drinks and spiked lemonade, the study found.
Get a list of movies without tobaccco use from Smoke Free Movies.