Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 135-143 (doi:10.1542/peds.2007-3420)
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ARTICLE

Movie Character Smoking and Adolescent Smoking: Who Matters More, Good Guys or Bad Guys?

Susanne E. Tanski, MDa,b, Mike Stoolmiller, PhDc, Sonya Dal Cin, PhDd, Keilah Worth, PhDb, Jennifer Gibson, MSb and James D. Sargent, MDa,b

a Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire
b Cancer Risk Behaviors Group, Norris Cotton Cancer Center, Lebanon, New Hampshire
c Oregon Social Learning Center, University of Oregon, Eugene, Oregon
d Department of Communication, University of Michigan, Ann Arbor, Michigan

OBJECTIVE: To assess the association between smoking onset and exposure to movie smoking according to character type.

METHODS: A longitudinal, random-digit-dial telephone survey of 6522 US adolescents was performed with movie exposure assessed at 4 time points over 24 months. Adolescents were asked whether they had seen a random subsample of recently released movies, for which we identified smoking by major characters and type of portrayal (divided into negative, positive, and mixed/neutral categories). Multivariate hazard regression analysis was used to assess the independent effects of these exposures on the odds of trying smoking.

RESULTS: By the 24-month follow-up survey, 15.9% of baseline never-smokers had tried smoking. Within the sample of movies, 3848 major characters were identified, of whom 69% were male. Smokers represented 22.8% of 518 negative characters, 13.7% of 2486 positive characters, and 21.1% of 844 mixed/neutral characters. Analysis of the crude relationship showed that episodes of negative character smoking exposure had the strongest influence on smoking initiation. However, because most characters were portrayed as positive, exposure to this category was greatest. When the full population effect of each exposure was modeled, each type of character smoking independently affected smoking onset. There was an interaction between negative character smoking and sensation-seeking with stronger response for adolescents lower in sensation-seeking.

CONCLUSIONS: Character smoking predicts adolescent smoking initiation regardless of character type, which demonstrates the importance of limiting exposure to all movie smoking. Negative character portrayals of smoking have stronger impact on low risk-taking adolescents, undercutting the argument that greater exposure is a marker for adolescent risk-taking behavior.

Key Words: adolescent smoking • media

Abbreviations: MPAA—Motion Picture Association of America

Accepted Nov 6, 2008.


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