This table estimates the number of children alive in 2012 who were recruited to smoke by movies with smoking, how many will eventually die from tobacco-induced diseases, and the associated medical costs that will be incurred, both public and private.
Taxpayer dollars from major US subsidy states and countries to promote tobacco use.
STATE BY STATE | How many new young smokers do films recruit? At what cost?
|Costs through age 50
Evidence behind these results | “The evidence is sufficient to conclude that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among young people.” — US Surgeon General, 2012.
Longitudinal studies | In 2003, in a landmark longitudinal study, Dartmouth University researchers followed more than 2,600 adolescents for up to two years. After controlling for all the other factors bearing on smoking initiation, they found that the more smoking in movies kids saw, the more likely they were to smoke: a dose-response effect. The kids who saw the most smoking in movies were nearly three times more likely to have started smoking than kids who saw the least. Since then, studies from a dozen countries have confirmed the dose-response effect.
Based on all US longitudinal studies through 2012, exposure to on-screen smoking accounts for 37 percent of US smokers younger than eighteen (95% CI 0.25 - 0.52). The US Surgeon General (2014) has concluded that R-rating future movies with smoking would reduce the youth smoking rate by 18 percent.
Surveys | Complementing such experiments, cross-sectional surveys have asked large numbers of children whether or not they smoke and also what movies they have seen or who are their favorite stars. After accounting for other factors known to determine smoking, such as school performance and whether their parents smoke, the surveys find that kids who have seen a lot of smoking in the movies or have favorite stars that smoke are more likely to be smokers. These snapshots offer strong evidence. But to be certain of cause-and-effect, researchers follow kids' exposure to movies and their smoking behavior over time, in longitudinal studies.
Experimental evidence | Other scientific studies consistently demonstrate that smoking in movies stimulates kids to smoke. For example, it has been demonstrated that watching a movie with smoking moves kids' attitudes in a pro-smoking direction.
Note 1 | The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Table 12.2.1 Prevalence of current smoking among adults, 18–30 years of age, and projected number of persons, 0–17 years of age, who will become smokers and die prematurely as adults because of a smoking-related illness, by state — United States, 2012 (pp. 693-695). 17 January 2014. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, Ga.
Note 2 | Attributable risk 0.37 (95% CI 0.25-0.52). Glantz SA. Updated attributable risk for smoking due to movies: 37%. Blog entry 19 August 2012. UCSF Center for Tobacco Control Research and Education.
Note 3 | Probability of smoking-attributable mortality = 0.32. Centers for Disease Control and Prevention. Projected smoking-related deaths among youth—United States. Morbidity and Mortality Weekly Report 1996;45(44): 971–4.
Note 4 | $6,810 total additional medical cost per new smoker. $10,437 additional medical cost through age 50 per new smoker (because smokers die younger). Glantz SA. Costs of a new smoker 2016. 1 October 2016. Discounted present value of future medical costs of a 24 year old smoker based on values in Tables 5.6 and 11.2 of The Price of Smoking, by Frank Sloan, et al. (Cambridge, MA, MIT Press, 2004) adjusted to August 2016 prices using the Medical CPI. See also: Sloan FA, Ostermann J, Conover C, Taylor DH, Picone G. The price of smoking. November 2004. MIT Press, Boston.