Key reports

These scientific consensus reports have built global support for policies that will permanently and substantially reduce adolescent exposure to on-screen tobacco imagery:

Truth Initiative. Nicotine on demand. Truth Initiative. 8 March 2023. Washington, DC

This 2022 report analyzed tobacco imagery across the 15 most popular streaming shows among 15- to 24-year-olds, 2021 top movies and top 2021 Billboard songs' music videos and found that there was pervasive smoking and vaping imagery on young peoples' screens. The report urges immediate action from content creators, policymakers, educators and researchers to address the normalization and glamorization of smoking and vaping driven by pervasive tobacco imagery on screens. 

US Surgeon General. The health consequences of smoking — 50 years of progress: A report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 17 January 2014. Atlanta, GA

This 2014 report includes an extensive discussion of on-screen smoking’s effects on young people. It also discusses how to eliminate tobacco imagery in the movies young people see most.

The Surgeon General reports that an updated R-rating that reduced adolescents’ in-theater exposure from an annual mean of 275 tobacco images to 10 or less would reduce adolescent smoking rates by 18%. The Surgeon General also reports that, given current conditions, 5.6 million of all US children alive today can be expected to die from tobacco-induced diseases.

Combining these two facts leads to the conclusion that R-rating movies with smoking would avert one million tobacco deaths among today’s children and adolescents.

US Surgeon General. Preventing tobacco use among youth and young adults: A report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 8 March 2012. Atlanta, GA

This 2012 report recaps the long history of tobacco industry influence on the U.S. film industry. The report states:

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.

Its review of population-based studies finds that high exposure to movie smoking doubles the risk of smoking among adolescents and that exposure to on-screen smoking accounts for a substantial proportion of US adolescent smokers. The Surgeon General observes that the research evidence supports:

...expanding the R rating to include movies with smoking in order to further reduce exposures of young persons to onscreen tobacco incidents, making smoking initiation less likely.

World Health Organization. Smoke-free movies: from evidence to action. World Health Organization. 1 February 2016. Geneva, Switzerland

WHO considers the global influence of films with smoking, recommends policy solutions, and examines countries’ obligations under Article 13 of the global Framework Convention on Tobacco Control (FCTC). WHO supports adult film classification and other evidence-based policies. It concludes that public subsidies such as tax credits for media productions with tobacco imagery are 'counter' to the FCTC.

US National Cancer Institute. The role of media in promoting and reducing tobacco use. US Department of Health and Human Services, National Institutes of Health. 21 August 2008. Bethesda, MD

After reviewing studies of the effects of on-screen smoking, the US National Cancer Institute concludes that exposure to on-screen smoking is not merely associated with teen smoking: it actually causes kids to start smoking. Chapter 10, on the role of entertainment media, includes in-depth coverage of films with smoking, their role in youth smoking, and the remedies.