Smoke scenes on the big screen. (Focus)(Cover Story) Cathy Gourley.

It looks really cool if a Brad Pitt is smoking in a movie," says New Jersey teenager Erin Cullen. But Cullen is not applauding actors who smoke in the movies.

Erin is a member of a New Jersey youth group called REBEL (Reaching Everyone By Exposing Lies). One thing Erin wants to expose is that stars who smoke in movies are actually advertising tobacco products.

"What the movie doesn't show is the effects of smoking," says Erin, "how your lungs can be permanently damaged, how you might need oxygen, how you can end up dying. There's nothing pretty about that."

Get real! A movie is entertainment, not a health report ... right?

And yet ... smoking in the movies appears to have negative health effects. Recent studies by the Dartmouth Medical School found a link between smoke scenes on the big screen and youth who smoke. "We found that half the kids who started smoking did so because of seeing it in the movies," says Madeline Dalton, one of the authors of the Dartmouth study.

Star Appeal

The Dartmouth study surveyed 145 movies. Of the 77 movies that were rated PG-13, 82 percent featured tobacco use. In fact, PG-13 movies portrayed tobacco use more frequently than the adult, R-rated movies. Adding to the problem is the fact that adolescents may watch their favorite movies as many as 10 or more times.

"The tobacco industry has known for years that celebrities and movies can persuade kids to start smoking," Dalton continues. "The images of cinema are more powerful than any advertising or marketing campaigns."

The Dartmouth report is just one of numerous studies conducted in recent years linking tobacco's role in the movies with the number of adolescents who start smoking. One reason is star appeal. If a handsome, popular actor lights up, adolescents who admire the star are likely to imitate the behavior.

"It's unfortunate the smoking is usually done by actors who appeal to young people and is too often shown in a positive light," says Ron Todd, director of tobacco control for the American Cancer Society.

Some actors may argue that smoking helps them to portray their characters more accurately.

Todd disagrees. "Good actors and directors don't need cheap props like tobacco to establish a character."

Cause-and-Effect Relationships

Excessive smoking scenes have another effect: They suggest that smoking is a common activity.

Just what is excessive? According to a recent article in the British Medical Journal, a typical movie-going adolescent will see 800 smoke scenes each year.

In fact, the number of smokers has been steadily declining in the last three decades. The decline is due largely to the general public's understanding of the cause-and-effect relationship between nicotine and addiction, and between smoking and numerous diseases, including lung cancer.

This declining number of smokers, however, is the very reason why smoke scenes on the big screen increased in the 1990s and continue today, say media literacy experts.

In 1980, a major tobacco company hired a top public relations firm to "develop a strong relationship with the television and motion picture industry, and keep the presence of smoking" in the public eye. Placement of products, however, was only part of the agreement. The movie or TV scene had to portray tobacco use in a positive way.

In the 1980s, tobacco companies paid filmmakers, including popular actors, to use their products or have their products "placed" in a scene. Philip Morris, for example, spent $350,000 for a brand of their cigarettes to appear in the popular James Bond movie License to Kill. The following Philip Morris company memorandum, dated 1989, plainly states the important future role of tobacco products in the movies:

We believe that most of the strong, positive images for cigarettes and smoking are created by cinema and television. We have seen the heroes smoking in Wall Street, Crocodile Dundee, and Roger Rabbit ... If branded cigarette advertising is to take full advantage of these images, it has to do more than simply achieve package recognition--it has to feed off and exploit the image source.

When referring to images directed at the youth market, it's phrases like "feed off" that anger Erin Cullen and hundreds of other anti-smoking teen activists in the country.

Taking Action

Current movies are the "smokiest" they have been in years, says Stanton A. Glantz, Ph.D. A professor of medicine at the University of California, San Francisco, Glantz suggests two possibilities for this increase:

People in Hollywood are still getting paid to continue to promote tobacco. If this is the case, then the tobacco industry, says Glantz, "is corrupt." They have violated their MSA pledge not to promote to youth. (See "The Master Settlement Agreement" on page 11 for explanation of the pledge.)

People are doing it for free. If this is the case, then the filmmakers, says Glantz, "are stupid."

"It is time for the entertainment industry to accept responsibility for its actions and stop serving the interests of tobacco companies," wrote Glantz.

The film industry could, for example, state on movie credits that the filmmakers received no payment from tobacco industries for using or displaying their products. Another tactic might be making a strong anti-tobacco statement, either in the opening or closing credits, similar to those that assure audiences that "no animals were killed or hurt" during filming.

James D. Sargent, M.D., of the Darmouth Medical School, has this suggestion: The Motion Picture Association of American (MPAA) should revise its rating system to take into account smoke scenes. At present, strong language or scenes of violence often earn a movie an R, or restricted, rating. Because of the health risks associated with smoking, Dr. Sargent believes excessive smoking should also contribute to the R rating.

'Not for Sale'

Is industry regulation necessary? And would regulation achieve the hoped-for result of stopping underage smoking? Other alternatives may be more effective.

Imagine this: You are walking down a city street when you notice a crowd near the subway entrance. A young woman covers her mouth and turns away, obviously upset. You push forward. Lying near the curb is a human-sized rat. As the rat struggles to breathe, it holds a sign: There's cyanide in cigarette smoke. Same as in rat poison.

Is this a scene from a science-fiction movie?

Actually, the event took place a few years ago in Times Square in New York City. The crowd and the crowd's reactions were real. The rat creature was not. The young man who crawled inside the furry rat suit was making an anti-tobacco commercial.

The "Ratman" video was first broadcast on television in 2001 during the MTV video music awards, and again during the Super Bowl in 2002. Produced by a public health organization called the American Legacy Foundation (ALF), "Ratman" continues to play over the Internet on the foundation's interactive Web site, www.thetruth.com.

Tobacco manufacturers have long relied on advertisements to sell their products. Only recently, however, have public health groups begun an aggressive anti-smoking advertising campaign. In the years since "Ratman" was first broadcast, the ALF has spent millions of advertising dollars on similar videos and other anti-tobacco activities.

"You remember the TRUTH ads," says Richie, 15. "It's not a 'don't smoke' message. It's more powerful."

The American Legacy Foundation and TRUTH are not the only public education programs producing antismoking messages. In New Jersey, REBEL sponsors anti-smoking messages on billboards, bus signs, and book covers. They publish a Web site (www.njrebel.com) and hold Youth Summits focusing on tobacco awareness. REBEL's motto declares that New Jersey's youth are "Not For Sale."

In Florida, youth activists call themselves SWAT (Students Working Against Tobacco). Greg Hall, 17, joined SWAT when he was a sophomore at Cocoa High. He said he was "outraged" when he learned how tobacco advertising manipulated and profited from teen smokers. In 1997, for example, the five largest tobacco companies earned approximately $480 million in profits from cigarettes sales to smokers under the age of 18.

"We are sick and tired of being lied to," says Steve Disher, also a member of SWAT. As a high school senior he served on the SWAT summit planning committee. "SWAT gives us the unfiltered facts about what Big Tobacco has been up to, and more importantly, gives us ways to fight back."

Anti-tobacco messages like "Ratman," the REBEL billboards, and the SWAT team summits are effective. According to the Youth Tobacco Survey, smoking among high school students in Florida alone dropped by 50 percent. In the two years since Wisconsin initiated its anti-tobacco media campaign, smoking among middle school students in that state dropped by 46 percent in 2003.

Prism Awards

Not everyone in Hollywood smokes or supports smoke scenes. The Entertainment Industry Council (EIC) is one group working to increase public awareness and understanding of major health and social issues among the entertainment industries. Each year, EIC honors artists who accurately depict drug, alcohol, and tobacco use in film, television, video, and music with its Prism awards.

Recent Prism honorees were the artists who made the Academy Award-nominated film The Insider. The movie tells the true story of Dr. Jeffrey Wigland, who was the head of research and development for a major tobacco company. Dr. Wigland chose the dangerous course of telling the truth about tobacco products and promotion efforts.

Accurate depiction of tobacco use does not mean turning a movie into a health video. As The Insider proved, the truth can be dramatic and empowering. It can also influence audiences, especially young audiences, to think twice before lighting up.

formoreoreinfo www.americanlegacy.org www.smokefreemovies.ucsf.edu www.scenesmoking.org

OBJECTIVE

Students will be able to analyze the appearance and influence of smoking in contemporary films and television.

REVIEW/DISCUSS

* Most movies present a one-sided view of smoking. Explain. (Seeing idolized celebrities smoke on screen may influence impressionable teens to try it for themselves. Excessive smoking scenes in movies and on television also suggest to teens a false norm concerning the number of people who smoke, suggesting that "everybody's doing it," when in fact, the number of people who smoke has been steadily declining. The movies seldom show the negative health consequences of smoking.)

* Summarize some of the strategies that the film industry could adopt to try to combat the effects of scenes of tobacco use on screen. (Actors, directors, and producers could avoid--or at least reduce--the use of smoking scenes on film and on television. Filmmakers could use disclaimers similar to those used regarding the safeguarding of animals, at the beginning and/or in the credits of movies and TV shows, stating that they received no payment from tobacco industries for displaying their products. The film rating system managed by the Motion Picture Association of America could be modified to take into account, in setting "R" ratings, the health risks associated with smoking.)

* Three Web sites referred to in the article offer different advocacy approaches to the issue of smoking in the entertainment media. They are: Scene Smoking, a project of the American Lung Association, at www.scenesmoking.org; The American Legacy Foundation at www.thetruth.com; and a New Jersey youth organization called REBEL at www.njrebel.com. Compare and contrast the approaches used by these three organizations. (Answers will vary, but should reflect that Scene Smoking is an evaluation and advocacy skills-based site; the American Legacy Foundation is educational but primarily imbeds its anti-tobacco information in parody advertisements for public consumption; and REBEL is a statewide effort to engage youth in a campaign with a similar anti-tobacco message theme.)

ACTIVITIES

1.Brainstorm with your class ideas for working with younger students on anti-tobacco programs (e.g., take surveys on attitudes, prepare factual materials on tobacco, etc.). You might research the teen extension of SWAT, mentioned in the article (visit www.getswat.com and click on About Us), and see www.njrebel.com.

2. Assign students to write a letter to an actor, actress, or producer who has obviously promoted smoking in a film or television show. They should use their persuasive skills to try to convince the person to stop promoting tobacco use.

TEACHER RESOURCES

The Internet has many good sources of information on the topic of product placement. A simple search using the terms "Product Placement" and "Smoking" will yield helpful information. One resource that offers images and many useful links is a University of South Carolina School of Medicine site at www.med.sc.edu:1081/prodplacement.htm.

A Tobacco Advertising Timeline

1964: Luther L. Terry, M.D., Surgeon General of the United States Public Health Service, releases "Smoking and Health." The report concluded: "Cigarette smoking is a health hazard of sufficient importance in the United States...."

1968: Philip Morris launches new cigarette "for women only." Virginia Slims campaign includes advertisements in all women's magazines and on prime-time family television programs. The advertising agency predicts the broadcast campaign alone will reach 96 percent of all women in America.

1969: The Public Health Cigarette Smoking Act of 1969 bans cigarette advertising on television and radio and requires this labeling on all cigarette packages: "Warning The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health."

1980: Philip Morris pays $42,300 for Lois Lane to light up a Marlboro in Superman II. In the original comic book series, neither Lois nor Clark Kent--a.k.a. Superman--smoked.

1987: Joe Camel cartoon advertising campaign launches, celebrating "Old Joe's" 75th anniversary.

1988: In a lawsuit against the tobacco industry in the United States, investigators uncover a confidential document prepared by the Philip Morris Research Center that contains the phrase, "Think of the cigarette as a dispenser for a dose of nicotine." At another lawsuit trial, a confidential document from a tobacco company refers to young teenagers as "replacement smoker."

1991 : Joe Camel merchandise earns RJ Reynolds $40 million.

1991: The Journal of the American Medical Association published two reports on Joe Camel and kids. One study finds that 91 percent of 6-year-aids recognize Joe Camel, similar to the percent who recognize Mickey Mouse. The second finds that since the inception of the Joe Camel campaign in 1987, Camel's share of the under-18 market has risen from 0.5 percent to 32.8 percent.

1998; Four of the five major cigarette manufacturers sign the Master Settlement Agreement with 46 states, agreeing to pay $250 billion to the states over 25 years.

1999: Tobacco manufacturer Philip Morris acknowledges that tobacco smoking causes lung cancer, emphysema, and heart disease, and that tobacco smoking is addictive.

2002: NBA drops Lorillard as a sponsor of its youth Hoop-It-Up tournament. Lorillard was promoting its Tobacco is Whacko if You're a Teen program.

Smoky, Smokier, Smokiest

When tobacco use in the movies and on television is portrayed as fun, exciting, sexy, rebellious, or connected to wealth and power, it reinforces common advertising themes of the tobacco industry," says the American Association. One of its California-based programs Thumbs Up! Thumbs Down! monitors smoking in movies.

Here is how Thumbs Up! Thumbs Down! works. Teams of adults and youth volunteers screen movies and rate them as smoky, smokier, and smokiest They base their ratings on four essential questions:

1. How is smoking depicted--in a positive are negative way? Positive depictions are those that associate smoking with glamour, power, and wealth.

2. How often do the smoking images appear? Frequent images by multiple characters suggest tobacco use is acceptable, even desirable.

3. Who uses the tobacco product? If a popular film star or the hero or heroine of the movie smokes, the effect on the adolescent audience may be greater than if a less popular or less heroic character lit up.

4. Where is tobacco used? If shown on screen in restaurants, that's misleading. Many public spaces, including restaurants, now restrict smoking because of the health dangers from secondhand smoke.

Based on these four criteria, the smoke-free movies receive a pink--or healthy--lung rating. The smokier movies receive either a light gray or dark gray lung. The smokiest movies, including last summer's Scary Movie 3 and last fall's School of Rock, receive a black--or diseased--lung rating. The ratings are available on the American Lung Association Web site devoted to smoking in the movies, www.scenesmoking.org.

RELATED ARTICLE: The Master Settlement Agreement.

In November 1998 America's largest tobacco companies and 46 states signed a Master Settlement Agreement (MSA). The agreement ended a four-year legal battle over the Promotion of tobacco use to youth.

The MSA permanently changed how tobacco manufacturers could market their products. For example, tobacco companies can no longer.

* use cartoon characters to promote or label cigarettes

* promote cigarette brands on clothing such as caps and T-shirts.

* offer gifts to youth in exchange for the purchase of tobacco products, coupons, or proofs of purchase

* advertise tobacco products on billboards, stadium signs, and transit (bus and rail) venues.

In addition, tobacco industry leaders claim they have also ended the practice of Promoting their products in the movies. But have they?

Screening some of last summer's big screen hits among preteen and teen audiences suggests a different story. School of Rock, rated PG-13, portrays tobacco use, as did these PG and PG-13 rated films popular with youth audiences: Bruce Almighty, Charlie's Angels--Full Throttle, Anger Management, Holes, Men in Black 2, and Mr. Deeds, to name a few.