Leading health groups demand film industry give R rating to movies that depict smoking

A coalition of the nation’s most influential health organizations -- responding to a July 7 report by the U.S. Centers for Disease Control and Prevention -- have demanded that movie producers, distributors and exhibitors apply an R rating to all films that include depictions of smoking or tobacco.

Seventeen public health and medical groups signed a letter to film industry leaders in response to the CDC report, which showed that progress in reducing tobacco imagery in PG-13 movies stalled after 2010. The letter demands that the film industry meet a June 1, 2018, deadline to end its practice of using tobacco depictions in youth-rated movies that research has shown has a direct impact on children who go on to smoke.

The letter was signed by the largest-ever coalition of health leaders to unite behind this critical issue, including medical organizations that represent more than 630,000 doctors – the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, and the American Medical Association.

Signers also include the American Cancer Society, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, American Public Health Association, Association of State and Territorial Health Officials, Americans for Nonsmokers Rights, Breathe California Sacramento Region, Los Angeles County Health Agency, Smokefree Movies, Trinity Health, and Truth Initiative.

“As physicians and advocates, we are speaking with a unified voice: Filmmakers must stop enabling the tobacco industry to target our children.” said Fernando Stein, MD, FAAP, president of the American Academy of Pediatrics. “The evidence is clear that when children see movie characters smoking, they are more likely to smoke. Ninety percent of smokers start smoking in their teen years, and many of them will battle a tobacco addiction that will eventually kill them. By rating movies appropriately, filmmakers can help protect the next generation from tobacco-related disease and death.”

The CDC has projected that exposure to on-screen smoking will recruit more than 6 million U.S. children to smoke, of whom 2 million will die prematurely from tobacco-induced cancer, heart disease, lung disease or stroke. By voluntarily implementing policies that require R ratings for smoking, the film industry can avert 1 million tobacco deaths among today’s children, according to estimates from the CDC.

Tobacco use continues to be the leading cause of preventable death in the U.S., responsible for nearly half a million adult deaths annually. Exposure to on-screen smoking recruits an estimated 37 percent of all new young smokers. The U.S. film industry has known about the risk from exposure and the public health value of the R rating since 2003. Under pressure from health groups and state attorneys general, some major studios reduced but did not end smoking in youth-rated films between 2005 and 2010, but then progress ceased. The smoking in PG-13 films is “of particular public health concern,” said the CDC in its July 7 report.

“Cigarette smoking is the leading cause of cancer mortality, responsible for approximately 30 percent of all cancer deaths in America,” said Gary Reedy, CEO of the American Cancer Society. “Most smokers are enticed into nicotine addiction as children, and the American film industry must take assertive action now to ensure that our kids are not lured into using this uniquely lethal product by depictions of smoking in major motion pictures.”

The updated R rating guidelines, as described in the letter, would apply to all movies with smoking except those that “exclusively portray actual people who used tobacco (as in documentaries or biographical dramas) or that depict the serious health consequences of tobacco use.”

The letter was sent Aug. 25 to the Motion Picture Association of America, Comcast, Disney, 21^st Century Fox, Sony, Time Warner, Viacom; independents A24, Broad Green, Lionsgate, Open Rad, STX, The Weinstein Company; exhibitors National Association of Theatre Owners, AMC, Carmike, Cinemark, Marcus, Reading Int’l, Regal; retailers Amazon, Apple, AT&T, Best Buy, CinemaNow, Google, Hulu, Netflix, Redbox, Target, Verizon, Vudu and Walmart.

The Surgeon General notes that the magnitude of the effect of an R rating for smoking would be similar to increasing the price of cigarettes from $6.00 to $7.50 per pack.

“There is nothing that could be done that is so easy and cheap that would have such a big effect on youth smoking as making youth-rated films smokefree,” said Stanton Glantz, a professor of medicine at the University of California San Francisco and director of the Smokefree Movies project. “It’s long past time for the motion picture industry to act.”

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