Why is smoking still being glamorized in media and pop culture?

While the cartoon mascot Joe Camel hasn’t puffed on a cigarette on TV screens since 1971, tobacco imagery in entertainment media and culture is far from gone.

Even as national smoking rates have declined to record lows, there has been a pervasive re-emergence of smoking imagery on screens, and research shows that higher exposure to some of this imagery makes youth and young adults twice as likely to start smoking. Glamorizing and re-normalizing smoking, and making it appear “cool,” could threaten the progress the U.S. has made in decreasing tobacco use, which kills 1,300 Americans every day and is still the country’s leading cause of preventable death and disease.

“It’s confusing and a dangerous contradiction for young people who take their cues from pop culture and celebrity influencers, and are especially vulnerable to believe that smoking is more popular than it really is,” said Truth Initiative® CEO and President Robin Koval. “That perception of popularity, of course, serves the increasingly desperate needs of the tobacco industry.”

Public health experts, entertainment industry professionals and youth convened at the most recent Truth Initiative Kenneth E. Warner Series earlier this month to discuss the impact of tobacco imagery in culture. Washington Post reporter Travis Andrews, who wrote the story “Streaming services such as Netflix have more sex, violence — and, it turns out, smoking,” facilitated the discussion on why smoking in media and pop culture is still a problem in 2018.

It is the “last bastion” of advertising.

The surgeon general’s 1964 report — which concluded that smoking cigarettes causes death and disease — began a slow wave of tobacco control measures in the decades following, including restrictions on tobacco advertising.

Now, as a result of various laws and the 1998 Master Settlement Agreement, tobacco companies can no longer advertise cigarettes or smokeless tobacco on TV, radio, transit or billboards. Paying for branded product placement, using cartoons and sponsoring sporting events and concerts are also banned.

“We’ve really shut down all the avenues where tobacco companies can advertise,” said Centers for Disease Control and Prevention Public Health Analyst Michael Tynan, who noted that the retail “marketing machine” is an exception (the tobacco industry spends more than $1 million an hour marketing in retail environments). “It’s just natural that with all the other channels getting shut down for them to market, this is one of the last bastions for them to reach consumers — to reach those replacement smokers.”

There has been an explosion of content.

Today’s media landscape has created more opportunities for young people to be exposed to tobacco imagery on screens.

For example, tobacco use is pervasive, rising and more prominent on streaming platforms than in broadcast and cable programming, according to a report from Truth Initiative, “While You Were Streaming.” The report revealed that 79 percent of the shows most popular with young people ages 15 to 24 depict smoking prominently.

Additionally, 26 percent of youth-rated G, PG and PG-13 movies had tobacco imagery in them in 2016, according to a CDC report. Though that marks a slight decrease in the percentage of youth-rated movies with tobacco imagery — from 31 percent in 2010 — the average number of tobacco incidents in youth-rated movies with tobacco depictions increased by 55 percent from 2010-16.

“I find it fascinating that the percentage of movies or TV with smoking in them is higher than the national smoking rate. The amount of smoking in movies is not an authentic representation of real life, and it gives some young people the wrong impression that smoking is more prevalent than it actually is,” said Kat Wojsiat, a high school sophomore and a youth activist with Reality Check of NY, who added that she and her friends often see smoking imagery on social media.

This exposure across screens make it difficult for researchers and policymakers to keep up.

“The way that young people are consuming media and the way through which media is being delivered is changing vastly and it’s rapidly evolving,” said University of Bath U.K. Department of Health lecturer Dr. Joanne Cranwell, who studies tobacco imagery and its impact. “The policy and regulation is probably not adequate to deal with it.”

Young people are consuming media in more intense ways.

Changes in media consumption behaviors have often resulted in consumer experiences that are more intense and immersive. For example, many people are binge-watching TV series and discussing them on social media.

Today’s video games — many of which are very realistic, first-person experiences that, according to Truth Initiative research, contain tobacco imagery portrayed in a positive light — are important examples of how media consumption has changed.  

“As games become more prevalent in people’s lives, it becomes less about the games and more about the community around the games,” said Steven Asarch, a writer for Newsweek Player One, who discussed the community of people who watch others play games on platforms like Twitch.

How media is being consumed may be impacting how tobacco imagery exposure affects young people.

Inadequate warnings and ratings make it difficult to monitor content.

Movies, TV, on-demand content and video games all have different rating systems and inconsistent track records when it comes to tobacco content warnings.

“Movie studios have policies and they aren’t following them,” said Tynan, who added that 89 percent of top-grossing, youth-rated films with smoking did not have a youth “smoking descriptor” in 2015.

Video games are also lacking consistent warnings to help adults monitor content. A 2015 survey by the University of California, San Francisco, verified tobacco content in 42 percent of the video games that participants reported playing; however, only 8 percent of these games had received tobacco warnings from the Entertainment Software Rating Board, the gaming industry’s self-regulatory organization that rates video games.

Other systems don’t have adequate ways to address tobacco. For example, the TV parental guideline ratings currently do not consider tobacco use when assigning a rating to a show.

“There is a major responsibility on the part of the industry to get involved with this. We all know smoking is bad,” said Michael Yudin, president of MY Entertainment.

Truth Initiative joined a group of public health organizations to issue a challenge to entertainment studios to apply an R rating to movies with smoking. The organization is also seeking to work with media companies who can help change the culture of tobacco use on screen. Only films that portray real people who used tobacco, such as documentaries or biographical dramas, or that depict the negative health effects of tobacco use, should be exempt.

As part of this effort, Truth Initiative and Trinity Health gave 10 youth-serving groups grants to raise awareness of the issue of smoking in movies and popular culture, and advocate for entertainment media companies to implement an R rating for movies with smoking. Each group received a “Reinvent the Reel” grant of up to $2,500 to educate and engage young people at local events and on social media about the issue of tobacco use in movies.

The Warner Series is named after Dr. Ken Warner, an economist by training, distinguished professor at the University of Michigan School of Public Health and a former Truth Initiative board member. Warner is one of the leading voices in tobacco control. The series honors his ongoing contributions by regularly bringing together leaders across tobacco control, public health and youth service communities to engage in thought-provoking conversations about ways to innovate and inspire action to save lives.