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Editorial
Assigning an ‘18’ rating to movies with tobacco imagery is essential to reduce youth smoking
  1. Christopher Millett1,
  2. Stanton A Glantz2,3
  1. 1Department of Primary Care and Public Health, Imperial College, London, UK
  2. 2Division of Cardiology, University of California, San Francisco, California, USA
  3. 3Center for Tobacco Control Research and Education, University of California, San Francisco, California, USA
  1. Correspondence to Christopher Millett, Department of Primary Care and Public Health, School of Public Health, Imperial College, 3rd Floor, Reynolds Building, St Dunstan's Road, London W6 8RP, UK; c.millett{at}imperial.ac.uk

https://doi.org/10.1136/thx.2009.133108

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    Exposure to smoking in movies is a potent stimulus for youth smoking.1–4 In this issue of Thorax, (see page 417) McNeil et al document the occurrence of tobacco in the most commercially successful films released in the UK from 1989 to 2008.5 While there is a decrease in the mean rate of tobacco episodes (which includes tobacco use, tobacco paraphernalia, inferred tobacco use, brand appearances) over time, 70% of the films had one or more tobacco episodes. Tobacco or tobacco-related products appeared in 68% of all youth-rated films (British Board of Film Classification (BBFC) rating ‘15’ and below). More important, of the films from 2004 to 2008 that contained tobacco, 97% were rated BBFC 15 and lower and 73% were deemed suitable for those <15 years of age.

    This continuing high level of exposure to smoking in films rated suitable for youth undermines efforts to reduce smoking among children and adolescents, not only in Britain but globally. Approximately one in five young teenagers (13–15 years) worldwide is a regular smoker with 80–100 000 children taking up the habit every day.6 7 One in six 15-year-old girls in England (17%) and Scotland (16%) were regular smokers in 2008, and the prevalence of smoking among 15-year-old boys in Scotland actually increased from 12% in 2006 to 14% in 2008.8 9 Smoking prevalence and usage are highest among youth living in deprived areas. For example, 29% of 15-year-old regular smokers living in the most deprived areas in Scotland reported smoking more than 70 cigarettes a week compared with only 12% in the most affluent areas.9

    Concern about the impact of exposure …

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