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What should be done about tobacco content in films?

The Government set out tobacco control ambitions in their 2011 white paper Healthy Lives, Healthy People: A Tobacco Control Plan for England [1], where reducing youth smoking was highlighted as a key ambition, with stopping the promotion of tobacco an identified priority.
In 2012 it was estimated that 23% of pupils (aged 11 to 15) had ever tried smoking [2], increasing with age from less than 4% of 11 year to 45% of 15 year olds [2], and 4% regular smoked (classed as smoking at least one cigarette a week), again increasing with age, with less than 0.5% of 11 year olds and 10% of 15 year olds classed as regular smokers [2].

Research evidence shows that the presence of smoking in films promotes smoking among young people, by encouraging adolescents to experiment and use tobacco products. The US National Cancer Institute has concluded that exposure to smoking imagery causes adolescents to smoke [3], a conclusion supported by various health bodies including the World Health Organization [4], the US Centers for Disease Control and Prevention [5, 6], the US Surgeon General [7], the British Medical Association [8], and the Royal College of Physicians [9]. This evidence demonstrates that preventing youth exposure to smoking films should be a public health priority and essential if we are to curb the promotion of tobacco.

Key changes

There are several key changes needed to prevent the promotion of tobacco, and the uptake of smoking, through films:

Default adult classification of films with tobacco content

The British Board of Film Classification (BBFC) should classify all new films with gratuitous smoking and other tobacco imagery as suitable for adult only audiences (BBFC “18” age classification category), with exceptions only when the presentation of tobacco clearly and unambiguously reflects the dangers and consequences of tobacco use or is necessary to represent the smoking of a real historical figure. BBFC guidance [10] should clearly state what the exceptions would and would not permit.

No brand identification

There should be no real world tobacco brand identification or the presence of tobacco brand imagery (such as billboards) in the background of any film scenes. If it is necessary to show brands in any film where the above mentioned exemptions exist (such as representing real historical facts or events), there is no need to depict real world brands, and fictitious (unrelated) brands should be used.

Require strong anti-smoking ads

Film studios and cinemas should be required to display a genuinely and effective anti-smoking advertisement (not one produced by a tobacco company) before any film with any tobacco presence, in any distribution channel, regardless of the age classification of the film.

Certify no payment

Film producers should be required to post a certificate in the closing credits of a film declaring that nobody on the production team received anything of value (cash money, free cigarettes or other gifts, free publicity, interest-free loans or anything else) from anyone in exchange for using or displaying tobacco.

Subsidies and funding

Governments should not provide films containing smoking that are rated for youth audiences with film subsidies, tax-breaks, or other funding.

References relating to the above

1. Department of Health. Healthy Lives, Healthy People: A Tobacco Control Plan for England. London 2011: Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124960.pdf

2. Fuller E, (Eds.). Smoking, drinking and drug use among young people in England in 2012. Health and Social Care Information Centre. London: NatCen Social Research and the National Foundation for Educational Research, 2013.

3. The National Cancer Institute. The Role of the Media in Promoting and reducing Tobacco Use. Tobacco Control Monograph No. 19. U.S. Department of Health and Human Services National Institutes of Health, 2008.

4. World Health Organisation (WHO). Smoke-free movies: From evidence to action. World Health Organisation Geneva 2009:1-29.

5. Glantz SA TK, Mitchell S, Polansky JR, & Kaufmann R. Smoking in top-grossing movies —United States, 1991-2009. Mortality and Morbidity Weekly Report, 20 August 2010. 59(32), 1014-1017 Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5932a2.htm?s_cid=mm5932a2_w

6. Glantz SA MS, Titus K, Polansky JR, Kaufmann R, & Bauer U. Smoking in top-grossing movies —United States, 2010. 15 July 2011 (27);909-913. Morbidity and Mortality Weekly Report Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6027a1.htm?s_cid=mm6027a1_w

7. U.S. Department of Health and Human Services. Preventing tobacco use among youth and young adults: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services 2012. Available from: http://www.surgeongeneral.gov/library/preventing-youth-tobacco-use/full-report.pdf

8. Hastings G, & Angus, K. Forever Cool: the influence of smoking imagery on young people. British Medical Association Board of Science: BMA Board of Science 2008:1-62.

9. RCP/UKCTCS. Fifty years since Smoking and health: Progress, lessons and priorities for a smoke-free UK. London: RCP 2012. Avaialble from: http://www.rcplondon.ac.uk/sites/default/files/fifty-years-smoking-health.pdf

10. BBFC. British Board of Film Classification: The Guidelines. London: British Board of Film Classifications: 2009, http://www.bbfc.co.uk/classification/guidelines>:1-40

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