Author: John Luik
Article Published: 20/07/2007
One of the “nice” things about the advocacy of the anti-tobacco lobby is how consistently silly, not to say nonsensical, its claims are. Unencumbered with the responsibilities of reputable research and rigorous analysis of whether their purported solutions really work, the anti-tobacco zealots are able to continue on year after year re-cycling to a lazy media their same sound-bite claims as the novel product of serious thinking on the hard problem of preventing smoking.
Take, for instance, the increasing media attention- generated entirely by the anti-tobacco movement- to the claim that smoking in films is a, some would say the central “cause” of youth smoking. For example, activist Stanton Glantz has claimed that seeing onscreen smoking is the main reason why teens begin to smoke. Indeed, Glantz even has precise figures, arguing that “smoking in movies is responsible for addicting 1080
Additionally a new study-actually merely a meta-analysis of previous studies- by
Unfortunately the ads have not had quite the effect that was intended. A just published study in Tobacco Control (June, 2007) by Christine Edwards and others examining the Australian approach found that the advertisements did not produce reduced intentions to smoke. For instance, 25% of smokers who had not seen the ads before films with smoking said that they would still be smoking in a year’s time compared to a striking 39% of smokers who had seen the supposed anti-smoking ads. And the ads had no statistically significant effect on the smoking intentions of nonsmokers. All of which suggests that the pre-smoking film ads are like so many anti-tobacco initiatives counterproductive as well as contradicting the supposedly evidence-based claims of the Institute of Medicine that such ads reduce the effects of youth viewing of smoking in the movies.
But the problems with the claims about the effects of young people seeing smoking depicted in films go far beyond the failure of anti-smoking advertisements preceding films to have any effect on smoking intentions. Indeed, they extend to the much more important claim about whether there is indeed a causal connection between adolescents seeing people smoke in films and starting to smoke themselves. In fact, what the evidence about the ineffectiveness of pre-film anti-smoking advertisements should do is to cast doubt on the entire hypothesis that seeing smoking in films is a cause of youth smoking.
There are three reasons to doubt that films that show smoking cause youths to smoke. To begin with, the research- at least ten major articles during the last five years- which purports to show this causal connection is deeply flawed. Take, for example, the just published analysis by Wellman et al “The Extent to Which Tobacco Marketing and Tobacco Use in Films Contribute to Children’s Use of Tobacco” (December 2006, Archives of Pediatric and Adolescent Medicine) According to Wellman, films which depict smoking create positive views about smoking and these positive views lead to an increased intention to start smoking. To support this claim, Wellman analyzes 51 studies with 89 exposure measures. But of these 89 measures of exposure, only 10 were about exposure to smoking in films- a very slender base on which to claim that such exposure causes adolescent smoking. Further, though Wellman cites crucial studies about the huge number of things that influence adolescents to begin smoking, some studies suggest over 200 different risk factors, he notes that the studies he uses in his meta-analysis fail to take account of these other risk factors for smoking. Yet without taking account of these it is impossible to determine what influence, if any, smoking in films might have. Most crucially, he fails to note several studies which have consistently found that young movie viewers do not rate smoking characters as particularly attractive. This undermines his central thesis that depictions of smoking create a positive view about smoking. It seems rather a stretch to conclude that adolescents are driven to smoke by smoking characters whom they do no like.
Nor is the questionable quality of the Wellman research unique. An often cited study by Madeline Dalton (The Lancet 2003 “Effect of viewing smoking in movies on adolescent smoking initiation: a cohort study”) which claims to establish a causal connection between smoking in films and youth smoking, for instance, did not even ask its subjects whether they found a film’s portrayal of smoking to be positive - which is surely the relevant research question given the assumption that such a positive attitude is the cause of beginning to smoke. Instead, Dalton assumes that because her subjects starting smoking after seeing someone smoking in a film that they must have started smoking because they saw someone smoking in a film.
This, however, is both confused and dishonest. Sequence is not consequence as anyone who has ever studied logic will remember. Post hoc ergo propter hoc-after this therefore because of this- is still a fallacy, even in anti-tobacco land. Just because something follows something else- in this case starting to smoke follows seeing movies with smoking scenes, it is not true that the one is the cause of the other. The fact that two things happen simultaneously over the same time period- adolescents begin to smoke and adolescents begin to go to R-rated films with smoking, does not mean that the one fact is the causal precipitator of the other.
The students in the
But here is an equally plausible interpretation of these and similar results. Since smoking scenes occur most often in R rated films, it could be that young people who view such films are more likely to become smokers, regardless of the content of the films. There is an association between R- rated films and smoking but it is not a causal one. The things which the smokers have in common is their attraction to R-rated films, not to the smoking scenes in R-rated films. In other words, potential youth smokers share a number of characteristics such as liking R-rated films, but this does not mean that R- rated films with smoking scenes lead to youth smoking. Alternatively, other risk factors for smoking than smoking scenes might be found in R-rated films. This possibility is in fact acknowledged by Sargent et al in their study on smoking in films and youth uptake, but dismissed on the odd grounds that their explanation is more “theoretically reasonable.” So indeed was the belief that the sun revolved around the earth. Unfortunately, the science suggested otherwise, as it does here.
But there is a third reason why such claims about films with smoking leading to smoking initiation cannot be trusted and that is that there is a very substantial mass of research which not only points in different directions but contradicts these claims. For one thing there are dozens if not hundreds of studies which find that the strongest predictors of youth smoking initiation are personality variables such as rebelliousness, socioeconomic factors such as family income, school-related factors such as academic success and remaining in school and such coping skills as resilience. These make nonsense of the Glantz claim that seeing onscreen smoking is the “main” reason why teens begin to smoke.
For another thing the research about the supposed effect of smoking in films on youth smoking itself contradicts the claim that seeing smoking lead to smoking. The just published study from
Finally, there is the odd claim that even if the evidence for a causal connection between seeing smoking in films and starting to smoke is weak, we know it is true because there is a causal relationship between violent media such as video games and “violent attitudes and behaviors in children and adolescents” which “makes it plausible that tobacco marketing and media also affect behavior.” (Wellman, p. 1293) Aside from the fact that only one study is listed as support for this sweeping conclusion about video games and violence, and that virtually all of the research is correlational and hence cannot establish causal connections, there is little evidence supporting such links between video games and violent behaviour according to the Federal Trade Commission’s review of the issue.
Youth smoking has suffered from over 25 years of bad research and simplistic policy prescriptions from the anti-tobacco movement. Despite the fact that the evidence is not supportive- there is no causal connection between tobacco advertising bans and reduced youth smoking, for instance, the anti-tobacco activists have always claimed that advertising is the major cause of young people starting to smoke. Now with tobacco advertising increasingly banned and young people still smoking, the claim is that it is seeing smoking in films that is the major cause of young people beginning to smoke. But the evidence for this is just as contrived and flimsy as it was for the claims about tobacco advertising. Neither removing smoking from films or young people from cinemas that show films with smoking will do anything to solve the problem of youth smoking. But it will sidetrack attention from the consideration of policies that might.
-- John Luik