Pointing to the U.S. Surgeon General's conclusion that depictions of smoking in movies lead young people to adopt the fatal habit, 17 leading public health and medical groups are calling on the film industry to give an R-rating to any movie featuring tobacco imagery.
The groups, including the American Academy of Pediatrics, the American Medical Association and the American Cancer Society, demand the Motion Picture Association of America implement this change for all movies submitted for classification after June 1, 2018.
The Motion Picture Association of America declined to comment.
The health groups' letter endorses the recommendations in a July report from the Centers for Disease Control and Prevention that found the total number of times that tobacco products were pictured in top-grossing movies increased 72 percent from 2010 to 2016. The CDC also found a 43 percent increase in scenes featuring tobacco in PG-13 films during that period.
The number of G, PG, and PG-13 movies with tobacco incidents had steadily declined between 2005 and 2010, the report says.
The CDC report supports the idea of assigning an R rating to any movie with smoking scenes, "unless the portrayal is of actual historical figures who smoked, a documentary, or if the portrayal includes the negative effects of tobacco use."
The six major film studios have policies to reduce depictions of tobacco use in youth-rated films, and those likely contributed to the reduction in the number of scenes featuring tobacco between 2005 and 2010, according to the CDC.
Altria, which owns Philip Morris USA, the largest tobacco company in the country, says it does not want its brands appearing on screen, acknowledging a causal relationship between depictions of smoking in movies and the risk of young people adopting the habit.
That position does not go quite as far as U.S. Surgeon General Dr. Regina Benjamin did in 2012, when she concluded that there's sufficient evidence to declare "that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among young people."
Altria says it contacted major and minor movie studios in 2008 to encourage them to take additional steps to eliminate smoking scenes in movies directed at youth.
"Today when we learn a film depicts one of our brands, we contact motion picture studio executives," Altria says in a statement on its website. "On several occasions, the California Attorney General has told us that one of our brands was depicted in a film. In these situations, we contacted the respective studio executives and asked them to remove our brands from current and future productions and promotional materials."
The idea of giving movies with smoking an R-rating has been debated for years. The CDC suggested it in 2010.
Seven years later, the CDC finds that progress in reducing depictions of smoking in youth-rated movies has stalled. It says that while there were fewer top-grossing films depicting tobacco use in 2016 compared with 2010, the number of times these incidents occurred increased, effectively concentrating images of tobacco use into fewer movies.
The report is based on a study conducted by Breathe California of Sacramento-Emigrant Trails, in which trained monitors counted all tobacco incidents in the 10 top-grossing movies in any calendar week.
A new incident was counted each time a tobacco product went off screen and then came back on screen; a different actor was shown with a tobacco product; or a scene changed and the new scene contained the use of tobacco. Tobacco was defined as cigarettes, cigars, pipes, hookah, smokeless tobacco products and electronic cigarettes.
"Since the industry's progress halted, major studios and independent producer-distributors have released 210 top-grossing, youth-rated U.S. films featuring more than 6,000 tobacco incidents, delivering 60.5 billion tobacco impressions to audiences in U.S. theaters alone," the letter says.
The letter continues: "If the industry had simply continued reducing tobacco content in its youth-rated films at the pace it did between 2005 and 2010, all youth-rated films would have been entirely smoke-free by 2015."