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a Department of
Psychological and Brain Sciences, Dartmouth College, Hanover, New
Hampshire, USA, b Departments of Pediatrics and Community & Family
Medicine, and the Norris Cotton Cancer Center, Dartmouth Medical
School, Hanover, c Department
of Pediatrics, and the Norris Cotton Cancer Center, Dartmouth Medical
School, Hanover, d Department
of Community & Family Medicine, Dartmouth Medical School, and
Veterans' Affairs Medical Center, White River Junction, Vermont, USA
Correspondence to: Jennifer J Tickle, 6207 Moore Hall, Department of Psychological and Brain Sciences, Dartmouth College Hanover, NH 03755, USA Jennifer.Tickle{at}Dartmouth.edu
Received 27 January 2000; Revision received 2 June 2000;
Accepted 23
June 2000
OBJECTIVE
To assess
the relation between adolescents' favourite movie stars, the portrayal
of tobacco use by those stars in contemporary motion pictures, and
adolescent smoking.
DESIGN AND SETTING632
students (sixth to 12th grade, ages 10-19 years) from five rural New
England public schools completed a voluntary, self administered survey
in October 1996. The survey assessed tobacco use, other variables
associated with adolescent smoking, and favourite movie star. In
addition, tobacco use by 43 selected movie stars was measured in films
between 1994 and 1996.
OUTCOME
MEASURESStudents were categorised into an ordinal
five point index (tobacco status) based on their smoking behaviour and
their smoking susceptibility: non-susceptible never smokers,
susceptible never smokers, non-current experimenters, current
experimenters, and smokers. We determined the adjusted cumulative odds
of having advanced smoking status based on the amount of on-screen
tobacco use by their favourite film star.
RESULTSOf the 43 stars, 65% used tobacco at least once, and 42% portrayed smoking as
an essential character trait in one or more films. Stars who smoked
more than twice in a film were considered smokers. For adolescents
whose favourite stars smoked in only one film, the odds of being higher
on the smoking index was 0.78 (95% confidence interval (CI) 0.53 to
1.15). For adolescents whose favourite stars smoked in two films, the
odds of being higher on the smoking index was 1.5 (95% CI 1.01 to
2.32). For adolescents whose favourite stars smoked in three or more
films (Leonardo DiCaprio, Sharon Stone, John Travolta), the odds of
being higher on the smoking index was 3.1 (95% CI 1.34 to 7.12). Among
never smokers (n = 281), those who chose stars who were smokers in
three or more films were much more likely to have favourable attitudes toward smoking (adjusted odds ratio 16.2, 95% CI 2.3 to 112).
CONCLUSIONSAdolescents
who choose movie stars who use tobacco on-screen are significantly more
likely to have an advanced smoking status and more favourable attitudes
toward smoking than adolescents who choose non-smoking stars. This
finding supports the proposition that the portrayal of tobacco use in
contemporary motion pictures, particularly by stars who are admired by
adolescents, contributes to adolescent smoking.
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