Media Influences on Adolescent Smoking

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Media Influences on Adolescent Smoking Behavior
James Sargent, M.D. Director of Cancer
Prevention Research Norris Cotton Cancer
Center Dartmouth Medical School Supported by
National Institutes of Health (CA077026,
AA015591)
2
Mass Communication
Simple one-way communication
Source
Medium
Receiver
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Media Influences on Adolescent Smoking Behavior
Supported since 1997 by National Institutes of
Health (CA-77026)
AIMS Describe smoking in popular contemporary
movies Assess exposure to movie smoking among
adolescents Determine if movie smoking exposure
is linked with adolescent smoking
Johnny Depp Blow
4
Content Analysis
5
Smoking Episodes in 532 Box Office Hits
64
36
Number of Movie Smoking Episodes
16
7
4
4
0
0
0
G
PG
PG-13
R
MPAA Rating
28 (25)
71 (44)
220 (76)
215 (87)
N - Movies ( w smk)
6
80
Smoking Screentime in 532 Box office hits
60
40
Percent of Movies
20
0
0
5
10
15
20
25
Minutes of Screen Smoking
7
Linking Smoking in Movies with Adolescent
Smoking
Jeff Bridges Seabiscuit
8
BMJ 2001323(7326)1394-7
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Chicken and the EggLongitudinal Study of
Never Smokers
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Findings Generalizable?

• Could this just be a regional finding?
• Can the findings be replicated?
• Do they hold across race/ethnicity?

11
Study Design

• Random digit dial telephone (RDD) survey
• Telephone protocol identified U.S. households
  with 10-14 year-old adolescents (N 6522)
• Major undertaking, 400,000 RDD numbers
• Could never have been accomplished without NIH
  funding

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Exposure Measurement
13
Select Popular Movies
Box office hits
N


Top 100, 1998-2002
500
gt 10mil revenues, 2003
32
Content Analysis
Count the tobacco use occurrences in each
movie
14
Select Popular Movies
Box office hits
N


Top 100, 1998-2002
500
gt 10mil revenues, 2003
32
Generate Movie Lists
Randomly select 50 movies for each survey
Use stratified sampling to ensure
representative distribution by rating
(R, PG 13, PG, G)
Survey Adolescents (Sep 2003)
Content Analysis
Questionnaire assesses which of the
Count the tobacco use occurrences in each
movie
50 movies the adolescent has ever seen

15
Select Popular Movies
Box office hits
N


Top 100, 1998-2002
500
gt 10mil revenues, 2003
32
Generate Movie Lists
Randomly select 50 movies for each survey
Use stratified sampling to ensure
representative distribution by rating
(R, PG 13, PG, G)
Survey Adolescents (Sep 2003)
Content Analysis
Questionnaire assesses which of the
Count the tobacco use occurrences in each
movie
50 movies the adolescent has ever seen

Merge
Movie Smoking Exposure Variable
Number movie tobacco use occurrences seen
16
Exposure to Movie Smoking and Adolescent Smoking
by Race/Ethnicity
Overall Smoking Prevalence
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Controlling for Covariates

• Sociodemographics
• Grade in school
• Gender
• Parent Education
• Social Influences
• Parent smoking
• Sibling smoking
• Friend smoking

• Personality Characteristics
• Self esteem
• Sensation seeking
• Rebelliousness
• Parenting
• Maternal responsiveness
• Maternal supervision
• Parental disapproval of smoking

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Multivariate Analyses
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Promoting Change within the Movie Industry
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Movie Character Smoking Trends
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Movie Character Smoking--Adolescents
20
18
16
14
Daily
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smoking,
10th
10
Percent of Adolescent Smokers
graders,
8
MTFS
6
Adolescent
4
movie
characters
2
0
1996
1997
1998
1999
2000
2001
2002
2003
Year
Monitoring of the Future Survey p-value lt
0.01 for downward trend among teen movie
characters
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Whats in Store?

• ReachGross impressions
• U.S. adolescents 10-14 2003

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Select Popular Movies
Box office hits
N


Top 100, 1999-2003
500
Top 50, 2003 (assessed 5/03) 32
Generate movie lists
Randomly select 50 movies for each survey
Use stratified sampling to ensure
representative distribution by rating
(R, PG 13, PG, G)
Adolescent ? randomly assigned to ? Movie
So a representative sample of about 550 U.S.
adolescents responded to each movie
Survey Students
Questionnaire assesses which of the
50 movies the adolescent has ever seen

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Lifetime Smoking ImpressionsUS Adolescents 10-14
in 2003,532 Popular Contemporary Movies

• Impression each time an adolescent saw a
  smoking scene
• These movies delivered
• 13.8 billion lifetime smoking impressions
• Does not count repetitive viewing

25
Smoking
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Whats in Store?

• ReachGross impressions
• Contextualized smoking
• Movie industry response
• Eliminate G and PG smoking

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Movie smoking Kid smoking relation by smoking
rating
.4
.3
.2
Proportion of Adolescent Ever Smokers
.1
GPG movie smoking
PG-13 movie smoking
R movie smoking
0
0
50
100
150
200
Episodes of Movie Smoking Exposure
28
Whats in Store?

• ReachGross impressions
• Contextualized smoking
• Movie industry response
• Eliminate G and PG smoking
• Most smoking is bad guy smoking

29
Movie smoking Kid smoking relation by character
type
.5
.4
.3
Proportion of Adolescent Ever Smokers
.2
.1
Bad Guy Smoking
Good Guy Smoking
Mixed Character
0
0
50
100
150
Episodes of Movie Smoking Exposure