Results from a US study suggest that there are significant ethnic and socioeconomic differences among adolescents in susceptibility to the portrayal of smoking in movies.
James Sargent and colleagues, from Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, found that smoking in movies positively predicted smoking behavior in White and Hispanic adolescents, but had no significant effect in Black teenagers.
And among White adolescents, those from affluent families were more susceptible to the portrayal of smoking in the movies than those from poorer families.
"In the case of movie smoking, evidence was found for effect modification that contrasts with usual findings in health disparities research ‑ a stronger movie smoking‑youth smoking relation among Whites, and especially among affluent Whites," write the researchers in Addiction.
The findings come from a study of 3653 adolescents, aged 13 to 18 years, who participated in the Dartmouth Media Study. Of the participants, 57.3% were White, 22.4% Black, 13.2% Hispanic, and the remaining 7.1% were from "other" ethnicities.
All of the participants completed questionnaires detailing whether they had ever tried smoking. Exposure to movie smoking was assessed using a sample of 384 movie titles included in the top 100 box office hits between 2004 and 2006, plus a group of older releases that dated back to 2000.
Overall, 36% of participants reported that they had tried smoking. By ethnicity, 38% of White, 32% of Black, and 41% of Hispanic adolescents had tried smoking.
After accounting for age, gender, peer smoking and other variables, the team found that the probability of having tried smoking increased with exposure to movie smoking in White and Hispanic adolescents, but not in Black teenagers.
Specifically, as exposure to movie smoking increased from the 10th to the 90th percentiles, the probability of smoking for White adolescents increased from 0.19 to 0.45, and from 0.31 to 0.50 among Hispanic teens.
The researchers also found that socioeconomic status (SES) moderated the effect of movie smoking for White adolescents. For example, the risk ratio for smoking between those at the 90th percentile of exposure to movie smoking versus the 10th percentile was 1.79 for adolescents one standard deviation below mean SES and 2.98 for those one standard deviation above mean SES.
There were no such effects in Black participants, and associations were of borderline significance in Hispanic participants.
Sargent and team conclude: "Exposure to movie smoking is not experienced uniformly as a risk factor for having ever tried smoking among US adolescents."
They add: "Just as Black adolescents fail to respond to the predominantly White character smoking in movies, a larger response among affluent White youth could be a result of the fact that movie characters that smoke are predominantly white and affluent.
"Further work using experimental designs would be needed to confirm this interpretation.
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