Christopher Millett from Imperial College, London, UK and colleagues report that, despite the WHO Framework Convention on Tobacco Control recommendation that films with smoking scenes have adult content rating, very few governments have complied with this advice. Arguing that exposure to tobacco imagery in movies is a "potent cause of youth experimentation and progression to established smoking," the authors say their primary reason for supporting the film rating recommendation is to create an economic incentive for producers to leave smoking out of movies that are marketed to youths.

Even more problematic, the authors say, is the fact that "many governments provide generous subsidies to the US film industry to produce youth-rated films that contain smoking and as such indirectly promote youth smoking."

"Governments should ensure that film subsidy programmes are harmonized with public health goals by making films with tobacco imagery ineligible for public subsidies," the authors conclude.

In an Essay also published this week in PLoS Medicine and addressing the same issue, Simon Chapman from the University of Sydney, Sydney, Australia and Matthew Farrelly from RTI International, USA strongly argue against adult ratings for film with smoking scenes, laying out four reasons why they believe this to be ill-advised. They argue that 1) the link between exposure to smoking in movies and smoking uptake is vexed by substantial confounding; 2) exposure to smoking scenes is much wider than just films, including internet; 3) adult classification of films is a highly inefficient way of preventing youth exposure to adult-rated content; and 4) censorship is not the best approach for this public health issue.

The authors say: "We believe that many citizens and politicians who would otherwise give unequivocal support to important tobacco control policies would not wish to be associated with efforts to effectively censor movies other than to prevent commercial product placement by the tobacco industry."

Note: If no author is given, the source is cited instead.

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