Should films with smoking have adult-ratings?

Two articles in this week’s PLoS Medicine address the question of whether films with smoking scenes should have “R” or “adult” ratings applied to them. (The two articles were not commissioned nor submitted together, but happened to be ready for publication around the same time – it was a great opportunity for us to publish these contrasting views together).

In the first, Christopher Millett and colleagues report that, despite the WHO 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 problematical, the authors say, is their finding 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.

A very different view is taken by Simon Chapman and Matthew Farrelly, who in an Essay this week 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.

Readers are invited to comment on the articles: do you think films with smoking should have adult-ratings?

JC