Monday, July 31, 2006

Anti-Smoking Groups Call On-Screen Smoking One of the Gravest Threats to Children; Legacy Asks Parents to Attack Legacy Partner

What are some of the gravest threats that middle-school and high-school children face? According to a number of anti-smoking groups, one of the gravest of them all is on-screen smoking.

Yes - you read that correctly.

A coalition of anti-smoking groups - including the American Legacy Foundation, American Heart Association, and American Medical Association - is telling parents, in a new ScreenOutGuide, that:
"On-screen smoking is one of the gravest threats that kids 10 and over will ever encounter."

The coalition is calling on parents to make their voices heard in Hollywood by urging the major movie corporations to get rid of smoking in movies - at least in movies that are seen by large numbers of kids.

According to the parent's guide, the simple act of getting smoking out of movies that kids see will save 60,000 lives per year:
"Whether your own kids are in Grade 1 or Grade 12, you can help prevent as many as 60,000 future tobacco deaths a year by taking the survival steps outlined in this special SCREEN OUT! parent'’s guide."

The coalition asks parents to write to Time Warner, parent of Warner Brothers - one of the chief culprits of this "grave threat" - along with other major media corporations and ask them to keep smoking out of R-rated films.

The Rest of the Story

I challenge any one of these organizations to take one walk down any street in inner-city Boston and see if they still feel that the gravest threat to children ages 10 and up is on-screen smoking.

If you live in Roxbury or Dorchester, or in almost any major city in the country, it would be difficult to argue that on-screen smoking is the most pressing and gravest threat to children. Let's face it. These kids' very lives are at risk (and not 40 years down the road) just by walking outside in some of these neighborhoods. Violent crime in Boston, and many other cities, is an imminent and grave threat to just surviving one's adolescent years.

Add to that the problem of gangs, drugs, alcohol, and non-fatal youth violence and you've got some truly grave threats to our children.

To list on-screen smoking in movies as part of this list seems to me to undermine the seriousness of these other threats to the nation's youths and to show disrespect to communities where parents have to worry about whether their children will make it home alive if they venture out to a movie, much less about whether some actor lights up in a film.

Don't get me wrong. I'm not arguing that smoking is not a severe threat to the health of our children. But to pick such a narrow aspect of the smoking problem - on-screen smoking - and single it out as somehow representing the gravest threat to the nation's kids - is one of the most narrow-minded, misleading, and disrespectful actions I've observed in the tobacco control movement.

The parent's guide states that "the scientific case is rock solid" to support its assertion that 60,000 lives would be saved if parents are successful in getting Hollywood to remove smoking from R-rated films. Nothing could be further from the truth. That supposed rock is full of holes. It's probably more accurate to say that "the scientific case is as solid as Swiss cheese."

As I have explained, there are a number of reasons why one cannot validly conclude that on-screen smoking causes 38% of youth smoking initiation, even given the studies which have shown an association between exposure to smoking in movies and smoking behavior.

For one thing, parents who allow their kids to go out and see the types of movies that contain a lot of smoking are quite different from the parents who are more restrictive about what they allow their kids to be exposed to. In addition, the kids who go out to movies often are different from those kids who choose not to go out to these types of movies very often. It is very difficult to control for these major differences between these populations, which could well explain why one group is more likely to smoke. It is quite possible that it is not smoking in movies, but some other factor - related to WHY a parent allows their kids to spend hours and hours out with their friends watching these types of movies rather than forcing them to be home or in more controlled settings - that is the actual cause of increased smoking among this group.

Another serious methodologic problem with these studies is that there is most likely a severe measurement bias. Parents who are controlling enough not to allow their kids to to out to the movies are probably more likely to be listening in to or monitoring the phone call in which their childrens' smoking status is ascertained. It has been demonstrated that kids are significantly less likely to admit that they smoke when they believe a parent may be monitoring the phone call. This effect would create the appearance that kids who see more smoking in movies are more likely to smoke when the real effect has more to do with parental factors.

Even if the smoking in movies were contributing to the initiation of smoking, it is far too premature to make definitive quantitative conclusions about the specific proportion of kids who start smoking because of smoking depictions in movies. These definitive quantitative conclusions are, after all, based on only a handful of studies. If our science were loose enough to be willing to make these kind of quantitative conclusions based on such limited studies, we would have long ago been told that drinking coffee kills thousands of Americans every year from cancer and that if we all only write to Maxwell House, we could save thousands of lives a year.

Moreover, it is extremely unlikely that these studies are measuring an exclusive effect of seeing smoking in movies. Movies are just one source of exposure to depictions of smoking and to the formation of attitudes and social norms regarding smoking. Movies most certainly do contribute to these attitudes and norms, but to suggest that movies are the only such factor or that these studies are measuring an isolated effect of smoking in movies, is ridiculous and certainly not scientifically sound.

And to top it all off, even if we were to accept that smoking in movies does cause 38% of smoking initiation, there is no evidence to suggest that simply requiring an R-rating of movies that depict smoking would reduce kids' exposure. What might happen instead is that parents will stop paying as much attention to the movie ratings and that kids may be more likely to go to R-rated movies. An action like this one could undermine the ratings system to the point that parents don't pay much attention to it anymore. I don't know if that would be the effect or not, but neither do these anti-smoking organizations know that it wouldn't occur. My point is that even if smoking in the movies is as bad as these groups are claiming, it is inappropriate and not scientifically sound to state that the R-rating will save 60,000 lives per year.

This is just another example of how the anti-smoking movement has become extremist in its perspective and its public communications. Everything gets stretched, distorted, and exaggerated to such an extreme that instead of smoking in movies being a significant problem that needs to be addressed, it is the most grave threat to the health of our nation's children that kills exactly 120,000 people each year. Instead of secondhand smoke being a significant threat to workers who are exposed to the toxins and carcinogens for 40+ hours per week, it is now such a severe hazard that even 30 minutes of exposure can cause heart disease or lung cancer. Instead of parents smoking around children being an important health issue that needs to be addressed, it is now the worst form of child abuse.

Distorting the science in this way isn't doing the tobacco control movement any favors. It may get newspaper headlines in the short run, but in the long run, it is going to cast us as a bunch of crazy fanatics and it is going to destroy our scientific credibility in the public's eye.

One other aspect of this story deserves mention. And that's the extreme hypocrisy.

The American Legacy Foundation is actually asking parents to write to Legacy's corporate partner - Time Warner - to demand that they act to solve this problem. How hypocritical is that? If the problem is so bad that Legacy needs to mount a public campaign to get parents to pressure Time Warner, then why doesn't Legacy simply exert pressure on Time Warner to stop "killing kids?" All Legacy has to do is threaten to rescind its corporate partnership if Time Warner doesn't immediately eliminate smoking in non-R movies, and Legacy will have accomplished overnight more than thousands of letters from parents could accomplish in months.

Moreover, it seems disingenuouss for Legacy to deceive parents by not revealing their partnership with the chief culprit of the problem. How can they put out such a 'feel-good' pamphlet to parents, blasting Time Warner and talking about everything that must be done to confront these child killers, but not mention to parents the minor fact that Legacy and Time Warner are partners, and that Legacy calls Time Warner a "leader" in the tobacco control movement?

The rest of the story is that the anti-smoking movement has become plagued by the problem of extremism, which has played out through a destruction of our scientific integrity, repeated exaggeration and distortion of science, a complete lack of perspective, extreme hypocrisy, and a lack of integrity.

Perhaps parents who receive the "parent's guide" would do well to write an additional set of letters - these to the anti-smoking groups who put out the ScreenOutGuide, and suggest that maybe, just maybe, they have lost a bit of perspective if they truly believe that on-screen smoking is one of the gravest threats faced by our nation's children.

It certainly wouldn't make my Top 10 list.

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