Near majority of adults favor R ratings for films with smoking

IF 503.1 1区 医学 Q1 ONCOLOGY CA: A Cancer Journal for Clinicians Pub Date : 2023-03-03 DOI:10.3322/caac.21776
Mike Fillon
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Blake, ScD, director of the Health Information National Trends Survey (HINTS) and a health scientist in health communication and informatics research at the National Cancer Institute in Bethesda, Maryland, notes that it had been almost a decade since the last nationally representative assessment of public support for R rating designations by the Motion Picture Association (MPA) for movies with cigarette smoking. “Our study adds to prior assessments and suggests that public support among the general population of US adults is gradually trending upward, from 40% in 2003, to 45% in 2013, to 47% in 2020.”</p><p>The main goals of this study by National Cancer Institute researchers were to determine the proportion of adults who support, are ambivalent about, or oppose the depiction of smoking as a sufficient criterion for an R rating and to identify characteristics of study participants that were associated with their opinions on this issue.</p><p>The researchers used data from the 2020 HINTS, a National Institutes of Health–initiated national, cross-sectional postal survey of 3865 individuals at least 18 years old. This survey included an item that assessed support, opposition, and neutrality regarding the idea that “movies with cigarette smoking should be rated ‘R’ to protect children and youth from seeing cigarette smoking in movies.” Demographic data recorded in HINTS included each participant’s age, gender, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, or non-Hispanic other); income; educational level; sexual orientation; geographic location; marital status; child status (whether a participant had children or not); and political leanings. They also asked participants about cigarette smoking and e-cigarette use (both classified as current, former, or never).</p><p>A slight majority of the participants were female (50.2%,), whereas more than half (58.7%) were non-Hispanic White. 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The only significant difference by race/ethnicity was that non-Hispanic Asians, relative to non-Hispanic Whites, were only 46% as likely to be neutral to or oppose the policy.</p><p>The researchers found no significant associations with any of the other independent variables, including gender, income, education, sexual orientation, marital status, geography, children in the household, political views, and even cigarette or e-cigarette use.</p><p>There has been a long-running battle between the tobacco industry and health organizations about cigarette smoking in movies and on television and other media.</p><p>Although the effect of smoking in films on teens was not a part of this study, “There is compelling evidence of a causal relationship between depictions of cigarette smoking in movies and youth smoking initiation,” says Dr Blake. “Policies enacted by the MPA to curb youth exposure to cigarette smoking in films have been limited or have expired.” She also notes that current classification and rating rules do not include cigarette smoking.</p><p>“Demonstrating broad public support for an R rating policy for movies with smoking, may influence the MPA’s consideration of R ratings.</p><p>“Our study demonstrates near-majority support and only 20.3% opposition among adults in the United States for a policy that would give movies with cigarette smoking an R rating,” she continues. “There is also a sizable amount of neutrality toward such a policy, suggesting a need for efforts to raise awareness of the value of R ratings for reducing adolescent smoking initiation and smoking overall.”</p><p>Nigar Nargis, PhD, senior scientific director of tobacco control research at the ACS, says that because the study provides recent evidence of near-majority modest support (and minimal opposition) for designating an R rating to all movies that depict cigarette smoking and because there is evidence of a causal pathway between depictions of cigarette smoking in movies and youth smoking initiation, this could be an important step in reducing youth initiation. She notes, however, that “the effectiveness of R rating of movies has yet to be evaluated as a tobacco control measure.”</p><p>“Although there may be some net benefit from such a policy, this is but one type of media that youth consume, and moreover I suspect those younger than 17 years old use social media more often and are likely exposed to tobacco use more often there,” continues Dr Nargis. She points to recent results from a systematic review and meta-analysis in <i>JAMA Pediatrics</i> (doi:10.1001/jama\n pediatrics.2022.2223) showing the relationship between exposure to tobacco content on social media and tobacco use. 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引用次数: 0

Abstract

Study author Kelly D. Blake, ScD, director of the Health Information National Trends Survey (HINTS) and a health scientist in health communication and informatics research at the National Cancer Institute in Bethesda, Maryland, notes that it had been almost a decade since the last nationally representative assessment of public support for R rating designations by the Motion Picture Association (MPA) for movies with cigarette smoking. “Our study adds to prior assessments and suggests that public support among the general population of US adults is gradually trending upward, from 40% in 2003, to 45% in 2013, to 47% in 2020.”

The main goals of this study by National Cancer Institute researchers were to determine the proportion of adults who support, are ambivalent about, or oppose the depiction of smoking as a sufficient criterion for an R rating and to identify characteristics of study participants that were associated with their opinions on this issue.

The researchers used data from the 2020 HINTS, a National Institutes of Health–initiated national, cross-sectional postal survey of 3865 individuals at least 18 years old. This survey included an item that assessed support, opposition, and neutrality regarding the idea that “movies with cigarette smoking should be rated ‘R’ to protect children and youth from seeing cigarette smoking in movies.” Demographic data recorded in HINTS included each participant’s age, gender, and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian, or non-Hispanic other); income; educational level; sexual orientation; geographic location; marital status; child status (whether a participant had children or not); and political leanings. They also asked participants about cigarette smoking and e-cigarette use (both classified as current, former, or never).

A slight majority of the participants were female (50.2%,), whereas more than half (58.7%) were non-Hispanic White. Current cigarette smokers and current e-cigarette users constituted 13.6% and 6.3% of the participants, respectively.

Overall, 20.3% strongly opposed or opposed a policy designating R ratings for movies containing cigarette smoking, 30.3% were neutral, and 47.0% supported or strongly supported this idea.

Using weighted, multivariable logistic regression models to identify characteristics associated with neutrality or opposition, with support as the referent category, the researchers found noteworthy differences by age and race/ethnicity. Older adults (at least 50 years old) were significantly less likely than the younger adults (18–34 years old) to be opposed to or neutral regarding smoking as an R rating criterion. For example, participants aged 50–64 years were only 56% as likely to be opposed to or neutral regarding this proposal, whereas those aged 65–74 years or older than 75 years were 39% and 27% as likely, respectively. The only significant difference by race/ethnicity was that non-Hispanic Asians, relative to non-Hispanic Whites, were only 46% as likely to be neutral to or oppose the policy.

The researchers found no significant associations with any of the other independent variables, including gender, income, education, sexual orientation, marital status, geography, children in the household, political views, and even cigarette or e-cigarette use.

There has been a long-running battle between the tobacco industry and health organizations about cigarette smoking in movies and on television and other media.

Although the effect of smoking in films on teens was not a part of this study, “There is compelling evidence of a causal relationship between depictions of cigarette smoking in movies and youth smoking initiation,” says Dr Blake. “Policies enacted by the MPA to curb youth exposure to cigarette smoking in films have been limited or have expired.” She also notes that current classification and rating rules do not include cigarette smoking.

“Demonstrating broad public support for an R rating policy for movies with smoking, may influence the MPA’s consideration of R ratings.

“Our study demonstrates near-majority support and only 20.3% opposition among adults in the United States for a policy that would give movies with cigarette smoking an R rating,” she continues. “There is also a sizable amount of neutrality toward such a policy, suggesting a need for efforts to raise awareness of the value of R ratings for reducing adolescent smoking initiation and smoking overall.”

Nigar Nargis, PhD, senior scientific director of tobacco control research at the ACS, says that because the study provides recent evidence of near-majority modest support (and minimal opposition) for designating an R rating to all movies that depict cigarette smoking and because there is evidence of a causal pathway between depictions of cigarette smoking in movies and youth smoking initiation, this could be an important step in reducing youth initiation. She notes, however, that “the effectiveness of R rating of movies has yet to be evaluated as a tobacco control measure.”

“Although there may be some net benefit from such a policy, this is but one type of media that youth consume, and moreover I suspect those younger than 17 years old use social media more often and are likely exposed to tobacco use more often there,” continues Dr Nargis. She points to recent results from a systematic review and meta-analysis in JAMA Pediatrics (doi:10.1001/jama pediatrics.2022.2223) showing the relationship between exposure to tobacco content on social media and tobacco use. Dr Nargis also wonders whether an R rating could serve as more of a magnet than a deterrent when films are viewed at home from streaming services, especially if parental controls are not activated.

Dr Blake suggests that future research could examine public opinion toward policies that would limit exposure to depictions of other forms of tobacco products among youth and also explore public opinion toward measures that would restrict exposure to tobacco use on additional media platforms, particularly those with a substantial youth audience.

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几乎大多数成年人赞成将有吸烟情节的电影定为R级
该研究的作者Kelly D. Blake博士是健康信息国家趋势调查(HINTS)的主任,也是马里兰州贝塞斯达国家癌症研究所健康传播和信息学研究的健康科学家。他指出,自上次美国电影协会(MPA)对吸烟电影的R级指定进行全国代表性的公众支持评估以来,已经过去了近十年。“我们的研究增加了先前的评估,表明美国成年人的公众支持率正在逐渐上升,从2003年的40%,到2013年的45%,到2020年的47%。”美国国家癌症研究所研究人员的这项研究的主要目标是确定支持、矛盾或反对将吸烟描述为R级的充分标准的成年人的比例,并确定研究参与者的特征,这些特征与他们对这个问题的看法有关。研究人员使用了2020年HINTS的数据,这是一项由美国国立卫生研究院发起的全国性横断面邮政调查,调查对象为3865名18岁以上的人。该调查包括一个项目,评估对“为了防止儿童和青少年在电影中看到吸烟镜头,应该将有吸烟镜头的电影定为R级”的观点的支持、反对和中立。提示中记录的人口统计数据包括每个参与者的年龄、性别和种族/民族(非西班牙裔白人、非西班牙裔黑人、西班牙裔、非西班牙裔亚洲人或非西班牙裔其他);收入;教育水平;性取向;地理位置;婚姻状况;子女状况(参加者是否有子女);还有政治倾向。他们还询问了参与者吸烟和使用电子烟的情况(两者都分为现在、以前和从不)。大多数参与者是女性(50.2%),而超过一半(58.7%)的参与者是非西班牙裔白人。目前吸烟者和电子烟使用者分别占参与者的13.6%和6.3%。总的来说,强烈反对或反对的比例为20.3%,中立的比例为30.3%,支持或强烈支持的比例为47.0%。使用加权的多变量逻辑回归模型来识别中立或反对的相关特征,并将支持作为参考类别,研究人员发现年龄和种族/民族之间存在显著差异。与年轻人(18-34岁)相比,老年人(至少50岁)反对或对吸烟作为R级标准持中立态度的可能性要小得多。例如,50-64岁的参与者只有56%的人反对或持中立态度,而65-74岁或75岁以上的参与者分别为39%和27%。种族/民族的唯一显著差异是,非西班牙裔亚洲人相对于非西班牙裔白人,只有46%的人可能对该政策保持中立或反对。研究人员发现,与其他任何自变量,包括性别、收入、教育、性取向、婚姻状况、地理位置、家庭子女、政治观点,甚至香烟或电子烟的使用,都没有显著的关联。关于电影、电视和其他媒体中的吸烟镜头,烟草业和卫生组织之间一直存在一场旷日持久的斗争。虽然电影中吸烟对青少年的影响不是这项研究的一部分,“有令人信服的证据表明,电影中吸烟的描述与青少年开始吸烟之间存在因果关系,”布莱克博士说。“电影协会制定的限制青少年接触电影中吸烟镜头的政策已经受到限制或已经过期。”她还指出,目前的分类和评级规则不包括吸烟。“表明公众对含有吸烟内容的电影的R级政策的广泛支持,可能会影响电影管理局对R级的考虑。她继续说:“我们的研究表明,在美国成年人中,几乎大多数人支持将吸烟电影列为R级的政策,只有20.3%的人反对。”“也有相当多的人对这样的政策持中立态度,这表明有必要努力提高人们对R级对减少青少年开始吸烟和整体吸烟的价值的认识。”美国癌症协会烟草控制研究高级科学主任尼加尔·纳尔吉斯博士说,因为这项研究提供了最近的证据,几乎大多数人对所有描绘吸烟的电影都给予适度支持(反对意见很少),因为有证据表明电影中吸烟的描绘与青少年吸烟之间存在因果关系,这可能是减少青少年吸烟的重要一步。 然而,她指出,“作为一项烟草控制措施,电影R级的有效性还有待评估。”纳尔吉斯博士继续说道:“尽管这样的政策可能会有一些净收益,但这只是年轻人消费的一种媒体,而且我怀疑17岁以下的人更频繁地使用社交媒体,也可能更频繁地接触烟草。”她指出,JAMA Pediatrics (doi:10.1001/ JAMA Pediatrics .2022.2223)最近的一项系统综述和荟萃分析结果显示,接触社交媒体上的烟草内容与烟草使用之间存在关系。纳尔吉斯博士还想知道,当人们在家从流媒体服务上观看电影时,尤其是在没有启动家长控制的情况下,R级是否会起到更大的吸引作用,而不是起到威慑作用。布莱克博士建议,未来的研究可以调查公众对限制青少年接触其他形式烟草制品的政策的意见,并探讨公众对限制在其他媒体平台上接触烟草使用的措施的意见,特别是那些拥有大量青少年受众的媒体平台。
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来源期刊
CiteScore
873.20
自引率
0.10%
发文量
51
审稿时长
1 months
期刊介绍: CA: A Cancer Journal for Clinicians" has been published by the American Cancer Society since 1950, making it one of the oldest peer-reviewed journals in oncology. It maintains the highest impact factor among all ISI-ranked journals. The journal effectively reaches a broad and diverse audience of health professionals, offering a unique platform to disseminate information on cancer prevention, early detection, various treatment modalities, palliative care, advocacy matters, quality-of-life topics, and more. As the premier journal of the American Cancer Society, it publishes mission-driven content that significantly influences patient care.
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