Viewing movie smoking undermines antismoking parenting practices

To test the hypothesis that viewing depictions of smoking in movies makes adolescents less responsive to parenting factors that prevent smoking. Cross-sectional survey of 4807 students (grades 5-8) through which we ascertained exposure to smoking in movies, parent smoking, and adolescents' perception of parental responsiveness (support), and parental demandingness (behavioral control). Adolescents attending randomly selected middle schools in the Northeastern U.S. ever tried smoking a cigarette. Exposure to movie smoking was ascertained by counting occurrences of tobacco use in 601 recent popular motion pictures; surveying students to identify films they had seen from a random subset of 50 films; and summing tobacco use occurrences for the films each adolescent reported seeing. We also measured adolescents' perceptions of parent smoking, parental responsiveness and demandingness. The overall prevalence of adolescent smoking was 17.4 percent. The prevalence of smoking increased with exposure to movie smoking (low vs. high exposure 8.8 vs. 25.8%, p < 0.0001). Parenting factors associated with lower rates of adolescent smoking were parent non smoking status (11.0% vs. 27.7% for parents who smoke, p < 0.0001), higher levels of demandingness (13.7% vs. 20.7% for low demandingness, p < 0.0001) and higher levels of parental responsiveness (12.4% vs. 23.1% for low parental responsiveness, p < 0.0001). Parenting factors were not strongly associated with exposure to movie smoking. For adolescents with low exposure to movie smoking the adjusted odds (95% confidence interval) of smoking were 0.31 (0.23, 0.42) if parents did not smoke, 0.57 (0.42, 0.78) if parents exerted high demandingness, and 0.52 (0.38, 0.71) if parents were highly responsive. Parents had significantly less influence for adolescents with high exposure to movie smoking, for whom the adjusted odds of smoking were only 0.50 if parents did not smoke (p = 0.014 for the interaction effect), 0.97 if parents exerted high demandingness (p = 0.007 for the interaction effect) and 0.73 if parents were highly responsive (p = 0.045 for the interaction effect). Viewing smoking in movies not only has a direct association with adolescent smoking, it may also undermine parental attempts to prevent this behavior.