Smokescreens and the Silver Screen: Smoking in the Media

Artwork by Dorothy L. © 2010 American Academy of Pediatrics (AAP) Children's Art Contest. Support for the 2009 and 2010 AAP Children's Art Contest was from the Flight Attendant Medical Research Institute.

WELCOME

Continuing Medical Education Credit• The American Academy of Pediatrics (AAP) is accredited by the Accreditation

Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

• The AAP designates this live activity for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• This activity is acceptable for a maximum of 1.50 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

• The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.50 hours of Category 1 credit for completing this program.

• This program is accredited for 1.50 NAPNAP CE contact hours of which 0 contain pharmacology (Rx) content per the National Association of Pediatric Nurse Practitioners (NAPNAP) Continuing Education Guidelines.

At the conclusion of this activity, participants should be able to:

• Describe tobacco imagery and how it is used in different forms of media

• Discuss the influence of tobacco imagery on children and evidence for tobacco use initiation

• Explain how to implement strategies to discuss the impact of tobacco imagery with children, adolescents, and families in a pediatric clinical setting

• Articulate the need for reducing children’s exposure to tobacco imagery in the media

Smokescreens and the Silver Screen: Smoking in the Media

Artwork by Dorothy L. © 2010 American Academy of Pediatrics (AAP) Children's Art Contest. Support for the 2009 and 2010 AAP Children's Art Contest was from the Flight Attendant Medical Research Institute.

WELCOME

Disclosure Statement

• Neither I nor any member of my immediate family has a financial relationship or interest (currently or within the past 12 months) with any entity producing health care goods or services consumed by, or used on, patients related to the content of this CME activity.

• I do not intend to discuss an unapproved/investigative use of a commercial product/device.

Registration Questions: Common Themes

• Clinicians a good resource to discuss tobacco imagery in media with parents and families: 78%

• Seeing smoking and/or tobacco use in media can directly influence tobacco use initiation among children and adolescents: 98%

Viewing the following topics in the media can have an impact on child behavior

0

50

100

150

200

250

Drinking Smoking/tobacco

use

Violence Bullying All Unsure None

N= 194

160

165

170

175

180

185

190

195

‘Media’ can be classified as the following

N= 194

Jim Sargent, MD, FAAP

Disclosure Statement

• Neither I nor any member of my immediate family has a financial relationship or interest (currently or within the past 12 months) with any entity producing health care goods or services consumed by, or used on, patients related to the content of this CME activity.

• I do not intend to discuss an unapproved/investigative use of a commercial product/device.

Jennifer Shu, MD, FAAP

Disclosure Statement

• Neither I nor any member of my immediate family has a financial relationship or interest (currently or within the past 12 months) with any entity producing health care goods or services consumed by, or used on, patients related to the content of this CME activity.

• I do not intend to discuss an unapproved/investigative use of a commercial product/device.

Smoking and the Media

The Role of Clinicians and Families

Jennifer Shu, MD, FAAPChildren’s Medical Group Atlanta

Why reduce exposure?

• Young people are target demographic

• Everyday in US, 3,800 people under 18 smoke their first cigarette, and about 1,000 become daily cigarette smokers.

• 88% of smokers started by age 18, 99% by age 26

• School age: 5% middle schoolers smoke

• Adolescents: Almost 20% high schoolers smoke

• Children exposed to tobacco imagery from young age: Movies, books, music lyrics, video games, TV shows, magazines, sporting events….

Why reduce exposure?

• Tobacco imagery exposure increases likelihood of becoming a smoker

• 2012 Surgeon General report: “causal relationship between depiction of smoking in movies and initiation of smoking among young people”

• UCSF study: smoking portrayals up in 2011 after a 5-year downward trend

• 44% teen smoking due to on-screen exposure

Tobacco and Movies

• Youth-rated movies G, PG, PG-13

• CDC: Almost one-half (45%) of top-grossing films in the United States between 2002 and 2012 were rated PG-13, making them easily accessible to youth.

• Low amount of smoking in G and PG movies (30 incidents in 2010 and 23 in 2012), but total tobacco incidents in youth-rated movies and incidents per youth-rated movie doubled between 2010 (1819) and 2012 (2818).

Tobacco Incidents in Movies

G-rated Movie

Pinocchio

PG-rated movie

Rango

PG-13

The Hobbit

Movies

• Know before you go: Research films prior to watching– CommonSenseMedia.org (non-partisan, not-for-profit

organization with its own reviewers)

– IMDB.com Parents Guide section (registered user comments)

Movie Strategies

• Talk about tobacco imagery after the movie

• Support motion picture companies with strong anti-tobacco policies

• Lobby legislators and appeal to other moviemakers to reduce tobacco imagery

• Consider automatic R rating for use of tobacco

Music Do you know what your kids are listening to?

Rihanna’s single cover for “Diamonds”

Books

• Smoking seen in 18 of 44 classic books and 4 of 40 contemporary books (2004 study)

Video Games

Puff Puff Pass

MyAshtray

Video Games/Apps

iRollUp

iSmoke

Talking to Families

• Discuss media early and often—anticipatory guidance at newborn and future visits

• TV is the gateway to other media

• Watch together!

• Easier to limit than to remove once started

Early Childhood

• AAP: Avoid screens in children under 2

• 90% children under 2 watch TV

• 1/3 of children under 3 have a TV in their room

• Under 2: turn off background TV– Displacement effect– Effects on language development

Children and Media

• Limit total screen time for children older than 2 years to no more than 1 to 2 hours per day

• Keep screens out of children’s rooms (TVs, computers, iPads, cell phones)

• Co-view media with children and teenagers and discuss the content

Substance Use and Media

• On prime-time television, 19% portray tobacco use (1/4 in negative light)

• Smoking in nearly 1/4 of all music videos

• Smoking in 1/4 of ads for R-rated movies and 7.5% of ads for PG and PG-13 movies

• Teens constitute 26% of movie audience but 16% of population

• Television venues with excessive substance use depictions include MTV, HBO, Showtime, Comedy Central, etc.

Talking about Tobacco

• HHS Office of Adolescent Health--Find teachable moments:– If your child/teen is going to be where tobacco might be

used, talk about how to deal with the situation.– Comment on an advertisement or TV show that shows

someone smoking.– If you see someone using tobacco—such as a relative at a

family gathering or one of your own friends—ask your child what he thinks about it.

– Discuss rules about tobacco use at the school or on sports teams.

Advocacy

• Pediatrician and family advocacy and involvement: lobby federal, state and local jurisdictions

• Counteradvertising mass-media campaigns

• School-based policies and programs (e.g., tobacco-free campuses, teaching refusal skills)

• Community interventions to reduce tobacco advertising, promotions (hats, T-shirts), and commercial availability of tobacco products

• Higher costs for tobacco products

Resources

Surgeon General report 2012http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-

use/index.htmlCenters for Disease Control and Prevention Office on Smoking and Health http://cdc.gov/tobaccoUS Dept. of Health and Human Serviceshttp://betobaccofree.govStanton Glantz, PhD, University of California San Francisco

http://smokefreemovies.ucsf.eduAAP Council on Communications and Mediahttp://www2.aap.org/sections/media/resources.cfmCenter on Media and Child Healthhttp://cmch.typepad.com

Advocacy

J. Gary Wheeler, MD, FAAP

Step One

• Be passionate

• Be prepared to be persistent

Step Two

• Get informed– Basic information

• Smoke Free Movies• Richmond Center• Campaign for Tobacco Free Kids• CDC• Americans for Non-smoker’s Rights

– Identify Partners• Public health units• ACS, AHA, ALA• Academics• State/local coalitions

Step three

• Recognize your role– You have credibility– You are the expert on child and youth health

• Complications of tobacco use• Youth behavior (modeling, impulsivity, etc)

– You may have to follow• Know what you don’t know

Step Four

• Go to Work/Act Now– Office environment: counter messages– Teach partners– Strategize

1) Local theatres• PTA/schools• The Big Pitch• Resolutions• Film subsidies

Questions?

Artwork by Emily L. © 2009 American Academy of Pediatrics (AAP) Children's Art Contest. Support for the 2009 and 2010 AAP Children's Art Contest was from the Flight Attendant Medical Research Institute.

2013 AAP Children’s Art Contest!

• US entries: grades 3-5, 6-8, 9-12

• International entries: ages 13-18

• Winners receive up to USD500

• Lesson planning info available for educators

www.aap.org/artcontest

AAP Richmond Center• Visit us: www.aap.org/richmondcenter

– Tobacco Prevention Policy Tool– Tobacco coding fact sheet – State-specific resources– Funding opportunities– Tobacco control listserv– Downloadable PowerPoint presentations

• Contact us: richmondcenter@aap.org

www.facebook.com/aaprichmondcenter