Prospective relationship between perceived prevalence of smoking in movies and smoking behavior during adolescence

Although research has shown that exposure to smoking in movies is associated with adolescent smoking, these studies have focused mainly on younger adolescents and have only measured exposure to smoking in movies at one point in time. The relationship between the exposure and smoking throughout adolescence has not been examined. We assessed the prospective associations between the perceived prevalence of smoking in movies and smoking behavior among adolescents as they age. Data are from the Minnesota Adolescent Community Cohort Study where teenagers aged 12 to 16 were recruited in 2000 and 2001 and surveyed every six months. We analyzed data from 4043 teenagers from when they entered the study at ages of 12.5 to 16 until they turned 18. We used structural equation models to evaluate the prospective association between prevalence of smoking in movies as perceived by teenagers (four levels) and smoking stage (six stages, from never to established smoker), measured every six-months, adjusting for demographic factors and age cohort. We found that prevalence of smoking in movies as perceived by adolescents consistently predicted smoking stage six months later, but not vice versa. Such perception consistently predicted smoking stage in younger ages (13.5 through 15.5), but not in older ages (16 through 17.5). Our results suggest that the association between smoking in movies and adolescent smoking is mostly unidirectional and primarily during younger adolescence. Interventions to eliminate or minimize exposure to smoking in movies should therefore focus on younger adolescents to reduce the prevalence of adolescent smoking.