Objective. Despite voluntary restrictions prohibiting direct and indirect cigarette marketing to youth and paid product placement, tobacco use remains prevalent in movies. This article presents a systematic review of the evidence on the nature and effect of smoking in the movies on adolescents (and others). Methodology. We performed a comprehensive literature review. Results. We identified 40 studies. Smoking in the movies decreased from 1950 to ∼1990 and then increased rapidly. In 2002, smoking in movies was as common as it was in 1950. Movies rarely depict the negative health outcomes associated with smoking and contribute to increased perceptions of smoking prevalence and the benefits of smoking. Movie smoking is presented as adult behavior. Exposure to movie smoking makes viewers' attitudes and beliefs about smoking and smokers more favorable and has a dose-response relationship with adolescent smoking behavior. Parental restrictions on R-rated movies significantly reduces youth exposure to movie smoking and subsequent smoking uptake. Beginning in 2002, the total amount of smoking in movies was greater in youth-rated (G/PG/PG-13) films than adult-rated (R) films, significantly increasing adolescent exposure to movie smoking. Viewing antismoking advertisements before viewing movie smoking seems to blunt the stimulating effects of movie smoking on adolescent smoking. Conclusions. Strong empirical evidence indicates that smoking in movies increases adolescent smoking initiation. Amending the movie-rating system to rate movies containing smoking as “R” should reduce adolescent exposure to smoking and subsequent smoking.

Objective-To assess the print media coverage of California's smokefree bar law in the state of California. Design-Content analysis of newspaper, trade journal, and magazine items. Subjects-Items regarding the smokefree bar law published seven months before and one year following the implementation of the smokefree bar law (June 1997 to December 1998). Items consisted of news articles (n = 446), opinion editorials (n = 31), editorials (n = 104), letters to the editor (n = 240), and cartoons (n = 10). Main outcome measures-Number and timing of publication of items, presence of tobacco industry arguments or public health arguments regarding law, positive, negative, and neutral views of opinion items published. Results-53% of items published concerning the smokefree bar law were news articles, 47% were opinion items. 45% of items regarding the smokefree bar law were published during the first month of implementation. The tobacco industry dominated coverage in most categories (economics, choice, enforcement, ventilation, legislation, individual quotes), except for categories public health used the most frequently (government role, tactics, organisational quotes). Anti-law editorials and letters to the editor were published more than pro-law editorials and letters. Region of the state, paper size, presence of local clean indoor air legislation, and voting on tobacco related ballot initiatives did not have an impact on the presence of opinion items. Conclusions-The tobacco industry succeeded in obtaining more coverage of the smokefree bar law, both in news items and opinion items. The tobacco industry used historical arguments of restricting freedom of choice and economic ramifications in fighting the smokefree bar law, while public health groups focused on the worker protection issue, and exposed tobacco industry tactics. Despite the skewed coverage, public health groups obtained adequate attention to their arguments to keep the law in eVect. (Tobacco Control 2001;10:154-160)

ObjectiveDescribe the attitudes, beliefs, and practices of U.S. obstetricians on the topic of prenatal environmental exposures.Study DesignA national online survey of American Congress of Obstetricians and Gynecologists (ACOG) fellows and 3 focus groups of obstetricians.ResultsWe received 2,514 eligible survey responses, for a response rate of 14%. The majority (78%) of obstetricians agreed that they can reduce patient exposures to environmental health hazards by counseling patients; but 50% reported that they rarely take an environmental health history; less than 20% reported routinely asking about environmental exposures commonly found in pregnant women in the U.S.; and only 1 in 15 reported any training on the topic. Barriers to counseling included: a lack of knowledge of and uncertainty about the evidence; concerns that patients lack the capacity to reduce harmful exposures; and fear of causing anxiety among patients.ConclusionU.S. obstetricians in our study recognized the potential impact of the environment on reproductive health, and the role that physicians could play in prevention, but reported numerous barriers to counseling patients. Medical education and training, evidence-based guidelines, and tools for communicating risks to patients are needed to support the clinical role in preventing environmental exposures that threaten patient health.

Smoke-free ordinances do not appear to adversely affect, and may increase, tourist business.

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