Prevalence and correlates of US adult opinions on restricting exposure of children to smoking in movies: The 2020 Health Information National Trends Survey

Abstract

INTRODUCTIONLegislative policies aimed at curbing early exposure to smoking among youth are a crucial public health strategy. Yet little is known about US adults' public opinion on restricting exposure of children to movies depicting smoking. This study sought to characterize US adults' levels of support to restrict the exposure of children to smoking in movies and explore associations with sociodemographic characteristics. METHODS We used cross-sectional data from the 2020 Health Information National Trends Survey (HINTS, n=3750) of adults in the United States to estimate the prevalence of opinions toward restricting the exposure of children to smoking in movies and examine correlates of support using weighted logistic regression. RESULTS In all, 48.2% of adults endorsed a supportive opinion. In multivariable logistic regression analysis, the odds of endorsing a supportive opinion were higher among Black/African American adults (OR=1.61; 95% CI: 1.04-2.49, p=0.033), and Hispanics (OR=1.78; 95% CI: 1.17-2.72, p=0.008) when compared to Whites. Similarly, compared to those aged 18-34 years, the odds of endorsing a supportive opinion were also greater among those aged 50-64 years (OR=2.15; 95% CI: 1.43-3.24, p<0.001) or aged ≥65 years (OR=3.83; 95% CI: 2.31-6.36, p<0.001). Higher odds for support were observed among those exposed to federal court-ordered anti-smoking tobacco messages (OR=1.37; 95% CI 1.06-1.78, p=0.018) and among those who reported using social media to share health information (OR=1.51; 95% CI: 1.02-2.23, p=0.041). CONCLUSIONS Only 48% of US adults endorsed support for restricting the exposure of children to smoking in movies. This study has identified subgroups of US adults for whom tailored communication interventions may increase support for policies that protect children from early initiation of smoking.

Predictors of U.S. Adults’ Opinion Toward an R-Rating Policy for Movies With Cigarette Smoking

“…This study sought to expand the literature on this issue by assessing the extent to which U.S. adults are supportive, neutral, or opposed to a default R-rating policy for movies with cigarette smoking; it also explored various predictors of support, neutrality, and opposition toward such a policy. Our findings indicate that almost half (48.2%) of U.S. adults support a R-rating policy for movies depicting cigarette use, which is relatively close to the upper limit (40.0%–48.2%) of what has been reported in other studies (Blake et al, 2010; Lama et al, 2022; McMillen, 2020; Oghenetega et al, 2022). We also found that there is more neutrality than opposition (31.1% vs. 20.7%) to such a policy, which could be due to a lack of public understanding regarding the link between depictions of cigarette smoking in movies and subsequent youth smoking initiation.…”

“…Finally, each respondent’s political viewpoint was assessed using the item: “Thinking about politics these days, how would you describe your own political viewpoint?” The original response categories included: “very liberal,” “liberal,” “somewhat liberal,” “moderate,” “somewhat conservative,” “conservative,” and “very conservative.” Due to the small cell counts for certain subcategories and for analysis purposes, we recoded the responses into three categories: “liberal” (very liberal, liberal, somewhat liberal), “moderate,” and “conservative” (very conservative/ conservative/ somewhat conservative). Furthermore, given that “social media” can be used as a platform for tobacco-specific communication designed to increase policy support (Oghenetega et al, 2022), we included this variable in our analysis. We assessed each respondent’s social media use using the item: “In the last 12 months, have you used the internet to visit a social networking site, such as Facebook or LinkedIn?” The response categories were “yes” and “no.”…”

“…Due to the small cell counts for certain subcategories and for analysis purposes, we recoded the responses into three categories: "liberal" (very liberal, liberal, somewhat liberal), "moderate," and "conservative" (very conservative/ conservative/ somewhat conservative). Furthermore, given that "social media" can be used as a platform for tobaccospecific communication designed to increase policy support (Oghenetega et al, 2022), we included this variable in our analysis. We assessed each respondent's social media use using the item: "In the last 12 months, have you used the internet to visit a social networking site, such as Facebook or LinkedIn?"…”