Bruce Davis, March 17 2015 Chair, Ontario Film Review Board Ministry
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2 Carlton Street, Suite 1306 Toronto, Ontario M5B 1J3 Tel: (416) 595-0006 Fax: (416) 595-0030 E-mail: [email protected] alPHa’s members are the public health units in Ontario. Bruce Davis, March 17 2015 Chair, Ontario Film Review Board Ministry of Government and Consumer Services alPHa Sections: Consumer Protection Branch, Boards of Health 4950 Yonge St. Section Toronto ON M2N 6K1 Council of Ontario Medical Officers of Dear Mr. Davis, Health (COMOH) Re: Tobacco in Movies – Background Papers Affiliate Organizations: On behalf of the Council of Ontario Medical Officers of Health (COMOH) Smoke- ANDSOOHA - Public Free Movies Working Group, I am pleased to provide you with a binder of Health Nursing selected materials that we believe make a clear case for reducing the exposure of Management youth to tobacco imagery in films. Association of Ontario Public Health Business Administrators We hope that the evidence that we have provided here is helpful in convincing you, your colleagues and the film industry at large about the importance of this Association of issue and of the simple interventions that are available to start saving countless Public Health Epidemiologists lives. in Ontario We are extremely appreciative of your willingness to engage with us on this issue Association of Supervisors of Public in recent weeks and your receptiveness to discussions of how to move toward Health Inspectors of acceptable and effective solutions. Ontario Health Promotion Best regards, Ontario Ontario Association of Public Health Dentistry Ontario Society of Nutrition Professionals Dr. Charles Gardner, in Public Health Medical Officer of Health, Simcoe-Muskoka District Health Unit Lead, COMOH Smoke-Free Movies Working Group. www.alphaweb.org Providing Leadership in Public Health Management Reducing the Exposure to Onscreen Tobacco in Movies among Ontario Youth: Selected Background Papers Binder Contents (Please note: Page numbers are taken from the electronic version of this document. Pages themselves are not numbered). 1. Reducing the Exposure to Onscreen Tobacco in Movies among Ontario Youth: Discussion of potential for changes to Ontario’s film rating system to include the depiction of tobacco (Background Information for Feb 25 meeting with OFRB Chair. Includes alPHa Resolution A11-11, MLHU and Peel recommendations and the Executive Summary of the OTRU Report) pp.1-11 2. Ontario Coalition for Smoke Free Movies: The Impact of Smoking in Movies on Children and Youth pp. 12-15 3. Ontario Coalition for Smoke Free Movies: Ontario Public Survey Results March 2011 (public perception regarding smoking in movies, how exposure to smoking in movies impacts teenagers as well as public support for policy initiatives to reduce youth exposure to on-screen tobacco) p. 16 4. Interventions to Reduce the Impact of Smoking in Movies (Peel Public Health - Overview) p. 17 5. Interventions to Reduce the Impact of Smoking in Movies: A Rapid Review (Peel Public Health - Full Report) pp. 18-72 6. Smoking in the Movies. (Centers for Disease Control Findings 2013) pp. 73-77 7. Smoking in Top Grossing Movies – United States, 1991-2009 (August 20, 2010 MMWR Excerpt) pp. 78-81 8. Role of Entertainment Media in Promoting or Discouraging Tobacco Use (National Cancer Institute Monograph) pp. 82-153 9. Exposure to Onscreen Tobacco in Movies Among Ontario Youth, 2004-2013 (Ontario Tobacco Research Unit Report) pp. 154-186 10. Preventing Tobacco Use Among Youth and Young Adults (Report of the Surgeon General - Executive Summary) pp. 187-208 11. Smoke-Free Movies: From Evidence to Action (World Health Organization Report 2011) pp. 209-251 12. Smoke-Free Movies: Go Deeper (A bibliography) pp. 252-263 Reducing the Exposure to Onscreen Tobacco in Movies among Ontario Youth: Discussion of potential for changes to Ontario’s film rating system to include the depiction of tobacco Background Information February 25 2015 Ministry of Government and Consumer Services Ontario Film Review Board/Theatres Regulation Unit 4950 Yonge Street, Suite 101 B PARTICIPANTS: Bruce Davis, Chair, Ontario Film Review Board (OFRB); Dr. Charles Gardner, Medical Officer of Health, Simcoe-Muskoka District Health Unit; Dr. Alex Hukowich, Medical Officer of Health (A), Northwestern Health Unit; Dr. Christine Kennedy, Associate Medical Officer of Health, Grey – Bruce Health Unit; Dr. Chris Mackie, Medical Officer of Health, Middlesex-London Health Unit; Dr. Ninh Tran, Associate Medical Officer of Health, City of Hamilton Public Health Services; Dr. Megan Ward, Associate Medical Officer of Health, Peel Public Health; Gordon Fleming, Manager Public Health Issues, Association of Local Public Health Agencies (alPHa). Exposure to Onscreen Tobacco: Recommendations for the Ontario Film Review Board Issue The World Health Organization recommends five policy actions to reduce youth exposure to tobacco imagery in movies. The Ontario Film Review Board (OFRB) is in a position to act on the adult rating (18A in Ontario) and to assist parents in placing parental restrictions on adult-rated movies. This briefing provides an overview of the policy recommendations and suggestions for the OFRB to address the issue. Background There is a strong and causal relationship between child and youth exposure to tobacco imagery in movies and the initiation and progression to regular smoking.1 Movies remain one of the only remaining areas where there is a lack of regulation regarding product placement. The number of youth-rated films with tobacco depictions is higher in Canada than the United States due to differences in film classification systems. In a recent study, 86% of movies with tobacco released in 2004-2013 were youth-rated in Ontario compared to only 54% in the United States.5 Assigning an R rating (18A in Ontario) to future movies with smoking would be expected to reduce the number of teen smokers by nearly 1 in 5 (18%) and prevent one million deaths from smoking among children alive today.4 In Ontario, tobacco use is currently included as a ‘content advisory’ and ‘detailed observation’, but is not a criterion when rating movies. An analysis of the OFRB ‘content advisories’ found that only 11% of the movies that independent monitors identified as containing tobacco received a ‘content advisory’ from the OFRB.5 There were also discrepancies between the number of movies with tobacco use ‘detailed observations’ issued by the OFRB and the number of movies with tobacco imagery identified by independent monitors.5 There are known effective interventions to reduce the impact of exposure to tobacco imagery in movies on smoking intention and initiation. A rapid review completed by Peel Public Health identified the following effective interventions: 1. Parental restrictions on adult-rated movies 2. Assign an adult-rating (18A in Ontario) to movies that contain tobacco imagery 3. Place anti-smoking ads prior to movies with tobacco imagery The World Health Organization (WHO) recommends five policy actions to reduce the exposure of children and youth to smoking in movies. The recommendations support Article 13 of the Framework Convention on Tobacco Control, which Canada has signed, which calls for a comprehensive ban on all tobacco advertising, promotion and sponsorship2: 1. Require adult ratings (18A in Ontario) for films with tobacco imagery 2. Require strong anti-smoking ads prior to movies depicting tobacco use 3. Certify no payoffs have been given in exchange for the depiction of tobacco use in a movie. 4. Stop identifying tobacco brands 5. Make productions with smoking ineligible for public subsidy As producers leave tobacco imagery out of films in order to obtain a youth rating in their domestic markets, these films will reduce overall exposure of youth to on-screen tobacco use in films released globally by major distributors.2 There is public support to address this issue. A survey of Ontarians 18 years of age and over indicated that 73% would support a policy to not allow smoking in movies that are rated G, PG or 14A.6 In Ontario there is strong municipal political support. The Association of Local Public Health Agencies (alPHa) as well as 27 public health units have passed resolutions in support of the WHO policy recommendations. Several organizations in Ontario from the broader health sector (e.g., Canadian Cancer Society, Heart and Stroke Foundation and Ontario Lung Association) have also submitted formal letters indicating their support. Many national and international organizations are advocating for increased knowledge of the impact of tobacco imagery in movies on children and youth as well as policies and interventions aimed at reducing tobacco exposure in movies. The United States, China, India, the UK, Malaysia, Kenya, Nigeria and South Africa have all initiated country-specific responses to address this worldwide issue.2 In addition, the International Week of Action on Smoke-free Movies is scheduled during the same week of the Academy Awards in order to take coordinated action globally. Recommendations for the OFRB The OFRB can take action to protect Ontario’s youth through the following actions: 1. Strengthen the ‘content advisory’ process to ensure that all movies containing tobacco imagery are assigned a content advisory. Prepared by: Peel Public Health Last updated: February, 2015 2. Assign an adult-rating (18A in Ontario) for all future movies that contain tobacco imagery. References 1) U.S. Department of Health and Human Services (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease and Health Promotion, Office of Smoking and Health. 2) World Health Organization (2011). Smoke-free movies: from evidence to action – 2nd edition. Geneva, Switzerland: World Health Organization Press. 3) Peel Public Health (2012). Interventions to reduce the impact of smoking in the movies on the smoking behaviours of youth: A rapid review. Mississauga, ON. 4) U.S. Department of Health and Human Services (2014).