378 Tobacco Control 1999;8:378–386 Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from Hollywood on tobacco: how the entertainment industry understands tobacco portrayal

David L L Shields, Julia Carol, Edith D Balbach, Sarah McGee

Abstract with writers, actors, directors, producers, and Objective—To determine how people in others involved in the television and movie the California-based entertainment in- industries, we investigated the Hollywood dustry think about the portrayal of “culture” as it relates to on-camera tobacco tobacco use in movies and on television. use. Specifically, we were interested in who Specifically, to explore who decides when decides when to include tobacco in a project, to include tobacco in a project; how that how that decision is made, what issues are con- decision is made; what issues are sidered in making that decision, what messages considered; what messages are intended; are intended, whether and how the issue of whether and how the issue of secondhand secondhand smoke is considered, and what smoke is considered; and what advocacy advocacy methods might be useful in influenc- methods might be useful in influencing ing future decisions about tobacco portrayal. future decisions about tobacco portrayal. Design—Qualitative in-depth interviews Method of entertainment industry personnel,with DATA COLLECTION AND ANALYSIS a semi-structured interview protocol to During autumn 1997, we developed an guide the interview. open-ended interview protocol, tested it, and Subjects—54 subjects drawn from a conducted 14 telephone pilot interviews with convenience sample of writers, actors, members of the film industry. Each interview directors, producers, studio executives, was audiotaped, although only nine tapes were and others involved in the film industry. transcribed due to taping problems. The tran- Results—Hollywood is heterogeneous scriptions were read by all members of the with varying perspectives on rates of research team to identify a preliminary list of tobacco use portrayal; intentionality of the themes. In the main phase of the research decision to use and the necessity to (spring 1998), we conducted 37 additional http://tobaccocontrol.bmj.com/ portray tobacco use; and its degree of interviews using a modified interview protocol. acceptance of responsibility for influenc- Interviews were conducted either by members ing societal smoking. Tobacco depiction of the research team or by an outside consult- may originate with the writer, actor, or ant who had greater access to film and director and is included most frequently television personnel. Each interview of 20 to elucidate character or portray reality. minutes to one hour duration was transcribed. On-camera smoking is influenced by From the transcriptions, we identified themes actors’ oV-camera tobacco use. and used NUD*IST, a computer program Conclusions—The research presented can designed to assist qualitative data analysis, to help advocates better understand the keep track of the themes through use of a cod- norms and values of those working within ing scheme; this scheme was continuously

the entertainment industry and thereby revised and expanded in response to new inter- on September 29, 2021 by guest. Protected copyright. assist them in creating more eVective views. We continued to conduct and code change strategies. interviews until we reached theoretical (Tobacco Control 1999;8:378–386) saturation—the point at which little new infor- mation was being derived from additional Keywords: films; movies; television; tobacco use interviews. All interviews were then re-coded by at least two members of the research team American Nonsmokers’ Rights Introduction using the final coding scheme. Foundation, Berkeley, Adult smoking rates in the United States have We then conducted a detailed textual analy- California, USA declined substantially in recent decades. sis to find recurring themes, common assump- D L L Shields J Carol Awareness of the dangers of secondhand tions, and points of interpretive disagreement S McGee smoke has increased, and the number of public and wrote summary statements for each code, areas in which smoking is allowed continues to attempting to encapsulate the various perspec- Tufts University, decrease, along with the social acceptability of tives held by our interviewees. An independent Medford, 1–3 Massachusetts, USA smoking. In contrast to these changes, facilitator presented a summary of our key E D Balbach research has documented that smoking was findings to a focus group of eight members of three times more prevalent in movies than in the entertainment industry, none of whom had Correspondence to: 4 Julia Carol, ANR the general population from 1960 to 1990, been interviewed previously. The focus group Foundation, 2530 San Pablo and smoking in films and on television had the opportunity to confirm, disconfirm, or Avenue, Suite J, Berkeley, 5 California 94702, USA; increased in the 1990s. amplify the findings. This discussion was also [email protected] This study was designed to learn how and transcribed, coded, and entered into the Received 1 May 1999 why tobacco use is portrayed as it is on televi- database. Finally, where significant diVerences Accepted 24 June 1999 sion and in the movies. Through interviews of opinion were evident in our data, we Hollywood on tobacco 379 Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

Table 1 Professional experience of subjects by age and sex* headings and conclude with comments about the implications of our study for tobacco Age/sex Actor Writer Director Producer Other control. <40 years Male 7 3 3 4 4 Female 5 3 0 3 2 RATES OF PORTRAYAL >40 years Research suggests that smoking in the movies Male 1 8 3 5 4 has increased over the past decade.5 People’s Female 5 4 2 11 7 impressions, however, may diVer from * Subjects may be included in more than one occupational objective rate counts. When asked about trends category if they have had significant experience in more than one; however, we limited each person to no more than two in on-camera smoking, several interviewees primary occupational roles. spontaneously compared current rates to the “classic” periods of film and television, conducted computer runs to explore suggesting that there is less smoking now on hypotheses about how these diVerences might television than in the ’50s and ’60s and less in relate to demographic characteristics. film than in the ’30s and ’40s. They uniformly We also reviewed television interviews with attributed the decline to greater public entertainment industry personnel, attended awareness of the health hazards of smoking and and reviewed the transcript of a political hear- a social trend away from approval of tobacco ing that dealt with tobacco use in film, use. reviewed the relevant literature, and kept “Look at films in the ’30s and ’40s. Everyone had abreast of the work of others. This review of a drink in one hand and a cigarette in the other. other source material helped us to confirm our That was part of the culture and it was supposed findings. to be glamorous. And it was also because actors needed props to hold in their hand and that’s still INTERVIEWEES the case. But I think there’s probably in the last All study participants were drawn from the 10 years been a lot less smoking and I think that California-based entertainment industry. To has a lot to do with the actors. As much as obtain the initial study participants, the Ameri- anything else, they just try not to smoke like eve- rybody else who’s stopped smoking.” can Nonsmokers’ Rights Foundation mailed Female, producer, film “contact forms” to its members and When asked specifically about the trends in colleagues. In the second phase of the study, the past decade or so, the answers were quite participants were obtained in multiple ways. diVerent for television and film. Most thought Some were identified through the contact list there had been a decrease on television, though built up during the first phase, some by third several had not noticed any change; only one parties familiar with the research, and some by thought smoking had increased. Those who other study participants. Most, however, were thought there had been a decrease attributed it http://tobaccocontrol.bmj.com/ contacted by a public relations firm hired to to the networks’ standards and practices (a set assist with the project. Every eVort was made of guidelines about what may be depicted to obtain a broad cross-section of Hollywood. on-camera), the quick pace at which television Altogether, we analysed transcribed inter- scenes move, the general unpopularity of views with 54 members of the entertainment smoking among the public, the need for main industry: 28 men and 26 women, ranging in characters to be likeable, and to the California age from 24 to 65 with a mean age of 40. At the law requiring most workplaces, including time of their interviews, nine were smokers, 13 television production sets, to be smokefree. were former smokers, 30 were non- Those interviewed were much more divided smokers,and two of unknown smoking status. over recent trends in film. Most thought there Twenty interviewees worked primarily in the had been a recent increase, which nearly every- movie industry, 19 in television, and another one attributed to an increase in independent on September 29, 2021 by guest. Protected copyright. 15 worked in both media (table 1). films and the popularity of gritty images. Several also noticed an increase in smoking in Results films targeting audiences under 40. Our intent was to provide a description of the “It seems like there’s an increase in smoking in influence of Hollywood’s “culture” on tobacco films, especially with 20-somethings, 30- portrayal. In the course of our study, however, somethings ...Inalotoftheindependent we learned that the industry is quite diverse, [films] . . . it’s almost like if they’re not smoking, fluid, segmented, and heterogeneous, with it’s unusual.” people frequently shifting occupational roles. Female, producer, television There is a substantial diVerence between the Several interviewees thought there had been norms and practices of the film and television a decrease recently, and several had not noticed industries. The television industry appears to a change either way. When told of the research be more hierarchical, structurally stable, and indicating an increase, those who had felt there internally integrated than does the film had been a decrease were inclined to question industry. Perhaps because television program- the science of these reports. ming is carried across the public airways and must seek corporate advertising, it tends to be PRODUCT PLACEMENT more “mainstream” in its content and values. Before 1989, it was common for tobacco com- As a result, in reporting these results, we panies to pay to have their products included in identify people by occupation and by media entertainment programs.6 Sylvester Stallone, and try to capture the diversity of the industry. for example, agreed to use Brown and We present our findings under 10 main Williamson tobacco products in no less than 380 Shields, Carol, Balbach, et al Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

five feature films for a fee of US$500 000.7 In are also writers, which increases their influence response to widespread criticism, in 1989 the in the decision-making process. As one industry voluntarily agreed to stop all paid respondent observed, “In movies the director tobacco product placements, although internal is king or the star is king, but in television it’s tobacco industry documents suggest that very much a producer’s medium because the placements may have continued well into the producers are usually the writers.” 1990s.8 For cigars, paid product placement 9 continued at least until 1998. WHY IS TOBACCO USED IN FILM? No interviewee spontaneously suggested The reasons for tobacco depiction generally paid product placement as a reason for why fell within two categories. Some reasons such tobacco use is included in entertainment as character development stem from the inter- media products. When queried about it nal logic of the project itself. These reasons are directly, however, many of our interviewees connected to artistic judgments made by those said they thought it occurred, although none responsible for the creative development of the had any first-hand knowledge of it. A typical project. Other reasons (such as if an actor per- comment: sonally smokes) are more external to the artis- “I’m sure it exists. I don’t want to believe it exists, tic process. but I know how much product placement there is in the world, and I believe that the tobacco lobby is powerful and strong and rich.” Intrinsic reasons for portrayal of tobacco use Male, producer, film By far the most frequently cited reason for No one thought product placement played a tobacco depiction was that it helped to develop prominent role in determining whether or reveal some aspect of the character: tobacco use would be depicted. Rather, “If a character is slightly manic or out of control respondents believed that if smoking was to be or nervous, you can visualize that very clearly by depicted, then either placement deals or prod- people having cigarettes in their hands and . . . uct donations might determine the brand, par- you can create visually a tremendous sense of tension or conflict or whatever by having people ticularly among independent film producers: use a cigarette and, also, by the way they smoke “They [independent producers] charge most of it, whether it is with a certain kind of desperation their post production on their credit cards. So or intensity.” they’re happy to get a bone from wherever they Male, director, film can get a bone. And if that means putting a pack Most industry personnel see the cigarette as of Marlboro on a table next to a major character for a couple of seconds on screen, you’re gonna a flexible prop that can be invested with a vari- do it.” ety of meanings and messages. It can help cre- Female, actor, television ate an aura of sexiness and sophistication, for

Virtually everyone agreed that there was no example, or convey an image of someone http://tobaccocontrol.bmj.com/ product placement in television. In fact, several caught in the grip of addiction, self-abuse, or commented on the extent to which networks neurosis. In fact, when asked what characteris- go to eliminate mention of brand names. tics an actor might convey through smoking, several interviewees had trouble answering, not WHO MAKES THE DECISION? because it was diYcult to think of any, but When asked who is responsible for deciding to because the possibilities were so expansive, use tobacco, there was broad agreement that it ranging from positive to negative. Rebellious- could be any of several people. ness, recklessness, “coolness”, toughness, “It could start with a scene direction in the script weakness, nervousness, indiVerence, and social that could be ‘character smoke’. And it can be the inferiority were most frequently mentioned. actor, once they’re on the set, deciding that they The full range of possibilities, however, was want their character to smoke or not smoke ...It more evident among those in the film industry. could be the director deciding that.” Most who worked in television felt smoking on September 29, 2021 by guest. Protected copyright. Female, producer, film was almost always associated with negative Writers, actors, and directors are most likely character traits, because networks would not to initiate tobacco depiction, with actors the allow positive images of smoking. single most commonly identified source. The There are also meanings or images that can final decision, however, reflects input from all be conveyed now through a cigarette that were of these sources, with perhaps additional input not available in previous film eras. As two from the camera operators. When di erences V interviewees noted, the contradiction between of opinion arise, it is often the person with the what we now know about the health eVects of most clout who prevails: tobacco and the reality of continued use open “If Arnold Schwarzenegger ...says,‘I’m gonna go smoke a cigar,’ I don’t think there’s anyone in up new possibilities for character depiction. the world who’s gonna tell him, ‘No, you’re not.’” Smoking can now communicate such personal Male, producer, film/television qualities as inner dissonance or psychological Although these comments apply to the mov- inconsistency. ies and television, we found important “There was that character in [name of movie] diVerences between them. Within the movie who would go for a jog and at the end of the jog industry, producers and studios are not seen as he’d light up a cigarette. That’s a good character illustration because he was a man of paradoxes. playing a major role in the creative He would do something good on one hand and development of a project. In television, then something bad on the other. And he did that however, studios play a much more prominent in his professional life, his romantic life, and in role, often through formal guidelines. his health life as well.” Moreover, in television many of the producers Male, director, film/television Hollywood on tobacco 381 Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

Though few interviewees saw variation in the Others, however, felt diVerently. They meaning of a cigarette by the race/ethnicity of suggested that it was nearly impossible not to the smoker, many commented on variation by give careful thought to tobacco depiction, age and sex. In particular, a smoking teenager because it is so much in the public might convey an image of rebelliousness, consciousness and because it causes problems whereas an older smoker is more likely to con- in filming and editing. According to one actor: vey an image of addiction, self-destructiveness, “There’s nothing arbitrary about smoking on or lack of control. Our interviewees felt female film....It’sadeliberate choice. It’s very hard to smokers were more often sexy and sophisti- smoke in a movie . . . because every take you have cated, while images of toughness, “coolness”, to light up and be at the same spot you were. It’s and nervousness applied equally to both sexes a big commitment to smoke on film. So in a scene that on film may take two minutes can take three and all ages. Cigars were often used to depict hours, and you’re lighting up every time you do a status or trendiness. take, and it’s hard.” In addition to character development, our Female, actor, film respondents suggested other reasons for In addition to technical diYculties, smoking tobacco depiction. Tobacco use might be on film has come to be seen as a problem by included in a film or scene to enhance its real- many in film and television. For them, the ism. Specific groups, such as high school drop- decision of whether to include smoking depic- outs, historical periods, such as mid-century, tion is no longer made on purely artistic or locations, such as a bar, would not seem grounds. It has become, in part, a moral issue. real—many of our interviewees suggested— As one person commented: without the presence of smoking. A cigarette “[Previously,] whether the character smoked or may also provide the actor with something to not was not discussed from the standpoint of do with his or her hands, or enable physical what would be responsible as filmmakers but movement from one part of the set to another. what was appropriate to the character. Now we Finally, smoking is sometimes included for the think about it more in the other way, in both pure lighting eVect of the on-camera smoke. ways.” Female, producer, film Extrinsic reasons for portrayal of tobacco use Not all reasons for inclusion of smoking have to TOBACCO DEPICTION: HOW ESSENTIAL IS IT? We asked our interviewees whether they do with artistic judgments. Two interviewees considered tobacco depiction to be a problem mentioned that tobacco is included because it is and whether they considered it essential. In within the historical tradition of cinema. order of frequency, respondents fell roughly Filmmakers also may see cigarettes as a way to into three categories: (a) those who found it project an edgy or gritty image, thus enhancing

useful, but rarely necessary, and thus http://tobaccocontrol.bmj.com/ box oYce appeal. Several interviewees somewhat of a problem; (b) those who consid- commented on how independent films in ered it to be gratuitous and highly problematic; particular seek to be “edgy”, targeting a market and, (c) those who believed on-camera that either is or would like to be smoking to be quite useful and not a problem. “counter-culture”. In contrast, television studios Most of our interviewees fell into the first have more of a corporate culture and desire to category—those who felt tobacco depiction project a trendy, yet mainstream, image. might have negative social repercussions, but The most significant cause of smoking who still felt its usefulness as a communication on-camera apart from the artistic reasons, device took precedence in some instances. however, is simply that many actors smoke in Many of these people volunteered that real life. While half of the directors, writers, cigarettes are overused props that sometimes and producers did not believe that the personal substitute for good acting. For example, one tobacco-use habits were important, actors on September 29, 2021 by guest. Protected copyright. person, commenting on Julia Roberts in themselves were virtually unanimous in My , said: acknowledging the relationship. One actor Best Friend’s Wedding “I felt that [her] smoking was extremely distract- commented: ing to me as an audience member; I thought it “I’m a smoker and my character study is every was not great acting....Ithought it was a prop character I play smokes a diVerent brand of ciga- that was unnecessary and I think it took me out rettes.” of her character a lot because I felt she was lean- Female, actor, film ing on it as a prop and not making a statement about the character.” HOW DELIBERATE IS THE DECISION? Female, producer, film With smoking being the single greatest cause of Smoking was not just perceived to function death in the United States, and exposure to as a crutch for actors, but for writers as well: secondhand smoke the third leading cause,10 “I know that in my earlier screenplays, having a one might anticipate that decisions about its character smoke was often a crutch. . . .It’s a portrayal on film would be given careful shorthand to character. And I think that over the thought. The care taken in making these deci- last few years, people have gotten away from that sions, however, seems to vary widely. crutch because: (a) when you read any book on According to some of our interviewees, gener- screenwriting or go to any seminar on screenwriting, one of the first things they say is, ally little thought is given to tobacco depiction. “Stop using the cigarette crutch; stop using the As one producer commented, “I don’t think telephone crutch; stop using the driving around it’s really that careful of a decision; I think it in a car crutch.” And I think it’s become cliché to just happens the way anything happens when the point where people don’t use it as much.” you’re telling a story.” Male, producer, film/television 382 Shields, Carol, Balbach, et al Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

Many of these interviewees resolved the ten- The California law that bans smoking in sion by limiting tobacco depiction to indoor work areas has also had an inhibiting characters with negative traits or characters eVect, according to several of our interviewees, who eventually get sick from it. The on the portrayal of smoking on television. assumption seemed to be that viewers would Within the movie industry, non-depiction be less inclined to imitate the behaviour of usually occurs for one of two reasons. those portrayed in a negative light. Non-depiction may occur naturally because “I think when a character is a villain and an evil smoking just does not fit the theme, characters, character and they’re unattractive in ways, the or circumstances. Alternately, tobacco use may smoking isn’t as glamorous.” be absent because of the strong personal beliefs Male, producer, film of an influential writer, actor, director, or pro- Those in the second category, who were ducer. strongly committed to non-depiction of Two interviewees made the point that smok- tobacco use, believe it to be nearly always inap- ing is not missed, even when the project’s propriate and gratuitous. theme could have easily lent itself to the inclu- “As far as I’m concerned, cigarettes are literally a sion of smoking. smokescreen between you and the audience and “I don’t think that anybody who saw that movie the character that they’re portraying.” stopped and said, “Gee, nobody’s smoking in Male, cameraman, film that movie! I wonder why they’re not smoking?” Finally, there were a few who saw no And, you know, that’s what I think—people won’t diYculty whatsoever with tobacco depiction. miss it if they don’t see it.” Coming mostly from the film industry, they felt Female, producer, film that their job was to depict reality. “I don’t personally think that positive imagery in INDUSTRY RESPONSIBILITY the media is necessarily a good thing. I think We asked respondents about the extent to honest depiction is more important. I think false positive images are just as harmful as negative which Hollywood shaped society and the images because they’re bullshit and they’re bad extent to which it was shaped by society. The for the psyche.” question was framed generally, without specific Male, writer, television mention of tobacco. As expected, most interviewees began by acknowledging a reciprocal influence between society and the REASONS FOR NON-DEPICTION entertainment industry. We asked our interviewees about non- “All you have to do is look at the hairstyles that depiction as well as depiction. Some of the you see on young women to see evidence that answers simply reflected the flip-side of the Hollywood influences behavior....Butthen on

reasons for portrayal. For example, the theme the other hand, certainly what the public http://tobaccocontrol.bmj.com/ “It just didn’t fit the character” was echoed in responds to and watches determines what numerous interviews. Many commented on programming gets made.” cigarettes being overused props. Some Female, studio executive, television observed that a few film studios, most notably The easy consensus around a reciprocal Disney, have a cultural identity such that peo- influence model of the relationship between ple working for them know, even without the entertainment industry and broader explicit guidelines, that most tobacco depiction culture quickly dissolved, however, when ques- is inappropriate. tions turned to issues of responsibility. At that Many television studios have specific policies point, many of our interviewees took a more or guidelines that restrict the portrayal of unidirectional view of influence, with some tobacco use. For example, CBS program emphasising the media as mirror motif and oth- ers, the media as shaper motif. Thus, when standards state: on September 29, 2021 by guest. Protected copyright. “Character portrayals and scenes depicting the asked whether watching characters smoke consumption of alcohol, drugs, cigarettes and influenced viewers to smoke, some respond- similar substances must be thoughtfully ents minimised their responsibility: considered, essential to plot and role “I believe that films always mirror society; what development and not glamorized. When the line film makers are trying to do [is] to document is crossed between normal, responsible what’s happening in society....Ithink that if consumption of a particular substance and people are going to be influenced to smoke less or abuse, the distinction must be clear and the to start smoking or smoke cigarettes as a adverse consequences of abuse specifically noted consequence of watching motion pictures or tel- and explored.” evision, then they probably need more help than Some of our interviewees, mainly from anyone can give them.” television, had been involved in projects where Male, director/producer, television either they or someone else on the project Similar comments were echoed by several intentionally included anti-smoking content. respondents who indicated that tobacco— Anti-smoking messages were conveyed either because it is a less serious issue in their minds by associating smoking with negative personal- than other issues, especially violence—does not ity traits or by driving home the adverse health rise to a level deserving of special attention. consequences of tobacco use. Although a minority, other interviewees saw “You show somebody who’s ravaged over years themselves as highly responsible for trends in by nicotine. And then has emphysema, the last society, including the trend towards smoking stages of emphysema, and those are pretty fright- among teenagers. They took this responsibility ening images.” seriously and often wondered what they could Male, writer, television do to improve the situation. Hollywood on tobacco 383 Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

“We have to take matters into our own hands, as smoking was beneficial. The following the architects and custodians of pop culture, to comment is illustrative: really police ourselves.” “I think it would be extremely naive to think that Male, producer, film much is going to really change in the portrayal of A few of our interviewees reflected on the smoking if there isn’t some pressure greater than ambiguity inherent in visual images. Although public opinion, some vocal pressure to cause they sought to be responsible in their work, people to say, ‘Whoa, we’ve got to get our act they also recognised their limitations, together on this or else we’re gonna be looking at understanding that they had little control over regulation’. The whole history of our industry how it is appropriated. suggests that it’s the threat of regulation that “As a filmmaker you never know what a viewer causes us to act. I’m not proud of it, but that’s it.” will appropriate from the image you create, Female, studio executive, television regardless of what your intention was in creating When we asked our interviewees about how that image. You have to be very careful because ...apicture tells a thousand words and best to approach the entertainment industry, they aren’t all yours.” the answers were again quite varied. With a few Female, producer, film notable exceptions, most in the motion picture industry felt that neither outside pressure nor

HOW BEST TO APPROACH THE INDUSTRY internal top-down pressure would work, and When we originally conceptualised this might even be counterproductive. Most research project, the possible relationship interviewees laced their responses with caveats between smoking on-screen and rising rates of about artistic freedom. In fact, several teenage smoking was only rarely, if ever, a topic interviewees felt that simply posing the of conversation within either the entertainment question of influencing the industry raised the or tobacco control communities. Our original spectre of censorship. intent in this project was to “listen” before “I would never presume to censor or to “acting”, because sound advocacy is built on a recommend censorship or to create some kind of clear understanding of the community targeted watchdog ...Imean look at Standards and Prac- for change. tices. It’s a disaster; it’s not good.” However, smoking in movies became a high- Female, producer, film profile topic with the proposed “global Several of our respondents suggested that settlement” of tobacco litigation in spring the “creative personality” is highly reactive to 1997. Smoking in the movies was discussed on pressure, often resulting in the opposite of the Senate floor, and Hillary Rodham Clinton11 what is desired. 12 and United States Vice President Al Gore “I just think that everyone has to be careful not to criticised the industry. California State Senator be dictatorial about these issues because that just John Burton held hearings on the issue with makes peoples’ hackles rise. You know the http://tobaccocontrol.bmj.com/ key industry leaders.13 In addition, the minute you tell some of these filmmakers, who all Entertainment Industries Council launched a think they’re infants terribles anyway, that they high profile initiative to reduce the gratuitous can’t do something, they’ll turn around and spit use of tobacco in film.14 in your face and say, ‘I’ll do what I please,’ even if We considered it likely that some of our they agree with you.” interviewees might have been influenced by the Female, studio executive, film public attention given to the issue. Moreover, Although some within the television as they were the targets of high profile eVorts to industry were also resistant to any outside or modify behaviour, we felt that the controversy top-down pressure, they were more open to might have aVected their thoughts on what hierarchical structure and guidance from advocacy methods might be eVective. To gauge studios. In fact, many looked for leadership these possibilities, we asked interviewees about from the upper echelons of their profession. on September 29, 2021 by guest. Protected copyright. their awareness of the controversy surrounding “I think the best way is probably to reach the smoking on-screen, and the extent to which the individual producers of each show that’s actually topic had become a point of discussion among ontheair....Ifyougettotheactual their colleagues. Surprisingly, nearly half of our writers/producers of the shows, it’s probably the respondents were unaware that tobacco use most eVective way, because they’re the ones that depiction had become a controversial issue. are creating the material.” Among those who were aware of the public Female, actor, television scrutiny that had been focused on smoking in Finally, several interviewees felt that the best the media, responses were varied. Although way to reach the industry may not be to some did not feel that it had had much of an approach the industry directly, but to continue impact, some, particularly from the movie to make progress on the issue within the industry, were angered by the attempt of politi- general population. They suggested that the cians to influence their work, with many public education campaigns about smoking believing that tobacco use was a minor issue: had already influenced the industry and would “I think that’s the return of fascism basically.... continue to do so. A number of our interview- I think it’s a violation of our rights and it’s, to me, very frightening as a society to allow that to hap- ees mentioned various advertising campaigns pen.” put out by the California Department of Male, producer, film Health Services, as well as state laws banning At the other end of the continuum, some, smoking in certain venues, as having had an mostly from the television industry, felt that the impact on how the entertainment industry outside pressure to change the portrayal of deals with smoking. 384 Shields, Carol, Balbach, et al Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

Discussion public. For example, nearly all of our In summary, Hollywood is heterogeneous with interviewees believe that as the broader culture varying perspectives on the rates of tobacco use has changed in its views about smoking, the in movies and on television, the necessity of industry has generally followed suit. portraying tobacco use, and Hollywood’s degree of responsibility for societal smoking. COMMUNICATE AN ANTI-CENSORSHIP POSITION Perceptions also varied on how conscious the Many within the industry preferred educa- decision was either to use or not use tobacco. tional strategies because such strategies The decision to portray tobacco use may origi- avoided the “briar-patch” of censorship. Those nate with the writer, actor, or director, and working within the film industry were particu- tobacco is included most frequently to larly protective of artistic freedom, and elucidate character or portray reality. eVective influence strategies can be designed to On-camera smoking is influenced by actors’ aYrm that value. The need to support artistic oV-camera tobacco use. freedom places a burden on tobacco advocates How then should these results inform the to communicate clearly that we do not want eVorts of tobacco control advocates? Health censorship, but want instead tobacco depiction advocates are currently actively encouraging a only when a project would substantially suVer reduction in the depiction of tobacco use in without it. film, believing that such a reduction will help to Although film and television personnel prevent or reduce smoking among the general abhor censorship, those in television already public, especially minors. Some advocates will work under guidelines. Moreover, some use an “inside” strategy, working within the interviewees thought that their colleagues entertainment industry. Others will use an would not change their behaviour unless they “outside” strategy, one which focuses the pub- perceived a credible threat of regulation. Those lic spotlight on the issue and creates social working the “outside” strategy may need to pressure for change. The present investigation finds ways to create such a threat, so that those uncovered information that can help guide working an “inside” strategy can create internal advocacy eVorts, whether advocates are using momentum for voluntary change. an “inside” or an “outside” strategy. We have distilled seven key issues to consider when IF YOU HIT HARD, HIT SMART devising advocacy strategies. Tobacco control needs members of the entertainment industry as allies. Advocates WE NEED A MULTI-PRONGED APPROACH intent on an “outside” hard-hitting campaign One of the most important things that we need to craft their message to provide an learned is that the industry is quite diverse, uncomfortable, but still potentially construc-

fluid, segmented, and heterogeneous, making it tive, stimulus for change. It may backfire, for http://tobaccocontrol.bmj.com/ close to meaningless to talk about “the example, to blame the entertainment industry entertainment industry” or “the Hollywood for the rise in teenage smoking. Such an attack culture”. One implication this finding holds for can easily be deflected as simplistic, as broad advocates is that they will have a diYcult time social trends such as teenage smoking rates finding ways to reach more than small stem from complex webs of causal factors segments of the industry. Even those who share rather than single sources. Pointing to a similar occupational role—producers, for instances when the cigarette is used in a super- example—do not interact or communicate fre- ficial, unnecessary, or clichéd way, and quently with others in their guild. A sustained, challenging writers, actors, and directors to coordinated, multi-channel approach is clearly find other, better vehicles of communication, warranted and needed. can provide a professional challenge that still

aYrms their competence and creativity. on September 29, 2021 by guest. Protected copyright. INCORPORATE EDUCATIONAL STRATEGIES Education of those within the industry can play ADDRESS MULTIPLE OCCUPATIONAL GROUPS an important role, because it was clear from Smoking portrayal may originate with writers, the interviews that many within the industry actors, or directors, although actors seem to be had not seriously thought about tobacco. Many the most frequent source. This finding points of our interviewees, and particularly members to the necessity of working with multiple of the focus group, spontaneously commented segments of the entertainment industry. As on how enlightening it had been to discuss the actors are the single most likely source, they issue in the course of the interview. may seem to be the most appropriate audience Educational modes of advocacy are for tobacco control advocates to address. On potentially useful for “inside” and “outside” the other hand, apart from top box-oYce stars, strategies. On the “inside”, education is a way actors often feel like they are at the bottom of to gain the voluntary cooperation of entertain- the power pyramid. Although directors and ment industry personnel. For example, the producers are less likely to initially suggest Directors, Writers, and Actors Guilds might be tobacco use, they are more likely to have the conduits to people working in the industry and power to determine the final outcome. Some help to encourage them to think about the producers, for example, simply do not allow impact of including tobacco use before they do smoking in their films. so. Working “outside”, advocacy groups can educate their own constituents about the WORK TO REFRAME THE ISSUE nature of the entertainment industry and can We found that on-camera tobacco portrayal continue to work on norm changes among the occurs for three main reasons: (a) cigarettes are Hollywood on tobacco 385 Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

a means through which an actor can convey depiction only when the scene would suVer information about a character; (b) people substantively without it. smoke in real life and film-makers are concerned about reflecting that reality; and (c) HELP THE INDUSTRY CREATE EFFECTIVE actors who smoke in their everyday life often ANTI-TOBACCO MESSAGES prefer to act with a cigarette in hand. Each of To date, when members of the industry have these reasons provides openings for tobacco included anti-tobacco content, they have control advocates. largely relied on one or the other of two meth- Many writers and actors recognise that con- ods. The first involves portrayal of negative veying character information through smoking health consequences stemming from tobacco is often a “lazy” reason for inclusion of tobacco use, an approach reminiscent of the 1960s health education models that were discarded use, a fact that is used in media-advocacy 19 eVorts by the Florida “Truth” campaign.15 For because of beliefs about their ineVectiveness. example, one newspaper advertisement created The industry also has tried to convey an an “L” rating for movies where the anti-smoking message by having smokers movie-makers were too “lazy” to find a better portrayed in a negative light. However, even way than cigarettes to make a character appear when smoking is designed to convey that a character is flawed, the character may still have rebellious or sexy. This may oVer a model of considerable appeal to certain viewers. Recent advocacy with the entertainment community. research on eVective tobacco control Accepting realism as a value, the tobacco messages20 might be of interest to many within control community has already begun to the entertainment industry. Creative treat- engage the entertainment industry in a 16 ments of tobacco industry manipulation and dialogue about improving on their realism. secondhand smoke themes, for example, might The discussion ought to continue and expand. well play an important role in reducing the How realistic is the smoking portrayed? Do allure of tobacco. portrayals of police oYcers who smoke, for example, include the image of them unable to Conclusion run down a suspect because they are short of In conclusion, there is no “quick fix”. While breath? For example, smokers in the movies the pro-health community has gained some were more intelligent and more romantically momentum in its commitment to working to and sexually active than non-smokers, often reduce tobacco depiction in movies and on tel- ignoring the actual negative correlates of evision, it needs a well-thought out approach. smoking. In addition, the negative conse- Moreover, given the nature of the entertain- quences of smoking were rarely presented in ment industry, it is critical that all advocacy the movies.17 Realism around the issue of sec- strategies be not only well-planned, but http://tobaccocontrol.bmj.com/ ondhand smoke is also a relatively unexplored coordinated. In the eVort to create change, an area for the entertainment industry. In real “inside” strategy and an “outside” strategy may life, when people light up in the middle of a have important roles to play. Although the crowd, a number of people around them are “inside” strategy of working with the industry, annoyed and may wave the smoke away. In rather than against it, has great potential for fact, interesting visual tension might be eVecting change, it may need the spur of the productively conveyed using response to outside strategy to keep it moving forward. secondhand smoke as the stimulus. Actors might be influenced to reduce The HOT (Hollywood on Tobacco) Project is a project of the ANR Foundation and is made possible by funds received from on-screen smoking through education. Smok- the Tobacco Tax Health Protection Act of 1988—Proposition ers, particularly younger smokers, overestimate 99, under Grant Number 96-26631 with the California Depart- the percentage of people who smoke in ment of Health Services, Tobacco Control Section. on September 29, 2021 by guest. Protected copyright. reality.18 So it is plausible that actors who 1 US Centers for Disease Control and Prevention. Surveil- smoke are likely to overestimate the likelihood lance for tobacco-use behaviors—United States, 1990– that a particular character would smoke. In 1994. MMWR CDC Surveillance Summaries 1994;Nov 18. addition, half of the writers, directors, and pro- 2 Fishman JA, Allison M, Knowles SB, et al. Statelawson ducers were unaware of the tendency of smok- tobacco control—United States, 1998. MMWR 1999; 48(SS03):21–62. ing actors to portray smoking characters. Sim- 3 US Centers for Disease Control. Passive smoking: beliefs, ply raising their awareness on this point may attitudes, and exposures—United States, 1986. MMWR 1988;37(15):239–41. lead them, at least in some instances, to 4 Hazan AR, Lipton HL, Glantz SA. Popular films do not question the decision of the actor to portray his reflect current tobacco use. Am J Public Health 1994; 84:998–100. or her character as a smoker. 5 Stockwell TF, Glantz SA. Tobacco use is increasing in popular films. Tobacco Control 1997;6:282–4. Keeping all three of these motives for inclu- 6 Luken TA. Testimony at hearings before the Subcommittee sion of tobacco portrayal in mind, health advo- on Transportation and Hazardous Materials, Committee on Energy and Commerce, US House of Representatives, cates ought to direct the discussion of smoking 101st Congress, 1st session, 25 July and 13 September depiction to the central question of necessity. 1989, Serial No 101–85. Washington, DC: US Govern- Simply pointing to the plausibility of a cab ment Printing OYce, 1989;1–3. 7 Glantz SA, Slade J, Bero LA, et al. The cigarette papers. Ber- driver being a smoker, for example, is not a keley: University of California, 1996;364–74. 8 Maresca GP. The American Tobacco Company letter to high enough bar to set for acceptable smoking CliV McMullen (President, Unique Product Placement, on screen. The question is whether a particular Inc.) RE: Contract Renewal, 1992; Bates No. ATX040161292. scene would lose its desired communicative 9 Klein A. Cigars lose starring role in future movies, TV eVect if the tobacco depiction were removed. shows. Baltimore (Maryland) Sun 1998 Mar 21. Framing the question in this way may help the 10 Glantz SA, Parmley WW. Passive smoking and heart disease. Epidemiology, physiology and bichemistry. Circu- industry adopt a norm to include tobacco lation 1991;83:1–12. 386 Shields, Carol, Balbach, et al Tob Control: first published as 10.1136/tc.8.4.378 on 1 December 1999. Downloaded from

11 Rodham Clinton H. Hollywood role models promote lung 17 McIntosh WD, Bazzini DG, Smith SM, et al. Who smokes cancer. San Francisco Examiner 1997 Aug 6. in Hollywood? Characteristics of smokers in popular films 12 Anon. Hollywood taking heat for all the lighting up in films. from 1940 to 1989. Addict Behav 1998;23:395–8. USA Today 1997 Aug 25. 18 US Department of Health and Human Services. Preventing 13 Vanzi M. Lawmaker targets on-screen smoking: movies influ- tobacco use among young people. A report of the Surgeon Gen- ence youngsters to light up, says state Sen. John Burton, eral, 1994. Atlanta, Georgia: Public Health Service, Cent- who will hold a hearing in eVort to ‘heighten awareness’ ers for Disease Control and Prevention, OYce on Smoking among filmmakers. Los Angeles Times 1997 Oct 26:A-3. and Health, 1994. (US Government Printing OYce Publi- 14 Madigan N. Hollywood alliance denounces tobacco use. cation No S/N 017-001-00491-0.) Reuters/Variety Entertainment news service, 1997 Dec 5. 15 Truth Campaign, Florida Tobacco Pilot Program, Tallahas- 19 Lynch BS, Bonnie RJ. Growing up tobacco free: preventing see, Florida, 1998. nicotine addiction in children and youth. Washington, DC: 16 Next Generation, California Tobacco Control Alliance, Institute of Medicine (National Academy Press), 1994. Entertainment Industry Working Group, Mission State- 20 Goldman LK, Stanton A. Evaluation of anti-smoking adver- ment, Sacramento, California, 1997. tising campaigns. JAMA 1998;279:772−7. http://tobaccocontrol.bmj.com/ on September 29, 2021 by guest. Protected copyright.

TOLES@1999 The BuValo News. Reprinted with permission from Universal Press Syndicate. All rights reserved.