Martha R. Staeheli
Smoking causes cancer. Smoking causes heart disease. Smoking causes premature aging, shortness of breath, and smoking is hugely addictive. For years we've understood the damage that smoking causes to those who indulge. Now, we've extended the breadth of damage to those who are only in proximity to smokers. Health-related effects of smoking strain our medical budgets and availability of health services. The toll on families of smokers is enormous as they watch the ones they love fight one of the most powerful addictions we know of and as they struggle through devastating and violent illness. Tobacco's swath of destruction is more damaging than most every other controlled substance combined.
Yet, smoking is legal. Not only is it legal, it is ubiquitous in our media. Though tobacco advertising is now legally limited, we read about smoking in print, we see people smoking in magazines, we see them smoke on TV, and, most powerfully, we see actors smoke in movies all the time.
How can we reconcile our knowledge of the dangers of smoking with our acceptance of it as a major character of our media? Further, how can we balance those concerns with our values of free speech, issues of censorship, feasibility of legislation, and the role of art in our society? We haven't yet decided.
The Nature of Addiction
Drug use comes in many forms and exists along a continuum, from casual/recreational, to habit, to abuse, to addiction. Most of us have had an experience with addiction, whether as a battle we've fought or as one we've watched others fight. The word "addiction" is thrown about constantly, as in "I'm so addicted to these chips" or "I'm totally addicted to TV", but true addiction causes people to indulge in behaviors that are destructive and seemingly out of control. The nature of addiction is complex, but drug abuse is caused by biological, psychological, and social factors. It is now believed that there is some biological disposition to addiction, and that this predisposition is mediated by social and psychological factors. These factors include: trauma, stress, childhood neglect, mental health disorders, disabilities, parental drug use, and peer pressure.
The nature of addiction, however, is characterized as a chronic, progressive disease that can exist in the realms of physiology (e.g. cocaine) or psychology (e.g. our traditional thinking about the effects of marijuana). Addiction consists of the following elements: craving, loss of control, physical dependence, and tolerance. A craving consists of a strong need or compulsion to use a drug, and a sense of panic or discomfort that occurs when the craving is not satiated. Loss of control is exhibited when the desire to use the drug overrides any other reasons to not use the drug, using in an inappropriate situation or time, and an inability to control these actions. Physical dependence describes those symptoms of withdrawal that occur when the drug is stopped, such as nausea, sweating, shakiness, anxiety, and an inability to focus and think clearly. Tolerance occurs as increasing amounts of the drug is needed in order to satisfy craving, to feel the "high", and to stave off withdrawal symptoms.
There are several warning signs of drug addiction. They include: 1) Using the drug regularly, such as daily, or on the weekends; 2) Tolerance for the substance; 3) Failed attempts to stop using the drug; 4) Physical or psychological dependence upon the drug; and 5) Withdrawal symptoms. It is helpful to note that drug addiction often occurs as a secondary diagnosis of serious mental illness, particularly in the case of depression or bipolar disorders. However, this is not always the case.
Substance abuse and addiction affect 25 million Americans, with millions more affected by a family member or friend with a drug problem. Though our particular focus is on teen smoking, it's crucial to note statistics on national drug abuse, because teenagers who smoke are at a higher risk for developing other kinds of drug addictions. According to 1999 data, teenagers who smoke are three times more likely than nonsmokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is also associated with other risky behaviors, such as fighting and engaging in unprotected sex. This data is based on correlational evidence, rather than causal, but it is still worth noting than teen smoking is a warning sign for other kinds of unsafe behaviors.
Evidence from many studies has shown us that tobacco addiction is as powerful as that of cocaine or heroin addiction. Around 80% of current smokers began before the age of 18, and 3,000 children under the age of 18 begin smoking every day. Approximately 36% of high school students smoke, as opposed to around 24% of adults. A recent University of Massachusetts study found that addiction behavior in children is stronger and faster than that of adults. Two thirds of children who begin smoking are addicted either immediately or within the first month of casual smoking. Many of those children will struggle with this addiction for the rest of their lives. Five million children alive now will die prematurely as a result of their smoking.
Questions for Discussion:
1. Why do people begin behaviors they know to be addictive?
2. What are examples of common kinds of addictions?
3. Why might children be more susceptible to addiction than adults?
4. Where might you find resources if you suspect you might have an addiction?
The Health Effects of Smoking
As educators, we've told our students for years about the risks they will take if they decide to start smoke (some of us even in contrast with our own behavior.) We warn them about horrible disease, cluck disapprovingly, and our students nod and smile and agree that smoking is a terrible habit they wouldn't indulge in. Yet, kids continue to light up and the average age of a new smoker has dropped to 12 years old.
So, what can we tell kids about the facts of smoking? The costs and effects of smoking are far-reaching, from subsidized medical care, to the dangers of second-hand smoke. Smoking causes more deaths than the combination of AIDS, alcohol, car accidents, murders, suicides, illegal drugs, and fires. In fact, one out of every five deaths is attributable to smoking, and this is the single most preventable health problem the United States faces. More than 400,000 people die every year as a result of smoking related illnesses, at a drain of around 100 billion dollars every year for medical costs. The World Health Organization predicts that 500 million people will have died from smoking by the year 2025.
Cigarettes contain around 4,000 chemicals, including: ammonia (floor/toilet cleaner), arsenic (rat poison), formaldehyde (body tissue preserver), and hydrogen cyanide (gas chamber poison). It is the nicotine in cigarettes, however, that acts as the drug: it produces a "high" that increases blood pressure and heart rate and it is highly addictive. Because cigarettes contain so much toxic material, smoking poses a great threat to the health of the smoker. The health effects of smoking are immediate. It causes shortness of breath and asthma attacks, increased chance of tooth-loss, bad breath, premature aging, and susceptibility to infection. While smoking can exacerbate almost any illness, it is known to directly cause diseases such as heart and lung disease, stroke, and cancers of the larynx, lung, mouth, pancreas, bladder, esophagus, colon, cervix, and kidney.
And those are the effects for someone who smokes through a filter designed to keep the real poison at bay. Even more devastating are the effects second-hand smoke has on people close to the smoker. Without the benefit of the filter, non-smokers can pick up every nasty element of cigarettes. An estimated 3,000 non-smokers die every year from second-hand smoke. Every year, 300,000 children who live with smokers suffer from serious respiratory ailments (as well as having an increased risk of becoming smokers, themselves.) The fetus of a pregnant woman who smokes is more likely to be born prematurely, under-weight and possibly with birth defects.
The question then becomes, knowing how destructive cigarettes can be, why do teenagers (and adults) begin to smoke?
Questions for Discussion:
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1. If we understand smoking is dangerous, why do people continue to smoke?
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2. What responsibility do tobacco companies and government have for regulating smoking behaviors? For addressing resulting health concerns?
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3. What causes people to begin to smoke in the first place?
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4. What is it like to be near a smoker? What do you notice about the effects of second-hand smoke?
The Role of Smoking in Film
There is little question that we understand the dangers of smoking; we can no longer plead ignorance. We continue to see the prevalence of smoking in movies rise, with bigger stars, in more situations, with less plot motive, lighting up. Teenagers make up a sizable portion of moviegoers, and anyone who has spent time around teenagers understands that they're paying attention to what happens in those movies. How can we tease out causal relationships from these independent facts? It is difficult, but there are some behavioral trends that are undeniably present and powerfully describe the relationship between what teenagers see and what they do.
Perhaps you associate smoking in the movies with the glamour of Rita Hayworth or Lauren Bacall. Perhaps cigarettes in movies makes you think of the toughness of Steve McQueen or John Wayne. Perhaps you think of the role of cigarettes as atmospheric or artistic, a mediator of ambiance, romance, or tension. Chances are, however, that you can recall at least one example of cigarettes acting as movie star. Tobacco has played a role in film for as long as the medium has existed. The question is, how much of that role has been designed by tobacco interests?
The manipulation of film directors by tobacco companies has been pervasive and consistent, and the sinister elements of this partnership cannot be overlooked. Examined from another point of view, the way tobacco is incorporated into films serves as an artistic vehicle and has become almost another character in the life of movies.
There are four major ways that cigarettes become part of a movie plot. Cigarettes may be introduced in order to set an historical period. They can be used to set a mood. They can reflect the "real-life" behavior of actors. Additionally, tobacco companies often pay for product placement in movies. There are many documented cases of tobacco placement in movies. For example, the producers of the James Bond film,
License to Kill
took $300,000 for 007's use of Larks cigarettes in the film. The producers of
Superman II
were paid $40,000 by Phillip Morris for Lois Lane to chain-smoke Marlboros and to introduce the brand name 40 times during the film. Sylvester Stallone received $500,000 from a tobacco company to smoke in three of his films. Even children's movies are not immune from tobacco companies; Phillip Morris placed cigarettes in
Who Framed Roger Rabbit?
and
The Muppet Movie
. The list can continue indefinitely.
According to a recent article in
The Lancet
, smoking appeared in 85% of movies, with four major American brands accounting for the majority of cigarette appearances. The rate of smoking in movies is increasing all the time, with more and more lead actors lighting up (about 75%, currently.) There is an estimated 300% more smoking in movies than in real life.
Outlined below are ways to conceptualize the artistic role of cigarettes in movies, including examples of movies that fit within these categories. Students will no doubt be familiar with many of these; they could probably generate an even larger list. Understanding the context in which an appearance by tobacco is set, it's important to understand the ways tobacco is presented to an audience on the screen. It's presence has become part of what movies are, and from that perspective, gaining insight into what that looks like is an important component of constructing a critical viewpoint of that presence.
Smoking as Glamour: Smoking portrays glamour; it is the past time of the wealthy and the beautiful, particularly in the first half of the 20th century. These films may include: James Bond films,
Casablanca
,
LA Confidential
,
Metropolitan
,
Grand Hotel
.
Smoking as Machismo and Rebellion: Smoking becomes a symbol of rebellion and toughness. This occurs in gangster movies, westerns, and war movies. Some films and actors include:
The Godfather
,
Rebel without a Cause
,
Apocalypse Now
,
The Thin Red Line
, and
Grease
.
Smoking as Artistic Metaphor: Smoking ceases to be just the inhalation of cigarettes and becomes and artistic and cinematic metaphor, as well as a plot device. These movies may include:
Smoke
and
The Usual Suspects
.
Smoking as Dilemma: As the role of cigarettes has become more complex, characters in movies have begun to wrestle with the problems of addiction and dependence, and ethical/moral responsibility. These films may include:
The Insider
,
Traffic
,
Bridget Jones
,
Leaving Las Vegas
, and
Meet the Parents
.
There is so much smoking in movies that it has become almost a matter of course, something we no longer think about or notice. This is not the case with children. A study at the Dartmouth Medical school examined 603 movies from 1988 to 1999, gauged the amount of smoking in each, and then interviewed 5,500 middle school students to see how their smoking behaviors would be affected. Investigators determined that children are incredibly susceptible to patterning their own behavior on what they see in the movies, because they believe a high rate of smoking to be normative. There are many speculations on why this is the case. Children want to emulate stars, they want to do what other children are doing, they want to experiment, and sometimes they self medicate. However, most children don't smoke. Arming children with information, talking about what children are seeing, what they're learning about dangerous behaviors, and the nature of their conflicts (with themselves, friends, parents, society) is an important step towards helping them make positive decisions.
Questions for Discussion:
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1. What do you notice about the use of tobacco in movies? Who uses it? Under what circumstances? What is the "creative reason" behind its use?
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2. Does having an awareness of tobacco use by the media make it easier to make decisions about your own tobacco use?
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3. If we are strongly influenced by the media, who is responsible for the behavior of the public?
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4. Can we use movies to influence us in positive ways?
Taking Action against Tobacco Use
While tobacco advertising has been limited since 1970, there are no laws currently that address the use of cigarettes/tobacco in films. In fact, it is difficult to imagine that there will ever be legislation or case law that limits the freedom of movie producers to that degree. Movies portray all kinds of unconscionable and/or criminal behaviors: abuse, drug use, murder, violence, and rape. But movies also use rating systems to alert audiences to the presence of these (potentially) objectionable elements. And the portrayal of these things is, by regulation, different than actual and live capture and distribution of these scenes on film.
"Art" has traditionally been held to different standards in terms of its content than newspapers, TV shows, and school curricula. However, the question of what art is exactly has never been agreed upon. Books have always been censored for content and language. Rap music has been analyzed and rated and warned against. Movies are rated for content. This is an issue that has always been of interest to the American public; the tension between First Amendment rights of freedom of speech and concerns for "decency", "appropriateness", "desirability", and "exposure." Artists cannot necessarily be censored for the content of their art. But they can make choices about what to include in the art they produce; balancing aesthetics with ideas about what their artistic, cultural, political, and personal values are.
The anti-smoking-in movies group Smoke Screeners recommends four things that should be required of movies that portray smoking. They believe that movie theaters should be required to run anti-smoking ads (not produced by tobacco companies) before any movie that contains smoking. They believe that tobacco brand names should never be mentioned in movies and they want all movies containing tobacco to receive an MPAA rating of "R." Further, they would like to see all movies containing tobacco to certify no-payoffs; that is, to declare that no goods or services were traded by anyone associated with the film in exchange for the placement of tobacco in the movie.
Due to the tide of lawsuits leveled against tobacco companies for negligence, endangerment, bad business practices, and other unconscionable behaviors, tobacco companies are finding themselves in an uncomfortable position. They manufacture a highly addictive and damaging drug that is legal, in a climate that will not allow them advertise. Is this censorship? If this trend continues, how else can tobacco companies advertise except by placing cigarettes in movies? What choices are we leaving tobacco companies and smokers?
Questions for Discussion:
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1. Is it the responsibility of artists and the media to portray what is in our best health interests?
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2. Who should decide if/how/when to limit tobacco advertising and media presence? How can we balance the freedoms of tobacco companies with our responsibilities to the public and to children?
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3. What will it take to discourage people from smoking or from continuing to smoke?
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4. Is limiting tobacco use in art a form of censorship? Is censorship okay if it protects the public health?