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      Cine y tabaco, el comienzo de una polémica amistad para el adolescente Translated title: Cinema and tobacco, the beginning of a controversial friendship for adolescents

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          Abstract

          Resumen El triángulo formado por tabaquismo, adolescencia y cine desarrolla una peligrosa amistad, una “violencia tabáquica” sobre la que no podemos desviar nuestra atención como pediatras. Las relaciones económicas entre la industria tabaquera y la industria cinematográfica permiten un marketing encubierto, complejo, omnipresente, difícil de evidenciar y más de denunciar, con modalidades como la publicidad por emplazamiento y el posicionamiento de marca. Se aprende a fumar, entre otras causas, con las películas y series de televisión y ello oscila desde el predominante cine con tabaco a lo largo de su historia, al escaso cine contra el tabaco, pasando por aquellas películas que tienen el tabaco como leitmotiv. Hay que tener en cuenta que, al inicio del tabaquismo, seducir y atraer es lo que importa y de esto se encarga en ocasiones los medios audiovisuales del entretenimiento; luego, la nicotina rubrica el enlace que en muchas ocasiones llega “hasta que la muerte los separe”. Son numerosas las instituciones (comenzando con la Organización Mundial de la Salud [OMS] y la Organización Panamericana de la Salud [OPS]) y grupos de trabajo que abogan por pasar de la evidencia a la acción en las normas y legislación de las películas sin tabaco, como una medida de salud pública. También nuestro grupo de trabajo, y como colofón del II Curso Nacional de Tabaquismo en Pediatría realizado el año 2019, ha elaborado el Documento de compromiso para mejorar el control del tabaquismo en medios audiovisuales. El siglo XXI debe caminar hacia un séptimo arte “sin malos humos”. Y todo recurso es válido, desde las políticas gubernamentales y políticas sanitarias en primer término, a cualquier otra medida de apoyo y concienciación ciudadana frente a esta práctica.

          Translated abstract

          Abstract The triangle formed by smoking, adolescence and cinema develops a dangerous friendship, a “smoking violence” on which we cannot look away as pediatricians. The relationships between the tobacco industry and the film industry allow a covert, complex, omnipresent marketing, difficult to evidence and to report, with modalities such as product placement and brand positioning. You learn to smoke, between other ways, with movies and television series and this oscillates from the predominant cinema with tobacco throughout its history, to scarce anti-tobacco cinema, passing through those films that have tobacco as their leitmotif. Keep in mind that at the beginning of smoking, seducing and attracting is what matters and this is sometimes commissions audiovisual media for entertainment; then, nicotine initiates the link that on many occasions arrives “until death separates them”. There are numerous institutions (starting with WHO and PAHO) and working groups that advocate moving from evidence to action in tobacco-free film standards and legislation, as a measure of public health. Also our working group, and as a culmination of the II National Course on Smoking in Pediatrics held in 2019, has prepared the Commitment document to improve control of smoking in audiovisual media. The XXI century must walk towards a seventh art “without bad fumes.” And every resource is valid, from government policies and health policies in the first place, to any other measure of citizen support and awareness of this practice.

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          Most cited references38

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          Exposure to movie smoking: its relation to smoking initiation among US adolescents.

          Regional studies have linked exposure to movie smoking with adolescent smoking. We examined this association in a representative US sample. We conducted a random-digit-dial survey of 6522 US adolescents aged 10 to 14 years. Using previously validated methods, we estimated exposure to movie smoking, in 532 recent box-office hits, and examined its relation with adolescents having ever tried smoking a cigarette. The distributions of demographics and census region in the unweighted sample were almost identical to 2000 US Census estimates, confirming representativeness. Overall, 10% of the population had tried smoking. Quartile (Q) of movie smoking exposure was significantly associated with the prevalence of smoking initiation: 0.02 of adolescents in Q1 had tried smoking; 0.06 in Q2; 0.11 in Q3; and 0.22 in Q4. This association did not differ significantly by race/ethnicity or census region. After controlling for sociodemographics, friend/sibling/parent smoking, school performance, personality characteristics, and parenting style, the adjusted odds ratio for having tried smoking were 1.7 (95% confidence interval [CI]: 1.1, 2.7) for Q2, 1.8 (95% CI: 1.2, 2.9) for Q3, and 2.6 (95% CI: 1.7, 4.1) for Q4 compared with adolescents in Q1. The covariate-adjusted attributable fraction was 0.38 (95% CI: 0.20, 0.56), suggesting that exposure to movie smoking is the primary independent risk factor for smoking initiation in US adolescents in this age group. Smoking in movies is a risk factor for smoking initiation among US adolescents. Limiting exposure of young adolescents to movie smoking could have important public health implications.
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            Exposure to smoking depictions in movies: its association with established adolescent smoking.

            To assess the association between exposure to movie smoking and established adolescent smoking. Longitudinal survey of a representative US adolescent sample. Adolescents were surveyed by telephone in their homes. Sixty-five hundred twenty-two US adolescents aged 10 to 14 years at baseline, resurveyed at 8 months (8M) (n = 5503), 16 months (16M) (n = 5019), and 24 months (24M) (n = 4575). Main Exposure Exposure to smoking in 532 box-office hits released in the 5 years prior to the baseline survey. Outcome Measure Established smoking (having smoked more than 100 cigarettes during lifetime). Of 108 incident established smokers with data at the 24M survey, 85% were current (30-day smokers) and 83% endorsed at least 1 addiction symptom. Established smoking incidence was 7.4, 15.8, and 19.7 per 1000 person-years of observation for the baseline-to-8M, 8M-to-16M, and 16M-to-24M observation periods, respectively. In a multivariate survival model, risk of established smoking was predicted by baseline exposure to smoking in movies with an adjusted overall hazard ratio of 2.04 (95% confidence interval, 1.01-4.12) for teens in the 95th percentile of movie-smoking exposure compared with the 5th percentile. This effect was independent of age; parent, sibling, or friend smoking; and sensation seeking. Teens low on sensation seeking were more responsive to the movie-smoking effect (hazard ratio, 12.7; 95% confidence interval, 2.0-80.6) compared with teens who were high on sensation seeking (hazard ratio, 1.01; 95% confidence interval, 0.4-2.6). In this national US adolescent sample, exposure to smoking in movies predicted risk of becoming an established smoker, an outcome linked with adult dependent smoking and its associated morbidity and mortality.
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              Smoking in movies and adolescent smoking: cross-cultural study in six European countries.

              To investigate whether the association between exposure to smoking in movies and smoking among youth is independent of cultural context. Cross-sectional survey of 16,551 pupils recruited in Germany, Iceland, Italy, the Netherlands, Poland and Scotland with a mean age of 13.4 years (SD=1.18) and an equal gender distribution. School-based surveys were conducted between November 2009 and June 2010. Using previously validated methods, exposure to movie smoking was estimated from the 250 top-grossing movies of each country (years 2004-2009) and related to ever smoking. Overall, 29% of the sample had tried smoking. The sample quartile (Q) of movie smoking exposure was significantly associated with the prevalence of ever smoking: 14% of adolescents in Q1 had tried smoking, 21% in Q2, 29% in Q3 and 36% in Q4. After controlling for age, gender, family affluence, school performance, television screen time, number of movies seen, sensation seeking and rebelliousness and smoking within the social environment (peers, parents and siblings), the adjusted ORs for having tried smoking in the entire sample were 1.3 (95% CI 1.1 to 1.5) for adolescents in Q2, 1.6 (95% CI 1.4 to 1.9) for Q3 and 1.7 (95% CI 1.4 to 2.0) for Q4 compared with Q1. The adjusted relationship between ever smoking and higher movie smoking exposure levels was significant in all countries with a non-linear association in Italy and Poland. The link between smoking in movies and adolescent smoking is robust and transcends different cultural contexts. Limiting young people's exposure to movie smoking could have important public health implications.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                March 2021
                : 23
                : 89
                : e23-e41
                Affiliations
                [2] Alicante orgnameUniversidad Miguel Hernández orgdiv1Departamento de Pediatría España
                [4] Alicante orgnameDepartamento de Salud Alicante-Hospital General orgdiv1Centro de Salud San Blas España
                [3] Alicante orgnameISABIAL-Instituto de Investigación Sanitaria y Biomédica España
                [1] Alicante orgnameHospital General Universitario de Alicante orgdiv1Servicio de Pediatría España
                Article
                S1139-76322021000100019 S1139-7632(21)02308900019
                8cbefbc9-6a8b-4c83-9015-0c6c668a195a

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Colaboraciones Especiales

                Cinema,Tobacco addiction,Product placement,Marketing,Brand placement,Audiovisual media,Adolescence,Tabaquismo,Publicidad por emplazamiento,Publicidad,Posicionamiento de marca,Medios audiovisuales,Cine,Adolescencia

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