CHICAGO, June 14 (UPI) -- Note to Hollywood producers: If you put a cigarette in your star's mouth, expect an "R" rating on your movie.
That is what the House of Delegates of the American Medical Association voted to adopt as the organization's policy Monday -- equating cigarette smoking to graphic violence, graphic language and nudity on the screen.
"Smoking in movies has increased dramatically since cigarette advertising has been banned from billboards," said Dr. Stephen Hansen, an internal medicine specialist from San Luis Obispo, Calif., in support of a resolution being debated by the AMA's House of Delegates at its annual meeting.
The House of Delegates creates policy for the 251,000-member organization of physicians.
Hansen argued that if characters smoke in movies, those pictures have an easier time being distributed to the nation's movie houses and to those in international markets.
"There are certain groups that have connections in controlling distribution of the films that are telling movie producers they will have a favored, greased pathway into theaters if there is smoking in the films," Hansen said in response to questions from committee members.
He said recent studies show there are 11 depictions of people smoking in one hour of an average film now, compared to just five such scenes in the films of the 1950s -- when half the people in the United States smoked. Today less than 25 percent of Americans smoke cigarettes.
The resolution, offered by the AMA's California delegation, demanded "that our American Medical Association encourages the motion picture industry to apply an 'R' rating to all new films depicting cigarette smoking and other tobacco use."
"Making these movies carry an 'R' rating is the right thing to do," said Dr. Melvyn Sterling, an internist in Orange, Calif. In California, he said, there is no smoking in the workplace, in stores, in restaurants, and yet teenagers are still experimenting with cigarettes. "The only place they see people smoking is in the movies. Their heroes, their heroines, the good guys and the bad guys -- anyone who has attributes the children will emulate are smoking."
Dr. Ronald Davis, a public health specialist in Detroit, Mich., and a member of the Board of Trustees of the AMA said there are "data that have shown portrayals of smoking in movies correlates with the onset of smoking in young people and teenagers." Placing an 'R' rating on films would make them, theoretically, off-limits to children under age 17 unless accompanied by a parent.
Dr. Robert Phillips, a delegate representing the American Academy of Psychiatry and the Law, from Annapolis, Md., questioned whether the AMA should be getting involved in the issue.
"It is not just plausible to accomplish this. This is not efficient use of our time," Phillips said. He suggested the organization was tilting at windmills in attempting to influence practicalities of the real world.
The public health committee, chaired by Dr. Jerome Cohen, a gastroenterologist in Binghamton, N.Y., recommended the adoption of the resolution and the entire body approved the recommendation without debate.
The resolution, in some ways, parallels policy outlined by Dr. Michael Maves, executive vice president of the AMA.
In a letter to the Smokefree Movies project of Stanton Glantz, professor of medicine at the University of California, San Francisco, in 2002, Maves argued that movies in which characters smoke should receive an 'R' rating.
In addition, he recommended:
-- Certify in the end credits that no one was paid anything or received anything of value for including cigarette smoking scenes in the movie;
-- require strong, independent anti-smoking advertising before films depicting smoking by actors, and
-- do not identify any cigarette brand in a movie.
Officials of the Motion Picture Association of America were unavailable for comment about this issue. But Jack Valenti, outgoing president and chief executive officer of the group, told a Senate committee last month: "If smoking by some actors is essential to the time and place of the story, and is indispensable to quickly identify the actor's demeanor and character to advance the narrative, no one ought to intervene in a director's design for telling his story the way he chooses to tell it."
Valenti said in addition to cigarettes, there "are a good many legal products and behavior that have, alas, a capability for inciting tragedy in the lives of too many of us." He cited alcohol abuse, murder by guns, unsafe driving and even obesity as examples.
Valenti also said the recent Dartmouth Medical School Study, which linked smoking initiation among teens with viewing depictions of smoking on screen, means it is "important for the filmmaking community to become familiar with the findings that were published. Filmmakers should be aware of any and all information that suggests that smoking in the movies may be linked to influencing young people to begin smoking. That's why we are fully cooperating with
the creative guilds to educate and sensitize their members and our executives about this issue. Ultimately, filmmakers must decide what story to tell and how to tell it, though others may be unsettled by what they see."
Ed Susman covers medical issues for UPI Science News. E-mail firstname.lastname@example.org