Q&A: Legacy’s Cheryl Healton

WASHINGTON Anti-smoking advocates have been successful in getting the tobacco industry to pay for public service ads that encourage teens to shun smoking. Most states have passed no-smoking laws in public spaces and 39 restrict smoking in private work places.

Now, nearly 10 years after the Master Settlement Agreement with 46 states (signed in April 1998), in which Big Tobacco agreed to curb some of its marketing practices, groups like the American Legacy Foundation—which runs the “Truth” anti-smoking campaign—are taking on Hollywood.

The goal is to get any film depicting smoking to carry an R rating. Legacy Foundation CEO and president Cheryl Healton discusses why she thinks depictions of people smoking in films are so dangerous to America’s youth.

Q: You have said that movie smoking is more powerful than traditional tobacco ads. Why do you think that is the case?
A: Because they are on the big screen. Because they are embedded in real-life scenes, which create a role model for the activity. It is less important who is smoking in a film—good girl or bad guy. [Smoking in movies] is akin to the original television advertising that was provided years ago.

When you testified before the House Subcommittee on Telecommunications and the Internet on June 22, you told lawmakers that smoking in movies has the greatest impact on youth who are normally the least likely to start smoking because their parents don’t smoke. What is it about the image of smoking in movies that is so persuasive to youth?
I think it is the glamorization in part, and it is also the role playing. The industry gets back the on-air imagery of smoking that they lost when they took their ads off. While Philip Morris USA publicly maintains that it gives no money for tobacco placement in film or TV, which is required by the Master Settlement Agreement, it is not clear what Philip Morris International does. In the past when there was paid placement, PM International cut a lot of the checks. Also, what kinds of investments are going into independent films, because it is very hard to find an indy film that doesn’t have smoking in it. And the data showing that smoking in movies has the greatest impact on youth who are the least likely to smoke comes from a study published in The Lancet.

Moviemakers like to say that depicting smoking is a necessary part of the creative process in filmmaking. They argue that what, for example, would the movie Casablanca be without the smoking. But you indicated in your congressional testimony that scenes with smoking can be the result of paid tobacco placement in movies. Does this practice still occur and if so, how prevalent is it?
All I would say is the appearance of smoking is exceedingly prevalent, and it is extremely prevalent on TV as well. We have asked the Federal Trade Commission what reports they have received from the industry about this, but we have been told they are not public. There are a number of ways to circumvent the Master Settlement Agreement.

Are there other creative cues that Hollywood could use instead of smoking to make the same point in a film?
They can show shaking, twirling hair, engaging in frenetic physical activity and changing clothes six times a day instead of standing there smoking. The Little Miss Sunshine film had no smoking in it and then the smoking was interjected after the film was written. What’s up with that?

The Motion Picture Association of America said in May that it would consider smoking along with sex and violence when determining how to rate a movie. Why do you say this isn’t enough? What more should the MPAA do?
The MPAA ought to recognize the very negative impact on young people brought about by smoking. A good example of a movie that just came out and one that was rated in relationship to the amount of smoking in it is Hairspray. The first issue is lots of teens will see this movie anyway. Those ratings largely affect parents who are controlling what the kids see. The ratings are very lax controls because they don’t necessarily I.D. you at the door. Just giving a film with smoking in it a rating doesn’t have nearly the impact that getting rid of the smoking images would.

In July, the Walt Disney Co. told Congress that it would not depict smoking in future Disney-branded films, except in limited circumstances. It also agreed to place an anti-smoking public service announcement on DVDs of any future film that does show actors smoking, and will ask movie theaters to run these PSAs before showing the film. Do you consider this an important step, and is it one you think other movie studios should follow?
What should happen is Disney should extend it to all of their films that they produce and distribute across their brands. They have pledged to try and improve that situation. And it would be great if the movie ratings board [operated by the MPAA and the National Association of Theater Owners] would go back and re-rate the last 100 films and tell us what the rating would be under this new policy. The policy is very amorphous and very unclear. If they can say to filmmakers, “If there is smoking in your movie, you will be bumped to an R rating,” then there would be economic pressure to get rid of it. Films depicting smoking should receive an R rating unless it is about a historical character where the smoking is intrinsic to the character or it is unambiguously about the health effects of smoking. Why not a PSA into a film when it goes out to the theaters the same way the MPAA did about the issue of pirating films? That type of PSA is now supported by two-thirds of Americans.

Why do you think that showing strong anti-smoking ads before a film which features smoking can counteract the effect of the smoking images?
Research finds that showing anti-tobacco spots before movies works to neutralize the pro-tobacco influence smoking in the movies has on young audiences, but it does not change the youth’s willingness to recommend the films to friends. In fact, in 2007, the National Academy of Sciences Institute of Medicine, after reviewing the scientific evidence, concluded, “The increased risk for smoking initiation as a result of exposure to smoking in the movies can be reduced by antismoking advertisements…” and recommended that such ads appear before movies with smoking.

How do you use marketing in the “Truth” campaign to change attitudes about smoking?
We encourage young people to rebel against the makers of tobacco products and reject tobacco as opposed to becoming a smoker as an act of rebellion. There is the bad boy image and youth smoke precisely because it is bad. How do you counter this attitude? The “Truth” campaign is targeted or directed to the most rebellious youth because we know the bad guys are the popular guys. The most popular teens are the ones most likely to use a variety of drugs.