From James Dean smoking in Rebel Without a Cause to Jennifer Lawrence lighting up in American Hustle, Hollywood has long used cigarettes to signal a sense of coolness. Unfortunately, experts think those puffing protagonists are a threat to public health. In 2012, researchers at the Centers for Disease Control and Prevention found a causal relationship between a youth’s first exposure to smoking on screen and the age they actually began smoking. Now, a new study from the CDC complicates the issue, revealing that the total number of incidents of tobacco use in movies has increased.

To protect the health of American youth, the researchers are calling for censorship.

This rise, the study authors argue, is serious enough that the Motion Picture Association of America should consider giving an R rating to “any movie with smoking or other tobacco-use imagery (unless the portrayal is of actual historical figures who smoked, a documentary, or if the portrayal includes the negative effects of tobacco use).”

According to this report, which was compiled by researchers at the University of California, San Francisco, nearly half of current movies with tobacco references are considered acceptable for children, meaning they are rated G, PG, or PG-13. Furthermore, depictions of tobacco use in films rose by 72 percent from 2010 to 2016. Over that period, movies with an R rating showed a 90 percent rise in tobacco imagery, and PG-13 movies saw a 43 percent increase.

These stats are stressing me out.

The statistics analyzed in this report were taken from data collected by the anti-smoking nonprofit Breathe California Sacramento Region in a film-focused project called “Thumbs Up! Thumbs Down!” In this project, the top-grossing movies that premiered between 2010 and 2016 were analyzed for the number of “tobacco incidents” they showed, a category that includes cigarettes, cigars, pipes, hookahs, smokeless tobacco products, and electronic cigarettes. The research showed that the overall percentage of movies with any tobacco incidences decreased over that period, but the number of tobacco incidents within movies increased by 72 percent. In other words, the movies that showed tobacco showed a lot of tobacco.

It’s a worrying change in direction considering that between 2005 and 2010 there was a decline in the overall number of tobacco incidents in movies. The researchers note that “had the trend established from 2005 to 2010 continued, all youth-rated films would have been smoke-free by 2015.”

While the CDC says hookah and electronic cigarette use has increased among adolescents from 2011 to 2016, the number of young people who smoke actual cigarettes actually declined during this same period. Nevertheless, there are still more kids smoking than the CDC deems safe. In the report, they note that “if current trends continue, 5.6 million youths who are alive today are projected to die from tobacco-related diseases.”

midnight in paris public health smoking
Smoking in films is undeniably, dangerously cool. 

Their plan for curbing that trend includes assigning an R rating to movies that feature smoking, a strategy that presumes that adolescents 17 and above are not as impressionable as their younger peers. However, the study authors also argue that the MPAA needs to take responsibility for its role in public health by ensuring that its studios and producers don’t include tobacco products from companies in exchange for sponsorship. Apparently, it happens all the time; according to the CDC report, 24 states awarded $3.5 billion in public subsidies, including tax credits, to productions of movies that included tobacco incidents between 2010 and 2016.

“Modernizing Hollywood’s rating system to protect the audience by awarding movies with smoking an R rating would save a million kids’ lives,” senior author and professor of medicine Stanton Glantz, Ph.D., said in a statement. “That is the best way that the six big media companies that control the Motion Picture Association of America could ensure that movies marketed to kids are also not selling cigarettes.”

Photos via Giphy (1, 2), Midnight in Paris