Hollywood images: Is tobacco use back in the picture?

Bogie lighting Bacall’s cigarette is an enduring image from the 1944 movie “To Have and Have Not.”

But especially since the 1960s, films showing constant cigarette smoking have largely vanished. The pervasive haze of smoke of the Humphrey Bogart era is a thing of the cinematic past.

Yet recent top-grossing films have gone in a different direction. The Atlanta-based CDC recently reported an increase in tobacco use in hit movies – a trend that has alarmed public health advocates.

The report says the number of individual occurrences of tobacco use in top-grossing movies increased 72 percent over six years, from 1,824 in 2010 to 3,145 in 2016. And there was a 43 percent jump in tobacco incidents among PG-13 rated movies, the study found.

The tobacco/movie study comes at a time when youth smoking, like cigarette smoking in general, has been declining.  In Georgia, 12.8 percent of high school students smoke, while the adult smoking rate is 17.7 percent – higher than the national average.

Tobacco use is the leading cause of preventable disease, disability and death in the United States. It accounts for more than 480,000 deaths every year, or 1 of every 5 deaths.

Nearly 40 million U.S. adults still smoke cigarettes, and about 4.7 million middle and high school students use at least one tobacco product, including e-cigarettes, according to the CDC. Every day, more than 3,800 youths younger than 18 years old smoke their first cigarette.

The U.S. Surgeon General has concluded that there is a causal relationship between depictions of smoking in the movies and the initiation of smoking among youth. The more frequently youths see smoking on screen, the more likely they are to start smoking.

“There’s a long history of Hollywood glamorizing tobacco use,’’ Paul Billings, a senior vice president of the American Lung Association, told GHN on Monday. He said the CDC report was disappointing “because it showed progress is stalled and more work is needed.”

“2016 was a bad year.”

From “To Have and Have Not”

The CDC report did not name the films that feature smoking.

An author of the report, Stanton Glanz, said that “modernizing Hollywood’s rating system to reflect the audience by awarding movies with smoking an R rating would save a million kids’ lives,” according to the Mercury News. Glantz is director of the University of California, San Francisco’s Center for Tobacco Control Research and Education.

Chris Ortman, a spokesman for the Motion Picture Association of America, defended the ratings system, which provides parents with guidance on a movie’s content, the New York Times reported this month. His organization did not directly address the rise in tobacco-use imagery found by the researchers.

“This system has withstood the test of time because, as American parents’ sensitivities change, so too does the rating system,” Ortman said in a statement, the Times reported. “Elements such as violence, language, drug use, and sexuality are continually re-evaluated through surveys and focus groups to mirror contemporary concern and to better assist parents in making family viewing choices.”

Billings of the Lung Association noted that a 1998 settlement in the suit brought against the tobacco industry by the state of Minnesota imposed a national ban on tobacco product placement in movies.

Yet Billings added, “There’s still concern about incentives for tobacco product placement’’ in films.

Researchers used data from the “Thumbs Up! Thumbs Down!” project, which counts occurrences of tobacco incidents. These are defined as the use or implied use of a tobacco product (cigarettes, cigars, pipes, hookah, smokeless tobacco products, and electronic cigarettes) by an actor, in U.S. top-grossing movies each year.

“Unless the film industry acts to keep smoking out of youth-rated movies, millions more will be influenced to smoke, resulting in tobacco-induced cancers, heart and lung disease, or stroke,” said Dr. Fernando Stein, president of the American Academy of Pediatrics, in a statement.

“The American Academy of Pediatrics urges filmmakers to remove depictions of smoking and tobacco use in U.S. movies that are geared toward children,” he said. “Filmmakers can and must do better.”