Institute for Therapy and Health Research (IFT-Nord), Harmsstrasse 2, 24114 Kiel, Germany.
Thorax. 2011 Oct;66(10):875-83. doi: 10.1136/thoraxjnl-2011-200489. Epub 2011 Aug 25.
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.
探究电影中吸烟场景与青少年吸烟行为之间的关联是否独立于文化背景。
横断面调查了德国、冰岛、意大利、荷兰、波兰和苏格兰的 16551 名 13.4 岁（SD=1.18）的学生，其中男女比例均衡。于 2009 年 11 月至 2010 年 6 月在学校进行调查。采用先前验证过的方法，根据各国（2004-2009 年）票房最高的 250 部电影来估算电影中的吸烟暴露情况，并将其与曾经吸烟的情况进行关联。
总体而言，有 29%的样本尝试过吸烟。样本中电影吸烟暴露的四分位数（Q）与曾经吸烟的流行率显著相关：Q1 中 14%的青少年尝试过吸烟，Q2 中 21%，Q3 中 29%，Q4 中 36%。在控制年龄、性别、家庭富裕程度、学业成绩、电视屏幕时间、看过的电影数量、感觉寻求和叛逆以及社会环境（同伴、父母和兄弟姐妹）中的吸烟行为后，整个样本中尝试吸烟的青少年在 Q2 中的调整后比值比（OR）为 1.3（95%可信区间为 1.1 至 1.5），在 Q3 中为 1.6（95%可信区间为 1.4 至 1.9），在 Q4 中为 1.7（95%可信区间为 1.4 至 2.0），与 Q1 相比。在所有国家，曾经吸烟与更高的电影吸烟暴露水平之间的调整关系都具有统计学意义，在意大利和波兰存在非线性关联。
电影中吸烟场景与青少年吸烟之间的联系是稳健的，并且超越了不同的文化背景。限制年轻人接触电影中的吸烟场景可能对公共卫生具有重要意义。
