As today's youth become increasingly transfixed by the seductive images of popular culture, it might be appropriate to ask what effect such a graphic fixation might have on adolescent health issues. While cigarette advertising is limited or banned in many countries, smoking images have far from disappeared in mainstream culture, and we need only look to the latest television or movie celebrity for confirmation that tobacco is still very much in the limelight. Cigarettes also have a less obvious connection with images of glamorous and very svelte women, as female teenagers – concerned about weight gain – catch on from an early age that smoking is associated with weight loss.
Thankfully, health organizations, charged with dissuading the young from taking up smoking, are twisting the knife into tobacco companies by turning the tables on them. While sexy superstars or sporting heroes were once seen laughing and joking with their extra long, extra mild, extra menthol, extra smooth, extra lifestyle cigarettes, we now see ghastly images of long-time smokers' (or bits of them, at least) diseased tissue and organs in TV commercials and on cigarette packets. But just how effective are these negative images of smoking; and are they an effective counter to the images that got kids hooked on nicotine in the first place?
A study in the American Journal of Preventative Medicine (AJPM), published in 2002, found that teen attitudes toward smoking are positively reinforced and normalized by images found in movies. It seems that while graphic sex and violence have become a big censorship issue in regard to teens, positive images of smoking have slipped quietly under the radar. The study showed that out of 3,500 middle school students (grades 5-8) sampled, around 20 percent were susceptible to smoking, 20 percent viewed peer smoking as normal, and 58 percent thought that adults smoking was normal. Using an extensive list of mainstream films where smoking occurs, the researchers found that adolescents who had viewed a greater number of films from the list had a greater susceptibility to smoking uptake. "Our research documents a strong relationship between viewing tobacco use in movies and more positive attitudes toward smoking among adolescent never-smokers... [supporting] the hypothesis that viewing movie tobacco use is an important factor in adolescent smoking initiation," said the authors of the study. These conclusions were drawn after accounting for and excluding other influences that may have normalized and initiated smoking among the test subjects, such as peers and personal reasons associated with weight loss.
This latter reason for smoking is commonly cited among young females, and difficult to prevent unless caught early. Media images of thin women and the normalization of smoking seem to represent a double-whammy for teenage females, with one reinforcing the other. As such, many teenage females consider smoking as a means to an end; a temporary measure to keep down their weight, fully intending to stop later. For this reason some studies suggest that not enough emphasis is placed on how difficult it is to kick a smoking habit. One could argue that some parental responsibility should come into play here, but how could a parent be expected to control the amount of positive smoking images their child sees? Especially when the AJPM study shows the amount of positive tobacco images that a normal adolescent would see in films are almost as influential on their attitudes as having friends who smoke.
While preventing adolescents from beginning a nasty smoking habit is a difficult task, not all is lost. There have been some encouraging studies on current and former smokers who view the new graphic anti-smoking campaigns as effective. Research conducted in Canada during 2003 and 2004 showed that 38 percent of people aged between 18-24 thought that smoking health warnings were more effective if both text and images are used. A broader study conducted by the Canadian Cancer Society showed that 58 percent of all smokers found the labels more effective than text. Full-color pictures of how cancer affects the mouth, lungs, heart and brain made many respondents think twice about the health effects of smoking. So it seems that health organizations have finally caught on to the importance of graphical images in getting their anti-smoking message across, and are now fighting fire with fire.
It would be comforting to know that these new graphic health warnings will assist in stopping teens from starting smoking. This could come as either a cessation of the normalization of smoking as more people quit, or teens quitting from exposure to the images themselves. In either case, time is a factor, as societal attitudes toward smoking will not change overnight. Which brings us to an even more surprising study on teen smoking.
One research group, whose work was picked up by the respected British Medical Journal, found that there was a correlation between the ubiquitous rise in popularity of the cellphone among teenagers, and a decline in teen smoking initiation. And this trend, say the researchers, well and truly predates graphic warning labels on cigarette packets. "Many aspects of mobile phone use provide teenagers with the same functions offered by smoking while offering an alternative for spending money," the group argued. "The mobile phone is an effective competitor to cigarettes in the market for products that offer teenagers adult-style."
This correlates with other studies that show young teens' smoking habits are restricted by cash flow. So now we have a situation where teens have to decide between smoking and having a mobile phone. "The need to own a mobile phone will provide vigorous competition for the spare cash once spent on cigarettes," say the authors. This newly discovered trend may even outweigh the importance of smoking as a form of weight control, as: "Mobile-phone use may act as an entry to a peer group and may be essential for membership of a peer group that arranges its social life on the move."
While health warnings that depict graphic warnings about the dangers of smoking are having some effect among older established smokers, a complete societal change in attitudes toward smoking is bound to take some time. The eradication of smoking as a social norm is most likely generational, which the latest study on teens and mobile phones highlights. Let's just keep our fingers crossed that cellphones are as safe to use as we've been told.
