| Study | Design | Measure of exposure | Categories of covariates used in adjustmenta | Outcome | Exposure comparison categories | Measure of association, association (95% CI)b | Comments |
|---|---|---|---|---|---|---|---|
| Cross-sectional | |||||||
| Dalton et al. 2002a | Cross-sectional school- based survey N = 4,544 White Aged 10–15 years United States (Northeast) 1999 | “How often do your parents let you watch movies or videos that are rated R?” (p. 3) (Never, once in a while, sometimes, all the time) | M, P, PS, S, SCH, SI | Prevalence of tried smoking (18%) | Allowed to watch R-rated movies: | ARR | Parental restrictions associated with lower viewership of R and PG-13 movies and lower rates of drinking alcohol |
| Never (16%) | 0.29(0.19–0.45) | ||||||
| Once in a while/ sometimes (53%) | 0.74(0.65–0.85) | ||||||
| All the time (31%) | Reference | ||||||
| Dalton et al. 2006 | School-based survey N = 2,606 Aged 9–12 years United States (Northeast) | Parental restrictions on R-rated movie viewing combined with whether they co-viewed the movies | PS, S, SI | Susceptibility to smoking (12.5%) | ARR | When assessing other movie-monitoring habits (requiring child to ask before seeing, going into video store, overseeing movie viewing at friends), it appeared that these behaviors partially ameliorated the effects of seeing R-rated movies | |
| Permits watching, no parent | Reference | ||||||
| Permits watching, co-views | 0.72 (0.54–0.96) | ||||||
| Prohibits child from watching | 0.54 (0.41–0.70) | ||||||
| Thompson and Gunther 2007 | School-based survey of 1,687 6th–8th graders N = 1,687 United States (Wisconsin) | “How often do your parents let you watch movies or videos that are rated R?” ([1] never to [5] all the time) | PS, S, SI | Smoking susceptibility among never smokers (24%) | R-rated movie restriction: | AOR | |
| Full | Reference | ||||||
| Partial | 2.1(1.5–2.8) | ||||||
| None | 3.3 (2.3–4.6) | ||||||
| R-rated movie restriction: | |||||||
| Tried smoking prevalence (29%) | Full | Reference | |||||
| Partial | 1.5(1.0–2.8) | ||||||
| None | 2.5(1.7–3.7) | ||||||
| Longitudinal | |||||||
| Sargent et al. 2004 | Longitudinal school-based survey with telephone follow-up, baseline survey N = 2,596 baseline never smokers Follow-up at 18 months White Aged 10–14 years at baseline Baseline smoking status: never smoker United States (New Hampshire, Vermont) 1999 | “How often do your parents allow you to watch movies or videos that are rated R?” (Never, once in a while, sometimes, all the time) | EA, P, PS, S, SCH, SI | Incidence of tried smoking (15.9% by 18 months) | Allowed to watch R-rated movies: | ARR | Statistically significant interaction with stronger results for adolescents living in nonsmoking households; relaxation of R-rated restrictions over time resulted in greater risk of smoking; strengthening of restrictions over time resulted in lower risk |
| Never (19%) | Reference | ||||||
| Once in a while (29%) | 1.8(1.1–3.1) | ||||||
| Sometimes/all the time (52%) | 2.8(1.6–4.7) | ||||||
| Hanewinkel et al. 2008 | Longitudinal, school-based survey N = 2,110 Follow-up at 1 year White Aged 10–15 years at baseline Baseline smoking status: never smoker Germany (Schleswig-Holstein) 2005 | “How often do your parents allow you to watch movies that are rated for 16-year- olds?” (Never, once in a while, sometimes, all the time) | P, PS, S, SCH, SI | Tried smoking incidence (16%) | Never (41%) | Reference | German rating categories refer to the age below which the restriction applies; they are FSK-0 (family), FSK-6, FSK-12, FSK-16, FSK-18; lower exposure to movies in all rating categories for adolescents reporting restrictions; mediational analysis shows indirect pathway from FSK restriction through lower movie substance-use exposure to behavior |
| Once in a while (28%) | 1.19 (0.85–1.67) | ||||||
| Sometimes (22%) | 1.71 (1.33–2.20) | ||||||
| All the time (9%) | 1.85(1.27–2.69) | ||||||
| Smoking and binge drinking (5%) | Never | Reference | |||||
| Once in a while | 1.64(1.05–2.58) | ||||||
| Sometimes | 2.30(1.53–3.45) | ||||||
| All the time | 2.92 (1.83–4.67) | ||||||
Covariates: EA = extracurricular activities; M = other media/advertising influences; P = personality characteristics; PS = parenting style/parental oversight of smoking behavior; S = sociodemographics; SCH = school attachment and function; SI = other social influences (friend and family smoking).
Measures of association: AOR = adjusted odds ratio; ARR = adjusted relative risk.
From: 5, The Tobacco Industry’s Influences on the Use of Tobacco Among Youth
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