# Introduction ndia is the second largest consumer of Tobacco products in the world with 35% of adults (15 years and above) consuming tobacco. 1 Overall tobacco use among males is 48% and among females is 20%. As per GYTS (2006), 14.1% 13-15 years school going children in India use tobacco products. It is interesting to note that the tobacco products use by the youth is also predominantly smokeless tobacco products, as is amongst the adults. 2 In the age group, 30 years and above, the proportion of deaths attributable to tobacco is almost 24% for men and 12% for females. Among those who die prematurely, almost one in every 8 deaths among those aged 30-44 years and one in 5 among those aged 45-59 years is attributable to tobacco use. 3 The next section of this article briefly introduces the literature review using pubmed, internet, published reports, and perspectives relating to evidence of association between smoking scenes in films and imagery and smoking by adolescents and youth. India is one of the major film producing countries in the world. There has been a steady increase in production of films over the years. While 764 Indian feature films were certified in the year 1999, the number increased to 1325 in 2008. In 2011, a total of 814 films were produced during the period ranging from April to November. 20 # Smokefree Movies in India-Converting Evidence into Action There is growing evidence that an adolescent's decision to try cigarettes is influenced by level of exposure to movies in which smoking is portrayed. Many studies in United States have indicated that higher exposure to smoking in entertainment programming leads to greater initiation among youth possibly through social modeling and by reducing resistance to counterarguments. [4][5][6][7] Some other studies linked smoking status of an adolescent's favorite movie star to attitudes and smoking behaviour. [8][9][10] The effect of exposure to movie smoking on behavior has also been shown to be mediated through attitudes towards smoking 11 and smoking status of peers. [12][13] A cross cultural study involving six European countries established the consistency of the association between movie smoking and adolescent smoking, despite their substantial differences in culture and tobacco policy, and after covariate control for the number of movies seen, adds further weight to the argument that smoking in movies is an independent risk factor for smoking uptake in youth. 14 Evidence from India has found that specific media content such as media advertising is associated with higher smoking rates 15 , and exposure to cigarette brand names or actors smoking on television have been found to be related to increased youth smoking in India. 16 One study provided evidence that exposure to pro-tobacco content in television and cinema may promote tobacco use among men and women in India. 17 Another Indian study found a strong association of tobacco use by the adolescents with having seen various role models ever smoking. 18 It is noteworthy that India has the largest population of adolescents in the world, being home to 243 million individuals aged 10-19 years. The country's adolescent constituted 20 percent of the world's 1.2 billion adolescents. 19 Indians working abroad and building a fan base in industrialized countries. Entry into the Indian film market is also a potential growth area for the United States film industry. For these reasons, national interventions in India can have a global impact on reducing youth exposure to tobacco imagery. 21 The Indian anti tobacco law provides for ban on all forms of advertisements, promotion and sponsorship of tobacco products. 22 The law also provides for regulating smoking scenes in movies. A few years ago the Indian government tried unsuccessfully to ban all smoking scenes in movies, as the provision was legally challenged. 23 A study of India's indigenous cinema industry conducted by WHO and the Ministry of Health and Family Welfare in 2003 (before the anti tobacco law was enacted) revealed that 76% of top-grossing films during 1990-2002 depicted tobacco use, tobacco incidents attributed to the lead actors growing from 22 % in 1991 to 54% in 2002. 24 Another study which was conducted after the anti tobacco law banned all tobacco advertisements revealed that 89% Hindi -language films produced in 2004-05 depicted tobacco use and smoking scenes were attributed to lead actor in 76% of the films. Interestingly 46% films, mostly large-budget films, displayed tobacco branding. 25 II. # Discussion The tobacco industry has long recognized the value of smoking in movies to promote cigarettes and developed extensive programs to promote smoking in the movies. 26 The images of smoking in movies both normalize the behavior and downplay the negative health effects associated with smoking, encouraging more tolerant, neutral, or nonchalant attitudes about smoking. Although teens generally acknowledge the long-term health risks associated with smoking, they immediately experience the perceived short-term benefits of smoking, such as looking tough or sexy or fitting in with their peers, which reinforces and motivates adolescent smoking. 27 Movies are such a powerful influence on adolescents that they can negate the effects of positive parental role modeling on smoking. 28 Looking at the strong empirical evidence indicating increased adolescent smoking initiation associated with smoking scenes in movies, amending the movie rating system to rate movies containing smoking as "R" should reduce adolescent exposure to smoking and subsequent smoking. It is further established that viewing antismoking advertisements before viewing movie smoking seemed to blunt the stimulating effects of movie smoking on adolescent smoking. 29 Concern about the impact of exposure to tobacco imagery in movies on youth smoking led the World Health Organization (WHO) to recommend that all future movies with scenes of smoking should be given an adult rating, with the possible exception of movies that reflect the dangers of tobacco use or that depict smoking by a historical figure who actually smoked. 30 Implementing this policy would substantially reduce the dose of onscreen smoking delivered to children and adolescents and the corresponding response of smoking initiation. 31 1. All new Indian and foreign films and television programmes displaying tobacco products or their use shall have to submit a strong editorial justification explaining the necessity of the display of the tobacco products or their use in the film, to the CBFC. 2. Screening of anti tobacco health spots of minimum thirty seconds duration at the beginning and middle of the films. This also applies to old Indian and foreign films and old television programmes displaying tobacco products or their use. 3. Display of anti tobacco health warning as a prominent static message at the bottom of the screen during the period of display of the tobacco products or their use in the film and television programme. 4. Screening of an audio-visual disclaimer on the ill effects of tobacco use, of minimum twenty seconds duration each, in the beginning and middle of the film and television programme. 5. The health spots and disclaimer will be made available to the CBFC by the Ministry of Health & Family Welfare, Government of India. 6. The failure to comply with the aforesaid provisions by the owner or manager of the cinema hall or theatre or the broadcaster of the television programme will lead to cancellation or suspension of the licence. The efforts of Ministry of Health in India to provide for adult rating to the movies with smoking scenes were countered by the Ministry of Information and Broadcasting, citing practical difficulties faced by the film industry in implementing the same. Although it directed the Central Board of Film Certification (CBFC) in May 2012 to ensure featuring a twenty second anti smoking message approved by Ministry of Health with voiceover of one of the actors who is seen smoking in the film at the beginning and middle (after interval) of the film and display of a static anti smoking message for the duration of smoking scene in the film. 32 There was further resistance to these provisions by the film industry arguing inference in the freedom of expression by such provisions. Finally the new law was notified and come into effect from 2 nd October, 2012 after a long legal battle and intense deliberations with the Ministry of Information and Broadcasting. 33 The law has the following provisions: initially. The film industry also tried to influence the Ministry of Information & Broadcasting and the media and tried to gain public sympathy by pleading that the law was a direct interference with their freedom of expression. However the Hindi-language and regionallanguage films and television programmes have now started following and implementing the provisions under the law. How much impact this regulation ultimately has on prevention of adolescent smoking and tobacco use needs further research. # III. # Conclusion At least 7300 feature length movies were produced and released in 2009 (many directly to video) in fifty nations worldwide, including 1341 (18%) in the European Union, 1288 (17%) in India, 677 (9%) 56 (6%) in China and 448 (6%) in Japan. 34 The tobacco industry knows that motion pictures are one of humanity's most common entertainment experiences. The world spends approximately US $ 120 billion a year to view films through legitimate distribution channels. 21 India leads the world with highest actual admissions into movie theatres (2.7 billion in 2010). 35 The depiction of tobacco use in the movies in India, which has one of the most active film industry globally, remains an active vehicle for promoting smoking and other tobacco products use, including in films rated as suitable for children and adolescents. A recent study finding suggested that scenes depicting tobacco use are shown in Bollywood movies even after the enactment of COTPA in 2004, Section 5, which prohibits direct and indirect forms of tobacco advertising and further provides evidence of association between seeing tobacco use in movies and youth tobacco use in India. 36 Hence it becomes imperative that the legislative provisions for regulating scenes depicting smoking and tobacco use in the movies are implemented in letter and spirit to ensure that the motion pictures no longer serve as a source of tobacco promotion aimed at young people. This along with the other provisions in the Indian anti tobacco law which aim at reducing access of minors (below 18 years of age) to all tobacco products, if strongly enforced will go a long way in preventing the youth from taking up tobacco use in India. # IV. Volume XIII Issue III Version I As the provisions are quite stringent, the film industry was much reluctant to implement the same ![Moreover Indian films are viewed in over one hundred countries worldwide, attracting 25 million Volume XIII Issue III Version I](image-2.png "") © 2013 Global Journals Inc. (US) ## Acknowledgements The views expressed in the article are of the authors and not necessarily of their respective organizations. * Ministry of Health & Family Welfare-IIPS, Mumbai. 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