Pubblicato: 2022-05-20

Cinema & smoking tobacco: a deal with the devil

S.S.D. Oncologia Medica Patologia Toracica, IRCCS Istituto Oncologico “Giovanni Paolo II”, Bari


Movies sell cigarettes well-known is a slogan, both in Hollywood, and among multinational tobacco industries. This slogan has been repeated for decades by worldwide researchers who study smoking-related risks [1]. From 1927 to 1951, the American Tobacco Company had around two hundred film stars on its payroll, including Clark Gable, Cary Grant, Spencer Tracy, Marlene Dietrich, and Humphrey Bogart. There is no doubt that, since then, the big stars have contributed in creating and promoting an incautious appeal to cigarettes on the silver screen. This appeal is like a magical aura for which cigarette smoking appears as an instrument of seduction, socialisation, transgression, and virility. The cinema has adopted a strategic role in the marketing of tobacco companies (not all of them, fortunately).

In the essay Ashes of stars, Cinema, smoking, and teenagers, published in 2014 and sponsored by WALCE Onlus (Women Against Lung Cancer in Europe), the authors of this editorial evidenced how the alliance with Big Tobacco by producers, directors and actors, has continued over time to the present day, despite a few ups and downs. There is a long list of movies featuring smoking scenes that still bring to life the age-old agreement between tobacco producers and the film industry. The most recent case which has caused strong perplexity by physicians, is the film The Hand of God, the latest movie by Paolo Sorrentino, whose Oscar-winning The Great Beauty arose the same controversy in 2013 for having smoking scenes in it. On the other hand, in the most recent Italian TV series At Home all Well by Gabriele Muccino, the frequency with which the leading actors light up and smoke cigarettes is merely shocking.

It has long been known that a massive number of smoking scenes in movies foster the initiation of tobacco use by teenagers [2], so much that the Article 13 of the Framework Convention on Tobacco Control, the world’s most important international treaty for the protection of public health, has recognised the harm caused by tobacco products and by the companies that market them, and has established global rules on advertising, promoting and sponsorship of cigarettes and similar items. However, due to the appeasement shown by our government on repeated occasions, today the Global Tobacco Industry Interference Index 2021 indicates that Italy, between favouritism and lack of transparency, is among the countries where tobacco policies are most exposed to be subdued by the tobacco [3] industry.

In fact, it is not only in Italy that no sooner do politicians dare to set measures to mitigate or fight this phenomenon – as done by the former Health Minister Barbara Lorenzin who tried to do this in Italy in 2015, and by the French senator Nadine Grelet-Certenais in 2017 who called for a ban on smoking in French-produced films – than the world of entertainment and culture reacts with a vigorous protest, coloured with a tone of sharp irony. “It is as if to say that Anna Karenina should be banned for instigating suicide?” [4]. At that time, the writer Natalia Aspesi commented by saying “the cinema-smoking uproar is thoughtfully ridiculous, even if it comes with a candid humanitarian purpose” [5]. This proposal was confronted with scepticism and sarcasm, even in France. However, despite the declared support by the European Commission and the Wolrd Health Organization (WHO), no action was taken regarding the issue. In the U.S.A., the Centers for Disease Control and Prevention (CDC) and Truth Initiative have long been (pre-)involved in monitoring smoking scenes in films accessible to young viewers. Such films are rated as G, PG and PG-13 by the Motion Picture Association of America (MPAA). However, it is reported that, despite a gradual decline in these scenes, tobacco still appears in some youth-rated films, and more so in non MPAA films (in 2020, 6 out of 22).

Then, between 2019 and 2020, the COVID-19 cyclone drastically changed the scenario. Due to SARS-CoV-2 and the restrictive measures to contain the pandemic, film production destined for cinemas has undergone a significant reduction, all to the full advantage of domestic episodic programmes via online platforms. However, since 2003, multinational tobacco industries have been introducing a variety of new products into the market (electronic cigarettes, heated tobacco and, in other countries, even tobacco powder pouches for oral use). This has led to the expansion of the supply of nicotine and tobacco in Italy and worldwide, and obviously, to the increase of smoking scenes in films and in TV series in particular.

Hand in hand with the prolonged and uninterrupted vision of episodic programmes, which can become a real binge-watching for many teenagers, we can see an increase in the exposure to smoking scenes, that show younger viewers these “new” electronic devices, giving rise to what the American authors today define as the “e-cigarette epidemic”. The outcome is that over the past decade, the reduction in conventional cigarette smoking has been more than balanced by the use of e-cigarettes, which has led to the increase in the overall number of teenagers consuming nicotine products.

A recent study, sponsored by Truth Initiative (a U.S. organisation that promotes public health), stated that youngsters who are most exposed to programmes and TV series containing tobacco imageries are three times more likely to start “vaping” than their unexposed peers [6].

The study, carried out by Jessica Rath, analyses the appearance of “tobacco incidents” (scenes of cigarettes, including electronic ones, pipes, and cigars) in TV series most watched by young viewers on video streaming platforms, HBO, Amazon Prime, Netflix, and cable TV. The results of the study suggest that teenagers’ exposure to tobacco using scenes in TV series may have an influence on e-cigarette consumption: in 86% of cases, programmes which have tobacco imagery, and in Netflix, the number of tobacco incidents has been gradually increasing [7].

It is clear that for some time now, the film industry cannot disregard the support provided by the multinational tobacco industries, whose aggressive marketing strategies should be fought against with adequate restrictive measures, starting from applying a more accurate monitoring of films and TV series provided by the media and by using new methods to assess the exposure of adolescents (amongst other viewers).

Whether for ethical or ‘aesthetic’ reasons, many viewers cannot stand smoking scenes which are irrelevant to the narrative context in the vast majority of films and TV series. The cinema could and should be a remarkable tool of entertainment and education, and not a deceitful tool to promote smoking (conventional and/or electronic cigarettes).

In a recent interview by an Italian newspaper, French director François Ozon criticised the use of “platform supermarket”, which is an anguishing scenario for those who, like him, make films for cinema theatres. He said “I wonder if Jane Campion, Alfonso Cuaròn, Martin Scorsese, Paolo Sorrentino needed Netflix money to work. For cinema theatres, these platforms represent the devil, and they have a deal with the devil” [8].

This is certainly not the first deal, we would add. And from the fire of the most ancient diabolical pact, namely with the multinational tobacco industries, the puffs of smoke, that still pervades cinemas all over the world, arise.


  1. Lum KL, Polansky JR, Jackler RK, Glantz SA. Signed, sealed and delivered: “big tobacco” in Hollywood, 1927-1951. Tob Control. 2008; 17:313-23.
  2. Sargent JD, Beach ML, Adachi-Mejia AM, Gibson JJ, Titus-Ernstoff LT, Carusi CP. Exposure to movie smoking: its relation to smoking initiation among US adolescents. Pediatrics. 2005; 116:1183-91. DOI
  3. Gruppo Italiano del Global Tobacco Industry Interference Index. Scienzainrete; 2021.
  4. Soffici C. La Stampa; 2017.
  5. Aspesi N. La Repubblica; 2017.
  6. Truth Initiative. Straight to Vape. 2020.
  7. Bennett M, Hair EC, Liu M, Pitzer L, Rath JM, Vallone DM. Exposure to tobacco content in episodic programs and tobacco and E-cigarette initiation. Prev Med. 2020; 139:106169. DOI


Edoardo Altomare

Domenico Galetta

S.S.D. Oncologia Medica Patologia Toracica, IRCCS Istituto Oncologico “Giovanni Paolo II”, Bari


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