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According to researchers at the Geisel School of Medicine at Dartmouth College, teen-friendly movies without smoking scenes would deter adolescents from picking up a cigarette.

The researchers surveyed, over a two-year period, over 6,500 teens between 10 and 14 years old. They asked them which of a random selection of box-office hits they'd seen in the previous year and whether they'd ever tried smoking.

Based on the results of the surveys, researchers concluded that teens who watched movies with more smoking scenes were more likely to try smoking themselves. About 60 percent of teens' movie smoking exposure comes from movies that are rated for teen viewing.

James Sargent, a professor of pediatrics at the Geisel School of Medicine at Dartmouth College, said that watching smoking is movies is almost equivalent to watching violence or sex.

"The film industry has known about the relationship between smoking in movies and kids smoking for years and it still has not meaningfully incorporated smoking into its rating system,' Sargent said. "What we want them to do is give an unambiguous 'R' rating for smoking. Just as kids shouldn't be watching extreme violence or extreme sex, they shouldn't be watching smoking."

According to researchers, the number of youth who try cigarettes could drop by 18 percent if smoking was not included in movie scenes. Researchers suggest making all movies with smoking rated "R."

"Smoking is a killer," Sargent said. "Its connection to cancer, heart attacks, and chronic lung disease is beyond doubt. Kids start to smoke before they're old enough to think about the risks; after starting they rapidly become addicted and then regret it. Hollywood plays a role by making smoking look really good. By eliminating smoking in movies marketed to youth, an R rating for smoking would dramatically reduce exposure and lower adolescent smoking by as much as one-fifth." 

The study was published in the journal Pediatrics and supports an earlier study this year that watching movie smoking causes teens to pick up the habit. However, researchers say more work must be done to figure out whether "on-screen smoking per se or other adult behaviors in films - the sex and violence that accompany smoking - that affect teens' behavior."

"It's a terrible thing when a kid starts smoking, and the idea that what they see in the movies can cause that and can be responsible for that is something we take very seriously for public health because smoking causes a lot of bad diseases in our population," said Sargent.

Researchers say it's up to the parents to monitor what their children watch, even if the Motion Picture Association of America includes smoking in its rating system. They also said that teens should not be watching more than two movies a week and they shouldn't be exposed to R-rated content until late in adolescence.

"The next step for us is to motivate and help parents limit access to these movies. Teens still get a lot of exposure to smoking from rated R movies," said, Sargent.