Objective To study the effects of smoking in a film trailer.
Design Experimental study.
Setting Ten secondary schools in Northern Germany.
Participants A sample of 1051 adolescents with a mean (SD) age of 14.2 (1.8) years.
Main Exposures Participants were randomized to view a 42-second film trailer in which the attractive female character either smoked for about 3 seconds or did not smoke.
Main Outcome Measures Perception of the character was measured via an 8-item semantic differential scale. Each item consisted of a polar-opposite pair (eg, "sexy/unsexy") divided on a 7-point scale. Responses to individual items were summed and averaged. This scale was named "attractiveness." The Cronbach 
for the attractiveness rating was 0.85.
Results Multilevel mixed-effects linear regression was used to test the effect of smoking in a film trailer. Smoking in the film trailer did not reach significance in the linear regression model (z = 0.73; P = .47). Smoking status of the recipient (z = 3.81; P < .001) and the interaction between smoking in the film trailer and smoking status of the recipient (z = 2.21; P = .03) both reached statistical significance. Ever smokers and never smokers did not differ in their perception of the female character in the nonsmoking film trailer. In the smoking film trailer, ever smokers judged the character significantly more attractive than never smokers.
Conclusion Even incidental smoking in a very short film trailer might strengthen the attractiveness of smokers in youth who have already tried their first cigarettes.
