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Meghan R. Longacre, PhD; Anna M. Adachi-Mejia, PhD; Linda Titus-Ernstoff, PhD; Jennifer J. Gibson, MS; Michael L. Beach, MD; Madeline A. Dalton, PhD

Arch Pediatr Adolesc Med. 2009;163(3):218-224.

Objective  To evaluate whether parents want smoking and alcohol use to be considered in movie ratings.

Design  Data were collected as part of a longitudinal study of adolescent health behavior involving 2564 parent/child dyads from northern New England. Parents (n = 2401) were surveyed at wave 2 about movie ratings. Qualitative interviews were conducted with a subset of parents (n = 62) 15 months later.

Setting  Participants were surveyed by telephone.

Participants  Most parents (94.9%; n = 2279) were mothers, 52.5% were younger than 40 years, and 90.6% were white, and children were aged 9 to 15 years.

Main Outcome Measures  Whether cigarette and alcohol use should be included as movie ratings criteria and if movies with cigarette or alcohol use should be rated R.

Results  About 52% (n = 1242) and 66% (n = 1579) of parents believed cigarette or alcohol use, respectively, should be used as movie ratings criteria; 28.9% (n = 693) supported an R rating for movies with smoking and 41.9% (n = 1003) supported R ratings for alcohol. In adjusted models, parents were more likely to support adding cigarette and alcohol use as ratings criteria if they believed the current ratings were not useful, they restricted their children from watching R-rated movies, and they were nondrinkers. Nonsmoking parents were more likely to support an R rating for smoking. Interviews revealed that parents may underestimate the impact of movie smoking and drinking.

Conclusions  Although a majority of parents supported including smoking or drinking in ratings criteria, fewer favored R ratings. Parental support could be a key factor in determining the impact of modifications to the Motion Picture Association of America rating system.

Author Affiliations: Departments of Pediatrics (Drs Longacre, Adachi-Mejia, Titus-Ernstoff, Beach, and Dalton) and Family and Community Medicine (Drs Titus-Ernstoff, Beach, and Dalton and Ms Gibson) and Community Health Research Program, Hood Center for Children and Families (Drs Longacre, Adachi-Mejia, Titus-Ernstoff, and Dalton), Dartmouth Medical School, and Department of Anesthesiology, Dartmouth-Hitchcock Medical Center (Dr Beach), Lebanon, New Hampshire. Ms Gibson is currently with the Norris Cotton Cancer Center, Dartmouth Medical School.

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