Context: Viewing smoking and drinking in movies may prompt adolescents to initiate these behaviors. Movies with R ratings contain more smoking than do movies in all other rating categories.
Objective: To evaluate the extent to which parents restrict the exposure of adolescents to R-rated movies and to determine whether such restrictions are associated with decreased tobacco and alcohol use in adolescents.
Design: Cross-sectional, self-administered survey.
Participants: Students in grades 5 through 8 enrolled in New Hampshire and Vermont schools. SAMPLING STRATEGY: Fifteen schools in Vermont and New Hampshire were randomly selected from all middle schools with > or = 150 students.
Outcome measures: Students who had tried smoking cigarettes or tried drinking alcohol without parental knowledge.
Results: Of 4544 students surveyed, 18% had tried cigarettes and 23% had tried alcohol. Although 90% were younger than 14 years of age, only 16% were completely restricted from viewing R-rated movies. The prevalence of having tried smoking was 35% for those with no restrictions on viewing R-rated movies, 12% for those with partial restrictions, and 2% for those with complete restrictions. The prevalence of having tried alcohol was 46% for those with no restrictions on viewing R-rated movies, 16% for those with partial restrictions, and 4% for those with complete restrictions. Even after controlling for other factors, including grade, parental disapproval of smoking, maternal supervision, maternal responsiveness, peer and family smoking, and child personality characteristics, children who were completely restricted from viewing R-rated movies were significantly less likely to smoke (relative risk, 0.29; 95% CI, 0.19 to 0.45) or drink (relative risk, 0.30; CI, 0.21 to 0.42) compared with those who had no restrictions on viewing R-rated movies.
Conclusion: Limiting the exposure of adolescents to R-rated movies may prevent early use of alcohol and tobacco.