In accordance with the conclusion of the US National Cancer Institute to consider smoking in films, in addition to other factors, as one risk factor for the initiation of smoking among children and adolescents, the World Health Organization has invited its member states to implement rules for limiting smoking depictions in films. Results of methodically high-value longitudinal and experimental studies which provide empirical evidence for the association between smoking depictions in films and smoking among children and adolescents are presented. Interpretation of this association as causal according to Hill criteria is discussed. In this systematic review, future personal and structural preventive interventions to address this problem in Germany are presented and discussed. Of special importance is the enhancement of both parental competence in media education as well as media literacy in children and adolescents. Rating films depicting smoking as approved for adults only could yield the largest effect, since it leads to an enduring reduction of exposure.