• by Thom Forbes , Featured Columnist @tforbes, October 16, 2015

A very close friend is dying from chronic obstructive pulmonary disease in the palliative care unit of the veteran’s hospital in the Bronx. For more than 45 years, he’d smoke a couple of packs of Kools a day. He was so addicted that even after he became permanently tethered to a tank of oxygen, he’d sneak a smoke.

Against this backdrop, an ad in TheHollywood Reporter’s Sept. 25 issue jumped out at me. “Five hard-nosed reasons to R-rate movies with smoking,” the headline reads.

It’s the latest volley in a series of 106 advertisements run mostly in trade publications since 2001 by Smokefree Movies, an organization started by Stanton A. Glantz, Ph.D., a professor of medicine at the University of California, San Francisco. The takeaway of the text-heavy, full-page ad, is in its lede: “Kid-rated movies with smoking will recruit 3.2 million new young smokers in this generation, resulting in a million deaths.”

The dire prediction comes from data extrapolated from The Health Consequences of Smoking — 50 Years of Progress, a 2014 report of the Surgeon General. It also accompanies a Centers for Disease Control infographic that shows that youth-rated movies (G, PG, PG-13) delivered 10.8 billion tobacco impressions to theater audiences last year, about the same as 2013. Meanwhile, smoking incidents per movie increased 38%, from 9.9 to 13.7. And the percentage of PG-13 movies without tobacco decreased 6%, to 54%.

A website maintained by Breathe California-Sacramento analyzes all films grossing more than $1 million for tobacco content. “The Walk” a PG-rated film that’s currently No. 7 on the box office list, for example, is deemed to have a “pro” tobacco stance, with four of its actors smoking in three locations, including at a park near a kids' birthday party.

Actors aren’t usually rolling their own from an unmarked pouch. From 2002 through 2014, Breathe California’s data show Altria/Phillip Morris’ Marlboro brand appeared 42% of the time that brands are displayed, followed by Reynolds' Camel (12%), Kool (8%) and Winston (8%) brands.

For the record, my friend does not believe that movies had any impact on his decision to start smoking, or to favor Kools. Both of his parents were heavy smokers, and he cites societal norms and peer pressure as his primary motivators.

But societal norms are wrapped in a big package of influential touch points. And what medium penetrates our psyches, and reflects the desires and aspirations of our culture, more powerfully than the movies?

A longstanding paradox of the advertising industry seems to have a close relative in content marketing. I’ve always found it curious that ad folk claim all sorts of wonderful results for increasing sales and influencing consumers -- except when it comes to such areas as underage drinking and tobacco. Then, advertising is said to have no impact. It just influences existing consumers in mature markets to switch brands.

In fact, “a large body of epidemiologic, behavioral and experimental data” led the Surgeon General to conclude in a 2012 report that “there is a causal relationship between depictions of smoking in movies and initiation of smoking among young people.”

That is surely a perverse testimony to the power of product integration on screens both big and ever smaller.

Indeed, product placement in movies and TV shows has been expanding rapidly, as ways to avoid commercial messages proliferate, from DVR skipping to ad-blocking apps.

A PQ Media report earlier this year found that product placement is “the smaller, but faster-growing segment of branded entertainment with global revenues increasing 13.6% in 2014 to $10.58 billion.” It also found that brands are “focusing more placements in media content favored by younger audiences.”

Although a 1998 agreement between state attorneys general and domestic tobacco companies prohibits tobacco product placement in entertainment accessible to kids, there are enough loopholes involving multinational corporations to render it toothless.

I’m sure there are many In Hollywood, Big Tobacco and the Heartland who would argue that Smokefree Movies is attempting to stifle the creative process or, worse, censor reality. People smoke, so why shouldn’t movie directors be allowed to depict that truth?

They can, says Smokefree Movies and a host of supporting groups, including the American Medical Association. Just give the movie an “R” rating, which means children under 17 must be accompanied by a parent or guardian.

Every time I see a young person with a cigarette, I want to tell him or her about my buddy who had a great verve for living, but is dying about 25 years before he should. I resist, because I know no one wants to hear from a nosy old coot. A movie star, that’s another story.