Much of the rise has occurred within a certain genre of film: biographical dramas. But even in these "biopics," characters aren't necessarily smoking because they represent a historical figure who smoked in real life.
Instead, "73% of characters who used tobacco in these biographical dramas were fictional," noted a team led by Michael Tynan, a researcher with the U.S. Centers for Disease Control and Prevention's Office on Smoking and Health.
Trends like these are important, Tynan and colleagues said, because "the Surgeon General has concluded that there is a causal relationship between depictions of smoking in movies and initiation of smoking among young persons."
The new statistics also run counter to recommendations from public health groups - the most notable being that the Motion Picture Association of America should slap an R rating on a movie that shows a character smoking, "unless it portrays an actual historical figure who used tobacco or depicts the negative effects of tobacco."
There was a bit of good news from the new report, which relied on a University of California, San Francisco database tracking onscreen tobacco use in top-grossing films.
That data showed there has been a notable decline in the use of tobacco in fictional movies aimed at the young.
"Tobacco incidents in PG-13 fictional movies declined 57%," the study authors wrote, "from 511 in 2010 to an all-time low of 221 in 2018."
However, a 233% rise in tobacco use during the same time in PG-13 biopic movies has "negated previous progress made in reducing tobacco incidents in youth-rated fictional movies," the researchers pointed out.
Two experts in curbing youth smoking agreed that the movie industry has been slow to change, and tougher measures may be needed.
"Rating films with an R may prevent youth from seeing the tobacco depictions and would provide the opportunity for movie studios to reduce tobacco incidents in their films," contends Pat Folan. She directs the Center for Tobacco Control at Northwell Health in Great Neck, N.Y.
And Dr. Len Horovitz, a lung specialist at Lenox Hill Hospital in New York City, wondered about another nicotine-driven scourge affecting U.S. teens.
"Although the study doesn't address vaping, this practice is also epidemic," he said. "The depiction of smoking as glamorous in movies that young people watch may be responsible for the audience emulating on-screen behavior."
There has been some progress made in Hollywood to curb depictions of smoking in films, Tynan and his team noted. But deeds speak louder than words, they added.
"All major motion picture companies have policies to reduce tobacco depictions in youth-rated movies; however, Disney and Viacom were the only companies with no tobacco use in youth-rated movies in 2018," the report said.
The findings were published in the Nov. 1 issue of the CDC journal Morbidity & Mortality Weekly Report.
Sources: Patricia Folan, D.N.P.,director, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Nov. 1, 2019, Morbidity & Mortality Weekly Report.