Help Us Prevent Teens from Smoking – and Save 1 Million Lives


In November, the Sacramento County Tobacco Control Coalition recognized Breathe California Sacramento Region as a statewide and national leader for their research on the depiction of tobacco in movies, as part of its Thumbs Up! Thumbs Down! (TUTD) Smoke-Free Movies Project.

Breathe Sacramento is well known as the only organization in the United States that consistently collects and catalogs data on smoking imagery in movies, and has been doing this for over 20 years. This wealth of data has been used by many national and international health organizations, and has been the foundation of many policy initiatives.

For example, in August of this year, a group of 17 of the nation’s most influential health and medical groups used this data and subsequent analysis to recommend that all films that contain depictions of smoking or tobacco be given an “R” rating (Restricted) to reduce exposure to children and teenagers. These groups include the American Academy of Pediatrics, the American Academy of Family Physicians, the American Medical Association, the American Cancer Society, the American Heart Association, and, of course, Breathe California Sacramento Region.

The data from Breathe Sacramento’s TUTD Smoke-Free Movies Project has been used and cited by the Surgeon General of the United States, the US Centers for Disease Control and Prevention, and the University of California San Francisco to make important findings about tobacco use by both children and adults.

In 2012, the Surgeon General concluded that exposure to on-screen smoking causes young people to begin smoking. The US Centers for Disease Control and Prevention (CDC) reported in 2014 that 6.4 million children alive today will become smokers because of this exposure. And that 2 million of these young recruits will die prematurely due to smoking-related diseases.

The CDC also found that by voluntarily implementing policies that require R-ratings for smoking in movies, the film industry can prevent an estimated 1 million premature deaths among today’s children.

Making youth-rated films smoke-free by giving them an R-rating is the simplest, most effective, and lowest-cost way to prevent our kids from starting to smoke. That is one of the conclusions in an opinion editorial published in the Sacramento Bee this past September by Dr. Gordon Garcia, Co-Chair of Breathe Sacramento’s Lung Health Collaborative, and Dave Modisette, the new CEO of Breathe Sacramento, entitled “Smoking Scenes Should Only be in R-Rated Movies,” which is included below.

Breathe Sacramento’s TUTD Smoke-Free Movies Project has three objectives: to inoculate young people against pro-tobacco messages in movies; to raise public awareness on the issue; and to encourage Hollywood to reduce tobacco content in entertainment productions. These objectives are achieved by organizing local youth to collect data on the context, quantity, and portrayal of tobacco use in each weekend’s top 10 films and any film grossing $1 million or more. Films are then given a rating – from Pink Lung to Black Lung – and the ratings are made publicly available on

Breathe Sacramento also has educational programs for young people to teach them about the harmful effects of smoking, programs to prevent exposure to second-hand smoke, and programs to establish smoke-free college campuses and housing complexes. For more information about these programs, contact Katie Cox or Claire Garcia at (916) 444-5900.

For additional reading, see the following materials:

  1. “Smoking Scenes Should Only be in R-Rated Movies,” Op-Ed by Gordon Garcia, MD, and David Modisette, the Sacramento Bee, September 11, 2017.
  2. “Leading Health Groups Demand Film Industry Give “R” Rating to Movies that Depict Smoking,” press release by 17 public health and medical groups, August 29, 2017.
  3. Letter to Major Movie Studio/Media Production/ Distribution Chain Executives, signed by 17 public health and medical groups, August 25, 2017.
  4. “Tobacco Use in Top-Grossing Movies – United States, 2010-2016,” Morbidity and Mortality Weekly Report, Volume 66/No 26, Centers for Disease Control and Prevention, US Department of Health and Human Services, July 7, 2017.
  5. “Sacramento Student Volunteers Earn National Recognition for their Research on the Depiction of Smoking in Movies,” Press Release from Breathe California Sacramento Region, August 30, 2017.