Children, Adolescents, Substance Abuse, and the Media

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FROM THE AMERICAN ACADEMY OF PEDIATRICSricula are available and should beused. 110–113Legislative Advocacy byPediatricians8. Pediatricians should encourageCongress to ban tobacco advertisingin all media accessible to children,which several Europeancountries have already done. Sucha ban would seem to be constitutional,given that the US SupremeCourt has already ruled that commercialspeech does not enjoy theabsolute First Amendment protectionsthat free speech does. 114Recently, Congress gave theFood and Drug Administrationthe authority to regulate tobaccoproducts; however, the tobaccoindustry is expected to challengeany advertising bans. 115,1169. Pediatricians should encourageCongress to require the alcohol industryto report its annual expendituresto the Federal Trade Commission,including expendituresfor media venues in which childrenand adolescents representmore than 10% of the marketshare (currently, voluntary advertisingrestrictions allow for venuesin which up to 30% of the audienceis children).10. Pediatricians should encouragethe alcohol industry to restrict advertisingand product placementin venues in which more than 10%of the audience is children andadolescents.11. Pediatricians should encouragethe White House Office of NationalDrug Control Policy to begin conductingantismokingandanti–teendrinkingpublic service campaigns,including strong antismoking andantidrinking ads to be placed beforetelevision programming andmovies that have youth ratingsand contain alcohol and tobaccodepictions.12. Pediatricians should encourageallocation of more money in mediaresearch, given the importance ofthe media on the development andbehavior of children and adolescents.Higher taxes on tobaccoproducts and alcohol could beused to fund such research.13. Pediatricians should encourageCongress to pass new strict lawsregulating digital advertisingthat targets children andadolescents. 100,117Involvement of the AlcoholicBeverage, Tobacco, Drug, andEntertainment Industries inEncouraging Responsible Behavior14. Pediatricians should encouragethe advertising industry, drugcompanies, public health groups,and medical groups to have a fulland open debate on the necessityof advertising prescription drugs.In addition, ads for erectile dysfunctiondrugs should be confinedto after 10 PM in all time zones andshould not be overly suggestive. 115. Pediatricians should encourage theentertainment industry to havegreater sensitivity about the effectsof television and movies on childrenand adolescents and accept that theindustry does, indeed, have a publichealth responsibility. 118 Cigarettesmoking in movies should beavoided at all costs and shouldnever be glamorized. 119,120 Disneyhas already promised to eliminatesmoking in its movies. 121 Making filmsets smoke-free zones would go farto diminish the portrayal of smokingin movies and would protect actorsand actresses from secondhandsmoke. Antismoking ads should precedethe showing of any film thathas tobacco use depicted. 119 Alcoholuse should not be portrayed as normativebehavior for teenagers, andthe traditional depiction of the“funny drunk” should be retired.Television networks that have alarge adolescent viewership shouldair public service ads about the dangersof smoking and drinking. Finally,the Motion Picture Associationof America (MPAA) ratings need tobe amended so that tobacco use willroutinely garner an R rating in allnew movies unless the risks andconsequences of smoking are unambiguouslyshown or the depictionis necessary to represent a realhistorical figure who actuallyused tobacco. 119 So far, the MPAAhas only agreed to considersmoking as a factor in assigninga rating. 122,12316. Pediatricians should encouragestate and federal agencies, the entertainmentindustry, and the advertisingindustry to develop andmaintain vigorous anti–drugadvertisingcampaigns that focuson the 2 drugs most dangerousto adolescents—tobacco andalcohol—in addition to illegaldrugs. Antidrug ads have beenshown to be highly effective at times(eg, the Truth campaign), 124–129 butthe effectiveness of the NationalYouth Anti-Drug Media Campaignhas been questioned. 130 Recently,and laudably, 6 major Hollywood studioshave agreed to place antismokingads on new movie DVDs that appealto children. 131,13217. Pediatricians should work withand support the American Academyof Pediatrics Julius RichmondCenter of Excellence (www.aap.org/richmondcenter), the missionof which is “to improve childhealth by eliminating children’sexposure to tobacco and secondhandsmoke,” including throughmedia exposure. 119PEDIATRICS Volume 126, Number 4, October 2010 795Downloaded from pediatrics.aappublications.org by guest on December 14, 2011
LEAD AUTHORVictor C. Strasburger, MDCOUNCIL ON COMMUNICATIONS ANDMEDIA EXECUTIVE COMMITTEE,2009–2010Gilbert L. Fuld, MD, ChairpersonDeborah Ann Mulligan, MD, Chair-electTanya Remer Altmann, MDAri Brown, MDDimitri A. Christakis, MDKathleen Clarke-Pearson, MDBenard P. Dreyer, MDREFERENCES1. American Academy of Pediatrics, Committeeon Communications. Children, adolescents,and advertising [published correctionappears in Pediatrics. 2007;119(2):424]. Pediatrics. 2006;118(6):2563–25692. Strasburger VC, Wilson BJ, Jordan, A. Children,Adolescents, and the Media. 2nd ed.Thousand Oaks, CA: Sage; 20093. Borzekowski DLG, Strasburger VC. Tobacco,alcohol, and drug exposure. In: CalvertS, Wilson BJ, eds. Handbook of Childrenand the Media. Boston, MA:Blackwell; 2008:432–4524. National Institute on Drug Abuse. Drug UseAmong Racial/Ethnic Minorities, 1995.Rockville, MD: National Institute of DrugAbuse; 1995. NIH publication 95-38885. Belcher HM, Shinitzky HE. Substanceabuse in children: prediction, protection,and prevention. Arch Pediatr Adolesc Med.1998;152(10):952–9606. American Academy of Pediatrics, Committeeon Substance Abuse. Tobacco use: apediatric disease. Pediatrics. 2009;124(5):1474–14877. Doyle R. Deaths due to alcohol. Sci Am.1996;275(6):30–318. US Department of Health and Human Services.The Surgeon General’s Call to Actionto Prevent and Reduce Underage Drinking.Rockville, MD: US Department of Healthand Human Services; 20079. National Center on Addiction and SubstanceAbuse. National Survey of AmericanAttitudes on Substance Abuse IX: TeenDating Practices and Sexual Activity. NewYork, NY: National Center on Addiction andSubstance Abuse; 200410. Kunkel D. Children and television advertising.In: Singer DG, Singer JL, eds. Handbookof Children and the Media. Thousand Oaks,CA: Sage; 2001:375–39311. Salkin A. Noir lite: beer’s good-time humorturns black. New York Times. February 11,2007:WK312. Strasburger VC, Jordan AB, Donnerstein E.Holly Lee Falik, MDKathleen G. Nelson, MDGwenn S. O’Keeffe, MDVictor C. Strasburger, MDPAST EXECUTIVE COMMITTEEMEMBERSRegina M. Milteer, MDDonald L. Shifrin, MDLIAISONSMichael Brody, MD – American Academy ofChild and Adolescent PsychiatryHealth effects of media on children andadolescents. Pediatrics. 2010;125(4):756–76713. Atkin CK. Survey and experimental researchon effects of alcohol advertising.In: Martin S, ed. Mass Media and the Useand Abuse of Alcohol. Rockville, MD: NationalInstitute on Alcohol Abuse andAlcoholism; 1995:39–6814. Pierce JP, Choi WS, Gilpin EA, Farkas AJ,Berry C. Industry promotion of cigarettesand adolescent smoking. JAMA. 1998;279(7):511–51515. Tobacco Free Kids. Available at: www.tobaccofreekids.org/reports/targeting.Accessed July 19, 201016. Kessler D. A Question of Intent: A GreatAmerican Battle With a Deadly Industry.New York, NY: Public Affairs; 200117. Editorial: Big Tobacco’s promises to reformgo up in smoke. USA Today. September12, 2006:14A18. Tobacco Free Kids. Deadly in Pink: Big TobaccoSteps Up Its Targeting of Womenand Girls. Washington, DC: Tobacco FreeKids; 200919. Editorial: a rogue industry. New YorkTimes. May 31, 2009:WK720. US Department of Health and Human Services.Preventing Tobacco Use AmongYoung People: Report of the Surgeon General.Washington, DC: US GovernmentPrinting Office; 199421. Johnston LD, O’Malley PM, Bachman JG,Schulenberg JE. Monitoring the Future:National Results on Adolescent DrugUse—Overview of Key Findings, 2009. Bethesda,MD: National Institute on DrugAbuse; 201022. Centers for Disease Control and Prevention.Cigarette brand preference amongmiddle and high school students who areestablished smokers: United States, 2004and 2006. MMWR Morb Mortal Wkly Rep.2009;58(5):112–11523. Pierce JP, Distefan JM, Jackson C, WhiteBrian Wilcox, PhD – American PsychologicalAssociationCONTRIBUTORJames D. Sargent, MDSTAFFGina Ley SteinerVeronica Laude Nolandvnoland@aap.orgMM, Gilpin EA. Does tobacco marketing underminethe influence of recommendedparenting in discouraging adolescentsfrom smoking? Am J Prev Med. 2002;23(2):73–8124. Brown JD, Witherspoon EM. The Mass Mediaand American Adolescents’ Health. Papercommissioned for Health Futures ofYouth II: Pathways to Adolescent Health.Annapolis, MD: US Department of Healthand Human Services; 199825. Alpert HR, Koh HK, Connolly GN. After theMaster Settlement Agreement: targetingand exposure of youth to magazine tobaccoadvertising. Health Aff (Millwood).2008;27(6):w503–w51226. Cortese DK, Lewis MJ, Ling PM. Tobaccoindustry lifestyle magazines targeted toyoung adults. J Adolesc Health. 2009;45(3):268–28027. Biener L, Siegel M. Tobacco marketing andadolescent smoking: more support for acausal inference. Am J Public Health. 2000;90(3):407–41128. Sargent JD, Dalton M, Beach M. Exposureto cigarette promotions and smoking uptakein adolescents: evidence of a doseresponserelation. Tob Control. 2000;9(2):163–16829. Sargent J, Gibson J, Heatherton T. Comparingthe effects of entertainment media andtobacco marketing on youth smoking. TobControl. 2009;18(1):47–5330. DiFranza JR, Wellman RJ, Sargent JD,Weitzman M, Hipple BJ, Winickoff JP; TobaccoConsortium, Center for Child HealthResearch of the American Academy of Pediatrics.Tobacco promotion and the initiationof tobacco use: assessing the evidencefor causality. Pediatrics. 2006;117(6). Available at: www.pediatrics.org/cgi/content/full/117/6/e123731. Hanewinkel R, Isensee B, Sargent JD, MorgensternM. Cigarette advertising and adolescentsmoking. Am J Prev Med. 2010;38(4):359–366796 FROM THE AMERICAN ACADEMY OF PEDIATRICSDownloaded from pediatrics.aappublications.org by guest on December 14, 2011
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