Parents concerned about the movies their kids watch tend to watch for sexually explicit scenes or the use of profane language. Even the disrespectful tone of a young character may lead parents to limit their child’s exposure to a movie. However, there are other things you may need to watch for when deciding what’s appropriate to show your kids. In the United States there are strict regulations about how much smoking imagery can be used in a film. However, in Europe there is more freedom to depict characters as smokers, and a study was designed to measure how this exposure impacted teen initiation of cigarette use. The longitudinal study is the first to measure the relationship between smoking in movies and the initiation of smoking. The researchers recruited 9,987 teens that had been involved in a larger research project involving 16,551 students. The participants attended 100 schools located in various parts of Germany, Italy, Poland, Iceland, the UK and The Netherlands. An initial analysis showed that 71 percent of the participants had never smoked. The remaining students were removed from the sample. A large number (85 percent) of those who had never smoked at baseline were retained for one year as a follow-up. The participants were evaluated for their exposure to smoking behaviors in the movies they had seen. The researchers presented a list of 50 major movies and the participants marked the number of times they had viewed each movie. The researchers were able to count the number of instances that smoking occurred in each movie. These measures were used to count the number of times each student was exposed to images of smoking. The researchers also evaluated several measures among the students that could also influence whether they would initiate smoking as a teen. Variables such as sociodemographic factors, exposure to television and parental smoking history were measured. Finally, the researchers evaluated each student for their smoking history, making note of how many cigarettes had been smoked over their lifetime. The results of the analysis showed that 17 percent of the teens began smoking between the initial assessment and the follow-up. Across all the six countries in which teens were evaluated, the exposure to movie images containing smoking predicted the initiation of teen smoking. For every 1,000 scenes that depicted smoking, teens that watched them increased the likelihood of initiating smoking by 13 percent. Even when the researchers controlled for variables such as gender, age and television time, the results remained consistent in five of the six countries where the participants were recruited. The researchers noted several limitations on the findings for this study. The study experienced a loss of participants from the baseline to the follow-up, a common situation occurring in longitudinal studies. Those who dropped out could have impacted the percentage of students who began smoking or abstained from smoking. In addition, while the researchers addressed the variables that could impact smoking behaviors, there are additional variables that could impact whether a teen began smoking and how movie exposure impacted that choice. The addition of smoking characters into a movie may serve a purpose in the story and effects of the movie. However, when the audience includes children and teens, the producers of the movie should be aware that characters who smoke may be planting a perception in a child or teen’s mind about how to be acceptable or earn approval in a peer group, and this has public health implications. When parents notice that their child or teen is watching a movie that includes characters who smoke or has scenes with smokers in it, they can talk with their child about the character. Being aware of the smoking in movies and how that might impact their attitudes about smoking may help parents navigate conversations with their teens about cigarette use.