And the more often their favorite actor or actress portrayed a character who smokes, the higher the students scored on a scale that rated their smoking behavior and the chance they would take up smoking.

The score was independent of other factors known to influence tobacco use, such as having friends and relatives who smoke.

"I think that's a very important contribution to the literature," says Alan Henderson, DrPH, who serves on the American Cancer Society's (ACS) national tobacco control advisory group. "Basically, these investigators put the issue squarely: we have excellent evidence that what movie stars do influences behaviors surrounding tobacco, no matter what anyone says."

When Favorite Stars Smoke

The researchers found that students whose favorite star smoked in two films were 1.5 times more likely to score on the upper end of the scale, and those whose favorite smoked in three or more films were three times more likely to score at the highest end.

The link was also strong with nonsmokers. Those whose favorite actor smoked in three or more films were 16 times as likely to express positive views about smoking than those whose favorite star was a nonsmoker.

"That was a pretty significant finding that even among young people who had never smoked at all -- who had never tried a cigarette -- that having a favorite star who smoked predicted their having a more positive attitude toward smoking," says lead author Jennifer Tickle, a graduate student at Dartmouth College in Hanover, N.H.

The study looked at tobacco use by actors in movies between 1994 and 1996. Topping the smoking list were Leonardo DiCaprio, Sharon Stone, and John Travolta. Popular non-smoking actors included Jean-Claude Van Damme, Tom Cruise, and Adam Sandler.

Tickle, a doctoral candidate in the department of psychological and brain sciences at Dartmouth, took information from a fall 1996 survey of 1,543 sixth to 12^th grade students in five rural New England public schools. The survey included an open-ended question about the student?s favorite film star as well as questions about smoking.

To analyze the association between the favorite actor's smoking or non-smoking on-screen persona and that adolescent's own involvement with tobacco, Tickle narrowed the study to actors chosen by at least five students, which amounted to 43 stars named by 632 students.

She and her co-investigators screened the 178 movies in which the 43 actors appeared, to evaluate the frequency of their smoking.

"We haven't been able to say yet that having a favorite star who smokes causes teenagers to take up smoking," says Tickle. But adults should understand the distinct possibility that movies and television affect children''s likelihood to take up smoking, she says -- particularly because tobacco is generally glamorized, with its grim health effects ignored.

"I feel strongly that these issues have to be part of a public dialogue; this can't just be in the tobacco-control community," says Henderson, who is also a professor in the health science department at California State University, Long Beach.

Parents and teachers should help young people understand how films are made, he emphasizes, so they develop the skills to separate reality from fantasy. Meanwhile, tobacco-control advocates need to incorporate such research results into their programs.

Whether or not films are intentionally sending pro-tobacco messages, says Henderson, "there is no way we can ignore the influence of the popular media."

The ACS is pursuing various avenues to help reduce tobacco use in films. ACS has met with entertainment industry leaders including Jack Valenti, president and CEO of the Motion Picture Association of America, various movie studios, and representatives of the Screen Actors Guild, the Directors Guild, and the Screenwriters Association.

Studios such as Turner Entertainment Group, FOX, and Castle Rock have established tobacco policies, but many others were noncommittal. The groups claimed that smoking is the actor?s choice, to use if necessary to build his/her character. In general, they view smoking as a creative freedom issue.

Rob Reiner, founder and principal of Castle Rock, understands that ultimately studios cannot restrict these freedoms. But he is an outspoken advocate of curbing cigarette smoking by actors onscreen. "I think many actors are just not aware of the message they?re sending," says Reiner. His company has recently established a policy that would keep most actors, especially the stars who are seen as role models, from lighting up. "Unless the movie is about the drug culture or some such thing, smoking just isn?t necessary. There are other ways to show that a character is anxious, nervous, neurotic, or whatever," he explained.

If an actor in his studio were to insist that the character smoke, Reiner says he personally would go on the set and talk to the actor, to make sure he or she understands the effect the decision will have on audiences.

"I?d tell them, if you really feel comfortable that this could result in someone?s death, then go ahead and do what you want," says Reiner. He advocates a strong educational campaign at the three guilds -- the unions for the actors, writers, and directors. "These are the artists that are creating and they are the ones that should be targeted," says Reiner. "Getting a studio head to establish a policy is nice, but they won?t police it. We have to reach the people on the set." Reiner pointed out that Warner Brothers has also been vocal against smoking in films, and fully supports such education efforts.

Although the rest of the entertainment industry?s commitment to reducing on-screen tobacco use remains to be demonstrated, the ACS has made some progress with its own product placement strategy. The sets of several television shows such as "ER" and "X Files" include ACS anti-smoking posters, which regularly appear in the shows. But according to ACS California Division CEO Pat Felts, "The issue is complex. There is no one group that has absolute power to reduce smoking on TV and in movies. It?s a matter of having meaningful discussions about public health with all the people who work to put a story on the screen. We need to all decide that there are other, better ways to build a character than with a cigarette."