Last week it was reported that the ratings board of the motion picture industry is now going to factor in cigarette smoking as part of the overall rating of a film.Films with excessive smoking will now certainly get a PG-13, if not an R rating.The goal is to cut down on the influence on teen smoking behavior.There is clear correlation between the glamorization of cigarette smoking on screen and people smoking.

While this development is certainly to be applauded from a public health point of view, it does seem to be off the mark if the goal is to lessen unhealthy behavior in young Americans. Excessive drinking, use of guns, corporate theft and deceit, physical and sexual violence are also bad for this country’s health and they are also widely depicted on the big screen.  It is absurd to think that a scene depicting gun violence or a robbery might get a less restrictive rating if the actors are not smoking. There is no need for me to dwell on this aspect of the topic, as Marshall Herskovitz, the accomplished Hollywood producer, has written a great piece on this development.

This news story did get me to thinking about cigarette smoking, but from a more historical point of view. It could be argued that, in the United States, cigarette smoking is a habit largely contained in a single century.  At the beginning of the 20th century, cigarette smoking was not widespread.  In the middle of the century it was very common, and at the end of the century it was in rapid decline.   In 1900 there were 2.5 billion cigarettes sold in the U.S., which is 54 per capita of people 18 or over. Fifteen years later, just prior to WWI the numbers were 17.9 billion and 285 per adult.  In 1920 those numbers jumped to 44 billion and 665 per adult.  Clearly the war helped to greatly increase smoking.

The twenty years from 1920 to 1940 saw a tripling in consumption with 182 billion cigarettes sold for a per capita number of 1,976.  Not coincidentally these twenty years saw the explosive growth of the new entertainment medium, the movies.  It was a rare move produced in those days that did not have smoking on screen.  WWII created another upsurge in smoking, as millions of GIs picked up the habit to temper the boredom and stress of combat. The 1945 numbers jumped to 341 billion and 3,449 per capita, or roughly half a pack a day for every person over the age of 18.

The twenty years from 1945 to 1965 was the zenith of cigarette smoking in the U.S.  This was due both to it having become a socially acceptable practice and having been aggressively advertised on television.  Tobacco advertising was one of the biggest product categories during this time, the ‘golden years’ of network television.  Dancing cigarette packs, the Marlboro cowboy, and cigarette named programs such as the “Camel Cavalcade of Sports” were everywhere.  Even the reigning sports figures of the day, Major League Baseball players, endorsed cigarette brands.  The 1965 per capita number of 4,259, or 213 packs for every person over the age of 18 was the highest number ever in U.S. history. 

This number has steadily declined to 2002 when it was 1,979, about the same number as in 1940.Clearly, there are still hundreds of billions of cigarettes sold in the United States today.  However the downward trend is clear. Smoking is no longer socially acceptable.  Smoking in bars and restaurants is now illegal in 30 states, with several more about ready to pass legislation.  This is an entirely different environment than when I was growing up when there was an ashtray on practically every restaurant table in America.  Over the next few decades smoking in the U.S. will continue to decline, and by mid century could well go back to the levels of the early 1900s.

What I found interesting while researching this column is that, primarily due to population growth, total global consumption of cigarettes is increasing, that less developed countries -which currently have the lowest per capita consumption - are increasing at the greatest rate, and that almost 40% of all cigarette consumption is by the Chinese.  All that being said, the rate of growth globally has slowed over the past ten years.   

Given all the dynamics around global warming, agricultural food production and the demands that tobacco put on the land it is probable that in the next two decades total consumption of cigarettes globally will begin to decline significantly.

Once again, the United States is leading the way, and regardless of ratings,  in this case, that is a good thing for the health of humanity.